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Demand-oriented care: the development and validation of a measuring instrument
Gerdien H de Weert-van Oene1, Victor J A Buwalda, Johan M Havenaar
1Julius Centre for Health Sciences and Primary Health Care, University Medical Centre Utrecht, Hp Str 6.131, PO Box 85500, Utrecht, GA 3508, The Netherlands. g.h.deweert@umcutrecht.nl
Social Psychiatry and Psychiatric Epidemiology
|January 21, 2006
Summary
This study developed the Demand-Oriented Care Questionnaire (DOC) to measure patient autonomy in mental health services. The DOC is a valid and reliable instrument for assessing demand-orientation and improving care quality.
Area of Science:
- Psychiatry and Mental Health Care
- Health Services Research
- Patient-Centered Care
Background:
- Demand-oriented care is increasingly important for patient autonomy in mental health services.
- A validated instrument is needed to measure demand-orientation in this population.
- Existing measures may not adequately capture the nuances of patient-centered mental healthcare.
Purpose of the Study:
- To introduce and validate a new measuring instrument, the Demand-Oriented Care Questionnaire (DOC).
- To assess the construct validity and reliability of the DOC in a diverse sample of psychiatric patients.
- To provide a tool for evaluating demand-orientation and its impact on care quality.
Main Methods:
- Concept mapping was used to define demand-orientation.
- A 19-item General-Demand Orientated Care Questionnaire (DOC-G) and a supplementary questionnaire (DOC-S) were developed.
- The instrument underwent factor analysis and confirmatory analysis in large patient samples (n=204, n=304).
Main Results:
- The DOC demonstrated a robust 4-factor structure.
- Both internal and external validity of the DOC were found to be sufficient.
- The questionnaire successfully differentiated care experiences based on treatment plans, crisis plans, and history of compulsory treatment.
Conclusions:
- The DOC is a valuable instrument for measuring demand-orientation in psychiatric patients.
- The DOC can be utilized to monitor changes in mental healthcare quality.
- Supplementary DOC questionnaires allow for rapid evaluation of specific care projects.