Quantifying Staff and Patient Perceptions of Quality of Care Improvement in the Psychiatric Inpatient Setting: Preliminary Psychometrics of a New Measure

A recent emphasis has been placed on improving the quality of care psychiatric inpatients receive. Although it appears a number of behaviorally specific strategies to reduce seclusion and restraint are being implemented around the country, efforts to systematically measure and evaluate the effectiveness of these strategies are limited by a lack of intervention specific instruments. In order to address this gap, two new measures, the Quality of Care Measure, Staff Form (QOC-S) and the Quality of Care Measure, Patient Form (QOC-P) were developed. The psychometric properties of the QOC-S and the QOC-P were evaluated in a sample of 68 staff and 81 patients in one of five psychiatric units of a large, southeastern hospital. Results indicated that both forms of the measure were internally consistent. Principal Component Analyses yielded three reliable components underlying the QOC-S (Environment, Staff Sensitivity to Patient Trauma History, and Engagement Model) and three reliable components underlying the QOC-P (Environment, Staff Sensitivity to Patient Trauma History, and Patient Involvement). These components, which are based on the Engagement Model of care, were strongly associated with theoretical factors posited by the developers of the measure. Clinical implications and future directions for research involving the QOC-S and QOC-P are discussed.