Demand-oriented care : the development and validation of a measuring instrument

• Published in: Social Psychiatry and Psychiatric Epidemiology 2006-03, Vol.41 (3), p.215-220
• Main Authors: DE WEERT-VAN OENE, Gerdien H, BUWALDA, Victor J. A, HAVENAAR, Johan M, SWILDENS, Wilma, VAN KEIJZERSWAARD, Albert, SCHRIJVERS, Augustinus J. P
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Concept mapping; Female; Health Services Needs and Demand; Humans; Male; Measuring instruments; Medical sciences; Mental Disorders - therapy; Mental health care; Mental Health Services - standards; Mental Health Services - statistics & numerical data; Netherlands; Patient satisfaction; Psychology. Psychoanalysis. Psychiatry; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Questionnaires; Surveys and Questionnaires; Techniques and methods
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-005-0019-x

Demand-oriented care has recently become a key topic in the area of care provision, fitting into the modern pursuit for patient autonomy. This paper introduces a measuring instrument to assess demand-orientation in mental health care. A concept mapping procedure was used to understand the concept of demand-orientation. The resulting items were introduced to a validating sample of 204 patients of three mental health facilities. After factor analysis, a 19-item General-Demand Orientated Care Questionnaire (DOC-G), and a supplementary questionnaire (DOC-S) containing 6 sections remained. This questionnaire was submitted to confirmatory analysis in a random sample (n = 304) of psychiatric patients. Respondents were predominantly female (57.6%), of Dutch ethnic origin (84.1%), and outpatients (71.4%). The analyses confirmed the 4-factor structure of the questionnaire. Both internal and external validity of the instrument proved to be sufficient. The questionnaire discriminated in the experience of demand-orientation of care between patients who did and those who did not have a treatment plan put up; between those who did and those who did not have a crisis plan, and between those who had a lifetime prevalence of undergoing compulsory treatment, and those who had not. We conclude that the DOC is a useful instrument to measure demand-orientation in a population of psychiatric patients. It is useful to measure changes in care quality. The supplementary questionnaires make it possible to evaluate chosen projects or subprojects quickly.