VOICE: Developing a new measure of service users' perceptions of inpatient care, using a participatory methodology

TLDR

Service users report dissatisfaction with inpatient care, citing staff interactions, treatment involvement, activity availability, and safety, and those compulsorily admitted perceive the environment more negatively than voluntary patients, highlighting a gap in existing clinician‑designed satisfaction measures. The study aims to develop a patient‑reported outcome measure of perceptions of acute care. Using a participatory methodology, 397 service users participated in focus groups that informed the construction of the measure, which was then validated by expert panels and tested for psychometric properties. The 19‑item VOICE questionnaire is easy to understand, suitable for in‑hospital completion, and demonstrates strong validity, internal consistency, and test‑retest reliability, capturing the issues most important to service users.

Abstract

Background Service users express dissatisfaction with inpatient care and their concerns revolve around staff interactions, involvement in treatment decisions, the availability of activities and safety. Traditionally, satisfaction with acute care has been assessed using measures designed by clinicians or academics.Aims To develop a patient-reported outcome measure of perceptions of acute care. An innovative participatory methodology was used to involve services users throughout the research process.Method A total of 397 participants were recruited for the study. Focus groups of service users were convened to discuss their experiences and views of acute care. Service user researchers constructed a measure from the qualitative data, which was validated by expert panels of service users and tested for its psychometric properties.Results Views on Inpatient Care (VOICE) is easy to understand and complete and therefore is suitable for use by service users while in hospital. The 19-item measure has good validity and internal and test–retest reliability. Service users who have been compulsorily admitted have significantly worse perceptions of the inpatient environment.Conclusions A participatory methodology has been used to generate a self-report questionnaire measuring service users' perceptions of acute care. VOICE encompasses the issues that service users consider most important and has strong psychometric properties.