The World Health Organization (WHO) recognises the need to improve the quality of care and ensure full respect for the human rights of people with mental health problems and psychosocial disabilities. The participation of both inpatients and professionals is essential to understand and improve mental health care. This study aimed to describe and compare the perceptions of care quality between inpatients and health professionals in mental health hospitalisation units, and to determine possible relationships between these perceptions and other study variables. A descriptive cross‐sectional comparative study was conducted. The study population was recruited through nonprobabilistic convenience sampling. The quality of care was measured using the QPC‐IP and QPC‐IPS instruments, each with 30 items assessing six dimensions. A descriptive analysis of the database was performed, generating descriptive statistics for numerical variables and frequency tables for categorical variables. Data analysis was carried out using IBM SPSS v.28. The sample consisted of 150 inpatients and 163 professionals from mental health hospitalisation units in the Barcelona area (Spain). Final results showed high overall levels of care quality from both patients’ ( m = 94.20 ± 15.59) and staff’s ( m = 91.32 ± 12.42) perspectives. Both inpatients and staff gave high scores to the dimensions of Encounter (patients: 3.3 ± 0.6; professionals: 3.4 ± 0.5) and Support (patients: 3.2 ± 0.7; professionals: 3.4 ± 0.5), while the dimensions rated lowest in terms of quality were Secluded Environment (patients: 2.6 ± 0.7; professionals: 2.5 ± 0.8) and Secure Environment (patients: 2.9 ± 0.8; professionals: 2.5 ± 0.7). Conclusions: Continuous evaluation of quality in mental health hospitalisation settings is essential to ensure the highest quality of care. This guarantees full respect for rights and dignified care, considering the perspectives of the main stakeholders.

AIMS AND OBJECTIVES:Patients' perspectives on quality of care are vital, and cross-country comparisons of inpatient settings can provide valuable insights. This study aims to describe and compare Norwegian and Swedish patients' perceptions of the quality of their inpatient mental healthcare. It also explores how admission status (voluntary vs. involuntary), demographics and clinical characteristics are associated with these perceptions. ETHICAL ISSUES AND APPROVAL:The study adhered to the Declaration of Helsinki and received approval from the Regional Ethical Committees in both countries. RESEARCH METHODS:A cross-sectional, descriptive-comparative design was applied. Adult inpatients meeting inclusion criteria were recruited from 21 mental health hospital wards in Norway and Sweden using convenience sampling. Data were collected using the validated Quality in Psychiatric Care-Inpatient (QPC-IP) instrument. Of 354 returned questionnaires, 40 were excluded due to missing data, leaving 155 Norwegian and 159 Swedish for analysis. Descriptive statistics and inferential analyses were conducted to examine differences (p ≤ 0.05). OUTCOME MEASURES:Perceived quality of mental healthcare, measured with the QPC-IP. RESULTS:Norwegian patients reported significantly higher perceived quality of care than Swedish patients across all QPC-IP dimensions: Encounter, Participation, Discharge, Support, Secluded Environment and Secure Environment. Significant interactions between country and admission status were observed on the Support and Discharge dimensions, with involuntarily admitted Swedish patients reporting the lowest quality of care. STUDY LIMITATIONS:Although the study included multiple hospitals in both countries, the sample size was relatively small. While not designed to yield generalisable results, the limited sample may still restrict transferability. Data was collected during different time periods, which may have introduced time-related variation. CONCLUSIONS:The findings reveal significant differences in perceived quality of mental healthcare between the two settings, underscoring the need to explore factors contributing to these disparities.

