Latent structure and factor reliability of the National Health Service Community Mental Health Service User Questionnaire. (2nd November 2022)

• Record Type: Journal Article
• Authors: Hoffmann, Mauricio Scopel; Rocha, Katia Bones; Evans-Lacko, Sara; Gosmann, Natan Pereira; Becker, Natalia; Magalhães, Pedro Vieira da Silva; Razzouk, Denise; Spanemberg, Lucas; Fleck, Marcelo Pio de Almeida; Mari, Jair de Jesus; Thornicroft, Graham; Salum, Giovanni Abrahão
• Is Part Of: Journal of mental health. Volume 31:Number 6(2022)
• Page Start: 809
• Page End: 815
• Publication Date: 2022-11-02
• Subjects: Mental health service -- care quality -- factor analysis; Mental health -- Periodicals; Mental health services -- Periodicals; 362.2
• DOI: 10.1080/09638237.2021.1922655
• Languages: English
• ISSNs: 0963-8237

Abstract

Abstract: Background: National Health Service use the Community Mental Health Service User Questionnaire (NHS-CMH) to assess care quality. However, its reliability and internal validity is uncertain. Aims: To test the NHS-CMH structure, reliability and item-level characteristics. Methods: We used data from 11, 373 participants who answered the 2017 NHS-CMH survey. First, we estimated the NHS-CMH structure using Exploratory Factor Analysis (EFA) in half of the dataset. Second, we tested the best EFA-derived model with Confirmatory Factor Analysis (CFA). We tested the internal validity, construct reliability (omega – ω ), explained common variance of each factor (ECV), and item thresholds. Results: EFA suggested a 4-factor solution. The structure derived from the EFA was confirmed, demonstrating good reliability for the four correlated dimensions: "Relationship with Staff" ( ω = 0.952, ECV = 40.1%), "Organizing Care" ( ω = 0.855, ECV = 21.4%), "Medication and Treatments" ( ω = 0.837, ECV = 13.3%), and "Support and Well-being" ( ω = 0.928, ECV = 25.3%). A second-order model with a high-order domain of "Quality of Care" is also supported. Conclusions: The NHS-CMH can be used to reliably assess four user-informed dimensions of mental health care quality. This model offers an alternative for its current use (item-level and untested sum scores analysis).