Abstract
There is a need for an internationally standardized and psychometrically tested instrument to measure the perceptions of staff members on the quality of forensic inpatient care provided. The aim of the present study was to adapt the Swedish instrument Quality of Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS) to the Danish context and to evaluate its psychometric properties and factor structure in this context. All permanently employed staff members at all 27 forensic inpatient wards in Denmark were invited to answer the Danish version of the QPC-FIPS. In total, 641 staff members participated, resulting in a response rate of 80%. The Danish version of the QPC-FIPS showed adequate psychometric properties and excellent goodness of fit of the hypothesised factor structure. Hence, the Danish QPC-FIPS is an excellent instrument for evaluating quality of forensic inpatient care both in clinical practice and in cross-cultural research. The members of staff generally reported that the care provided to patients was of high quality. The quality of the forensic-specific dimension was rated the highest, followed by the support, secluded environment, encounter, discharge and participation. The quality of the secure environment dimension was perceived to be the worst. The QPC-FIPS includes important aspects of staff members’ assessments of quality of care and offers a simple and inexpensive way to evaluate psychiatric forensic inpatient care. The QPC-FIPS can be used together with the Quality of Psychiatric Care-Forensic In-Patient (QPC-FIP) instrument, which covers the same items and dimensions as the QPC-FIPS, to identify patients’ and staff members’ views on quality of care and to improve the quality of forensic psychiatric care and benchmarking.
Highlights
In forensic psychiatry, as in all health care fields, the assessment of quality of care is becoming recognized as an important outcome measure of the care provided [1]
Because there are no psychometrically evaluated instruments in forensic psychiatric care, there is potential for the QPC-FIPS to be used to assess the perceptions of the quality of care among forensic psychiatric care providers in other countries
The confirmatory factor analysis (CFA) based on the Swedish QPC-FIPS factor structure showed a significant chi square (SBχ2 = 1258.12, df = 506, p < 0.001), a comparative fit index (CFI) of 0.99, an root mean square of approximation (RMSEA) of 0.048 (CI = 0.045 - 0.052), a p-value of .81 for the test of close fit based on the RMSEA (RMSEA < 0.05), and an SRMR of 0.078
Summary
In forensic psychiatry, as in all health care fields, the assessment of quality of care is becoming recognized as an important outcome measure of the care provided [1]. It is important that the care providers have information about how they perform and that they assess the quality of care they provide in relation to patients’ perceptions of the care [5]. There is a growing interest in improving the quality of care in forensic psychiatric settings [7], staff members’ assessments of quality of care are rarely used in the forensic psychiatric services [8] [9]. The instrument Quality in Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS) questionnaire has been developed and shown to have adequate psychometric properties in the Swedish context [5]. Because there are no psychometrically evaluated instruments in forensic psychiatric care, there is potential for the QPC-FIPS to be used to assess the perceptions of the quality of care among forensic psychiatric care providers in other countries
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