Describe and compare patients’, next-of-kin’s and healthcare professionals’ perceptions of the quality of care in community mental healthcare services. Patients value family involvement in mental healthcare, but next-of-kin feel unprepared and lack the necessary skills to be supportive. Since healthcare professionals predominantly focus on patients, they may fail to understand the complex needs of families. Thus, the quality of community mental healthcare may vary across patients, next-of-kin, and healthcare professionals. Cross-sectional study with patients, next-of-kin and healthcare professionals in community mental healthcare services in Norway. 140 participants, of whom 43 are patients, 43 next-of-kin, and 56 healthcare professionals. Participants filled in the translated version of the Quality in Psychiatric Care − Community Out-Patient (QPC-COP), Community Out-Patient Next of Kin (QPC-COPNK), and Quality in Psychiatric Care- Community Outpatient Staff (QPC-COPS). Next-of-kin and healthcare professionals scored the overall quality of community mental healthcare lower than patients. All three perspectives reported the Encounter to be of high quality. Patients rated Discharge, next-of-kin rated Next-of-kin, and healthcare professionals rated Environmentas havingthelowest quality of care. Patients were generally more positive than the next-of-kin and healthcare professionals about the quality of community mental healthcare. Patients, next-of-kin, and healthcare professionals rated interpersonal relationship between patients and healthcare professionals as having the highest quality of care. However, lowest quality scores were given by next-of-kin regarding being respected and invited to take part, and by healthcare professionals regarding the patients’ trust in the healthcare professionals, and feeling secure in their home environment. This is important knowledge for health authorities, leaders, and mental healthcare clinicians in developing and providing quality care.

The number of adults in need of psychiatric care is increasing in Sweden. To meet this need, new working methods are implemented. Home-based mobile specialist psychiatric nursing teams (SPOT) are being introduced to function as a complement to outpatient care and inpatient care, but still little is known about how healthcare professionals experience such efforts. The purpose of this study was thus to capture mental healthcare professionals’ experiences of the early phase of the introduction of SPOT. Focus group discussions and semi-structured interviews were conducted with 11 mental healthcare professionals, including nurses, psychiatric aides working within psychiatric care and on the SPOT team and psychiatrists who had a consultative role in SPOT. The data was inductively analysed through reflexive thematic analysis. The discussions and interviews revolved around three themes: The phases and conditions of the change, Opportunities and challenges in the new form of intermediate care and Care in the patient’s home for patient empowerment and engagement. Different perspectives on the new form of care emerged and many were positive about patients’ increased engagement in care when it was offered in the home environment. However, it was also emphasised that the need for different forms of care remains and that a new level of care should not exclude other forms of care. The results further showed a need to engage and offer continuous support to healthcare professionals at different levels when new working methods are introduced. Specifically, support from managers and increased competence and skills development in performing new work tasks were requested. Providing care in the home environment through SPOT interventions can help increase patients’ engagement in their own care. Preparing and equipping healthcare professionals at all levels and offering them knowledge support and influence in the introduction of new forms of care is important to reduce the vulnerability that professionals may initially experience in change processes and new ways of working.

As a Norwegian/Swedish research network based on a family-focused practice in mental healthcare, we recognise the need to highlight this approach for the future quality and sustainability of the care and services provided. The role of family members in caring for individuals with mental health conditions is situational and diverse, encompassing several support areas such as emotional support, continuation of social and living skills, economic assistance, and monitoring for signs of illness and relapse prevention. In this context, volunteers have also been encouraged to contribute as partners in the support and follow-up of individuals with mental health issues. Although mental health services were primarily hospital-based in the past, there has been a shift in recent decades towards community-based care with support from specialist services. The aim has been to foster a respectful partnership between patients, families, and professionals, including a commitment to increasing family involvement and providing greater support to family members. Despite the recommendation for family-focused practice, we believe that health professionals still prioritise their alliance with the patient as their foremost responsibility. In this article, we advocate for an enhanced emphasis on family-focused approaches and underscore the importance of utilising knowledge-based family-focused practice models.

BACKGROUND:The therapeutic relationship has been identified as essential for ensuring high-quality care in psychiatric outpatient services, as highlighted in several studies. This study focuses on the content of interactions between patients and staff in psychiatric outpatient care, as well as the quality of care provided, as perceived by the patients. AIM:The aim of this study is to explore the relationship between these interactions and aspects of the perceived quality of care from the perspective of patients in psychiatric outpatient services. METHODS:A sample of 706 patients from psychiatric outpatient clinics in Sweden completed the Verbal and Social Interaction Outpatient (VSI-OP) and the Quality in Psychiatric Care-Outpatient (QPC-OP) instruments. A structural equation model was conducted to explore these associations. The study was approved by the Regional Ethical Review Board in Uppsala, Sweden (Dnr. 2018/186). RESULTS:The model revealed that the staff showing an interest in the patients' feelings, experiences and behaviour influences the patients' perceived quality of participation through an intricate network of mediator variables, including the staff's ability to establish a relationship, a good encounter, support and a high level of information to the patients. High levels of Participation/Empowerment indicate a high level of quality of care in a psychiatric outpatient context. IMPLICATION FOR PRACTICE:The presented model provides an understanding of the associations between staff and patient interactions and perceived quality of care and sheds light on important aspects of quality of care from the perspective of the patients.

