Les barrières à l’accès aux soins : validation de la BACE-3 française

Abstract

ObjectivesTo translate into French and validate the BACE-3 scale (Barriers to Care Evaluation) and describe the barriers to access to care in mental health settings. MethodsThe instrument was translated into French with its author's authorisation and her supervision. Three outpatient consultation centres and two day hospitals in the same geographical region were involved. We included patients aged between 18 and 6years under regular follow-up with psychiatrists and diagnosed with a psychotic disorder, a bipolar disorder, a mood disorder, a personality disorder, an anxiety disorder or a somatoform disorder, all according to ICD-10 criteria. To be included subjects further had to have sought some health care support in the last twelve months or be be regularly treated in a continuous way at the time of inclusion. ResultsOne hundred twenty-one patients were successively included during a regular consultation. The exploratory factor analysis of the 30-item BACE-3 yielded to a method factor (items that could only be answered by patients with a family and/or at work were recoded) and two clinically meaningful factors were named, Stigmatisation and Cognitive Bias and Denial. We found that the first factor was nicely in line with the factors we had extracted from the Internalized Stigma Mental Illness (ISMI) scale in the same sample. This provided an external validation of the BACE but it was difficult to conclude any further given the limited size of our sample. ConclusionsBarriers to care need to be addressed by clinicians. Internal and external validity properties of the BACE-3 scale show it can be used in French-speaking populations of outpatients suffering from mental health problems.