University years are an important transitional time for young adults. Recently, an increasing number of students have reported mental health problems. The increasing numbers are an international phenomenon. Qualitative research on mental health promotion for students is, however, scarce. The aim of this study is to explore students’ descriptions of experiences in their student life that are beneficial to mental health. A Norwegian project named “In my experience” collected descriptions, through the web-based tool Sensemaker, from students about experiences that have had an impact on their student life. This study explores the descriptions of experiences beneficial to students’ mental health that the students categorized as having had a positive or very positive impact on their student life. A total of 171 descriptions from students aged 18–29 were analyzed using thematic analysis. Two main themes were identified: becoming a student, which consisted of descriptions about the feeling of a new life as a student, and being a student, which described experiences with managing student life that were beneficial for mental health. Experiences such as being welcomed, being included, belonging to a social group, finding one’s own identity, maturing, and developing were all highlighted in the descriptions. Student societies and other forms of civic engagement and being accepted and included in an academic community were fundamental. A limitation of the study was the relatively low number of male participants, and further research on male students’ descriptions about beneficial experiences is needed.

AIM:The aim of the present study is to evaluate the psychometric properties and factor structure of the Quality in Psychiatric Care-Outpatient Staff (QPC-OPS) instrument and briefly describe the staff's views on the quality of care provided in general outpatient clinics as well as demographic and clinical factors associated with quality of care. METHOD:The study employed a cross-sectional design to conduct a psychometric evaluation and survey of staff perspectives. A sample of 143 permanently employed members of staff in multiprofessional teams at 15 outpatient clinics in Sweden completed the QPC-OPS, which consists of 30 items covering eight dimensions of quality of care. RESULTS:The QPC-OPS exhibited excellent psychometric properties, with a total alpha coefficient of 0.94, a test-retest reliability of 0.96 and a goodness-of-fit measure for the proposed model with a RMSEA value of 0.048. The staff's rating was generally high. Ratings were highest for Encounter and lowest for Accessibility. Staff who rated their own mental health as higher rated quality of care higher in most of the dimensions. CONCLUSION:The Swedish QPC-OPS showed excellent psychometric properties and is a useful, inexpensive and simple way to evaluate the quality of care in outpatient care and contributes to health care improvement in the field of psychiatric care. The low quality of the dimension of Accessibility indicates an important area for improvement.

The aim of this study is to examine older adults’ experience of receiving medical and care efforts from a Mobile Geriatric Team (MGT). A phenomenologically inspired approach guides this study to stay empirically close to the data while exploring the experiences of five older adults with comorbidity receiving medical and care efforts from a MGT. Three themes emerged from the interviews: The relief of integrated treatment, Reclaiming time from the emergency room, and Finding sanctuary at home. The findings reveal that older adults particularly valued the MGT’s comprehensive view of their medical history and medication, highlighting how this holistic approach provided significant comfort. Participants also emphasized the relief brought by staff continuity and the ability to receive acute medical treatments in the familiarity of their own homes, thereby avoiding the stress and inconvenience of emergency room visits. While reducing emergency room visits was a stated goal of the MGT, this study distinctively illuminates the profound positive impact of this outcome from the older adults’ perspective. These findings demonstrate a project successfully aligning with initiatives for good, close, and coordinated care, ultimately promoting health and well-being for older adults.

INTRODUCTION:Treatment of older cancer patients can be complex due to frailty that comes with age, and the benefits of radiation therapy for frail older patients are unclear. Radiation therapy staff play a crucial role in identifying and monitoring frailty and tailoring treatment. Research on radiation therapy in frail older patients is limited, and frailty assessments are not widely used in routine care. Understanding staff experiences with clinical judgement and frailty assessment is important for effective treatment. This study explored the radiation therapy staff's experiences of clinical judgement, treatment decision-making, and managing frail older cancer patients. METHODS:The study has an inductive design in which 12 specialist oncology nurses and four clinical oncologists working with cancer patients at four radiation therapy units across four counties in Sweden were interviewed. In total, 16 participants were interviewed for the study. Data were collected in semi-structured individual interviews and were analysed using reflexive thematic analysis. RESULTS:Three themes were identified from the interview analysis: Putting the patient first, Care with integrity and humanity and Receiving support in treatment decisions, along with nine sub-themes. None of the participants was using any structured instrument for assessing frailty. CONCLUSIONS:Radiation therapy staff face significant and complex challenges when treating frail older cancer patients, which can lead to feelings of doubt and powerlessness. Awareness and use of structured frailty assessment are limited. Integrating structured frailty assessment could address the complex challenges experienced by staff by improving decision-making, communication, and patient outcomes, contributing to more ethical and person-centred care.

A review of the existing literature shows that although numerous factors influence the quality of care, only a few have been thoroughly investigated as potential mediators impacting mental health professionals' perceptions of quality in psychiatric inpatient care. This study aimed to explore how burnout mediates the relationship between individual characteristics, ward environment conditions and professionals' perceptions of the quality of psychiatric care patients receive. A total of 117 professionals from two Norwegian health trusts participated in the study. Data were collected through an online questionnaire comprising validated instruments measuring quality of care, job satisfaction, perceived stress and burnout while collecting background information on sociodemographic and work-related factors. The relationships between these variables were analyzed using univariate and multiple regression analyses. The results showed that professionals who were open for developing quality work, found their work stimulating, had sufficient time for tasks and were satisfied with their job reported lower levels of burnout. In turn, burnout was associated with lower perceived quality of participation and secure environment. Overall, professionals generally rated the quality of care as high. These findings provide insights for designing interventions to improve workplace conditions, reduce risk of burnout and enhance the quality in psychiatric inpatients settings.

BACKGROUND:The restructuring and decentralization of psychiatric services in Norway, aligning with global trends, has sparked debate on quality assurance. This study aimed to evaluate the psychometric properties of the Norwegian version of the Quality in Psychiatric Care - Inpatient Staff (QPC-IPS). Additionally, it sought to investigate the sociodemographic and work-related factors associated with staff perceptions of the quality of inpatient psychiatric care that they provide. MATERIAL AND METHODS:The Swedish QPC-IPS, a 30-item, 6-dimension tool, was thoroughly translated for the Norwegian psychiatric care setting. A web survey, including the QPC-IPS and sociodemographic and work-related items, was distributed to the mental health staff of two Norwegian health trusts, yielding 117 responses. RESULTS:The adapted version underwent confirmatory factor analysis, revealing a factor structure consistent with the original QPC-IPS and its versions in other languages. Staff generally reported high-quality care, with the highest for the secluded environment and the lowest for the secure environment. Positive associations were found between quality perceptions and factors, such as professional development, openness to quality assurance, and participation in quality work. Psychosocial environments and staff mental health were positively linked to quality-of-care dimensions and the staff recommendations correlated with their perception of patients' experiences of quality of care. CONCLUSIONS:The Norwegian QPC-IPS demonstrated adequate psychometric properties, facilitating its use in assessing psychiatric care staff's perception of patients' experiences of quality of care. Insights from staff perspectives contribute to identifying areas for improvement in inpatient psychiatric care, thereby enhancing cross-cultural comparisons and theory development in this domain.

Objectives To explore and describe how healthcare professionals within the oncological outpatient setting perceive quality of care.Design A qualitative, descriptive design with a phenomenographic approach was used, with focus group discussions as the means of data collection.Setting Primary care in oncological outpatient units in four hospitals in Sweden.Participants Through purposive sampling, 20 healthcare professionals entered and completed the study by participating in four focus groups, five participants in each group. Inclusion criteria were assistant nurses, nurses or physicians delivering treatment and care with radiation and/or anticancer drugs in oncological outpatient units. Excluded were healthcare professionals who had worked less than 3 months at the oncological outpatient unit.Results Two descriptive categories emerged from the data: ‘The professional’s personal ability for good care’ and ‘The structural conditions for good care’. These categories consist of descriptions of quality of care being perceived as a good meeting with patients, patient participation, continuity, accessibility and care grounded in science.Conclusions According to the healthcare professionals, quality of care relies on organisational structures in combination with a professional and personal interaction between the patients and the healthcare professionals. Knowledge about what healthcare professionals believe constitutes quality of care should therefore be highly valuable to policymakers and hospital management.

Abstract Background Validated instruments measuring the quality of mental healthcare from patients’ perspectives are scarce, and available instruments have been requested. One of the few instruments measuring the quality of care from a patient’s perspective is the Swedish Quality in Psychiatric Care–In–Patient (QPC-IP). This cross-sectional study aimed to translate and adapt the QPC-IP instrument for a Norwegian context and assess its psychometric properties. Methods The QPC-IP was translated and adapted to a Norwegian context using a translation back-translation process model. A total of 169 inpatients from specialised mental health services responded to the questionnaire. The QPC-IP comprises six dimensions: Encounter (eight items), Participation (eight items), Discharge (four items), Support (four items), Secluded Environment (three items), and Secure Environment (three items), totalling 30 items. Confirmatory factor analysis was conducted to assess the instrument’s factor structure. Additionally, Cronbach’s alpha was used to establish the instrument's internal consistency. Results The results indicated that the Norwegian adaptation of the QPC-IP possesses good psychometric properties, including internal consistency, content, and construct validity, as confirmed by the confirmatory factor analysis results. The confirmatory factor analysis demonstrated an adequate fit for the six-factor structure, consistent with the original Swedish instrument. Conclusions The QPC-IP is a user-friendly and easily implementable tool that assesses various dimensions of the quality of inpatient mental healthcare from a patient’s perspective. Moreover, the Norwegian QPC-IP holds potential for use in comparative, cross-cultural studies within mental healthcare services to monitor the quality of the provided services.

ObjectiveTo investigate the relationship between perceived mental health service provision and quality of life (QoL) as perceived by patients in psychiatric outpatient care.MethodsA total of 373 adult patients registered at 15 psychiatric outpatient clinics in three regions in central and southern Sweden were included in the study. Survey data were collected using a questionnaire on mental health service provision, symptom severity, recovery, clinical diagnosis, sociodemographics (serving as independent variables) and QoL (serving as the dependent variable). Three aspects of mental health service provision were used: patients’ perceived quality of care, perceived staff-patient interaction, and patient reported psychiatric treatments. Structural equation modelling was used to model the relationship among the variables.ResultsVariables in mental health service provision showed few direct associations with patients’ perceived QoL. Instead, the associations of mental health service provision on QoL were mainly mediated through symptom severity and recovery. These relationships were retained after adjusting for sociodemographic variables and clinical diagnoses. The final model achieved excellent goodness of fit (χ2 = 49.502, p = 0.230, RMSEA = 0.020, CFI = 0.997 and a SRMR = 0.024).ConclusionThis study shows that mental health service provision is associated with patients’ perceived QoL; however, this association is mostly indirect and mediated by reduced symptom severity and increased recovery. This finding can help inform the design of future interventions to enhance service provision to improve patients’ QoL.

PURPOSE:Evaluating the quality of psychiatric care from the patient's perspective is crucial to measure the effectiveness of the provided care. This study aimed to translate the original Swedish Quality in Psychiatric Care - Inpatient (QPC-IP) instrument into Faroese, adapting it to the specific context of psychiatric inpatient care in the Faroe Islands, conducting a detailed evaluation of its psychometric properties, and to describe patients' perception of quality of psychiatric care. MATERIALS AND METHODS:Following a thorough translation and back-translation, the content validity of the Faroese QPC-IP was confirmed by a group of Faroese patients. Subsequently, the instrument was completed by 61 psychiatric inpatients. RESULTS:Item total correlations revealed that most items strongly correlated with their intended dimensions, mirroring the original Swedish version. However, a noteworthy exception was found in the discharge dimension, leading to the exclusion of an item related to helping find an occupation; this task was not performed by the ward. While the internal consistency of the overall scale was excellent, specific dimensions exhibited lower consistency. CONCLUSIONS:The translation and cultural adaptation of the Faroese QPC-IP proved satisfactory. The psychometric evaluation affirmed a shared understanding of the quality of psychiatric care in both Faroese and Swedish cultural contexts. As a result, the Faroese QPC-IP emerges as a valuable instrument for assessing the quality of psychiatric care in the Faroe Islands. Its utility extends to quality assurance initiatives and contributes to cross-cultural research examining the quality of psychiatric care from the patient's perspective.

Patient perspectives on the quality of care received are fundamental to mental health care. This study aimed to investigate the association between patient-reported mental health care quality, perceived coercion, and various demographic, clinical, and ward-related factors. Using a cross-sectional design, data were collected from 169 patients in Norwegian mental health wards using the quality in psychiatric care-inpatient (QPC-IP) instrument and experienced coercion scale (ECS). The analysis revealed a consistent pattern in which patients with higher perceived coercion consistently rated lower quality on all QPC-IP dimensions. The significant findings of the multiple regression models further supported this association. Beyond coercion, the factors influencing quality ratings include self-reported treatment results, participation in treatment planning, and knowledge of complaint procedures. Emphasizing the pivotal role of coercion in enhancing mental health care quality, these findings contribute to a nuanced understanding of patient experiences and underscore the importance of patient participation in mental health care improvement efforts.

Background Cervical cancer is a global disease and it is well established that cervical cancer is caused by human papillomavirus (HPV). In Sweden self-sampling for HPV is now used as a complement to sampling performed by a midwife. However, there is a lack of knowledge on how older women perceive the self-sampling compared to the sampling performed by a midwife. Therefore, the aim of the study was to describe how women, aged 64 years and older, perceived the process of self-sampling and sampling performed by a midwife for HPV-testing. Methods Eighteen women were included in a qualitative interview study, and a phenomenographic approach was used for the analysis of the interviews. Results Three descriptive categories emerged: Confidence in sampling, Facilitating participation and Being informed. Within the categories, eight conceptions emerged describing the variation relating to how the women perceived the process of self-sampling and sampling performed by a midwife. Conclusions Women in this study describe confidence in self-sampling for HPV-testing and that the self-sampling was saving time and money, both for themselves and for society. Information in relation to an HPV-positive test result is of importance and it must be kept in mind that women affected by HPV may feel guilt and shame, which health care professionals should pay attention to. This knowledge can be used in education of health care staff. Trial registration https://researchweb.org/is/fourol/project/228071 . Reg. no 228,071.

Measuring the quality of care received by patients of mental health services is necessary to determine the effectiveness of prevention programs and mental health treatment. This study translated the original Swedish Quality in Psychiatric Care-Outpatient (QPC-OP) instrument to Brazilian Portuguese, adapted it to the context of Brazilian psychosocial care centers (CAPS), and evaluated its psychometric properties. The instrument was translated and back-translated by two independent professional translators. A seven-person expert group of professionals and 31 psychiatric outpatients verified the content validity of the Brazilian Portuguese QPC-OP, which then was completed by 253 outpatients from 16 CAPS in São Paulo, Brazil. Confirmatory factor analysis revealed adequate goodness of fit for the factor structure corresponding to the original Swedish version, except for the discharge dimension. Three additional items added in the Brazilian Portuguese QPC-OP formed a separate factor. The internal consistency of the entire scale was excellent but low in some dimensions. In conclusion, the translation and cultural adaptation of the Brazilian Portuguese QPC-OP was satisfactory, and the psychometric evaluation demonstrated that the concept of quality of mental health care is similarly understood in the Brazilian and Swedish cultural context. Thus, the Brazilian Portuguese QPC-OP is a useful instrument for assessing the quality of care in the Brazilian CAPS context and will be useful in quality assurance and in cross-cultural research addressing quality of mental health care from the patient's perspective.

The current paradigm of mental health care focuses on care provided in the community, increasingly moving away from hospital care models that involve considerable economic burden. Patient and staff perspectives on the quality of psychiatric care can highlight strengths and areas for improvement to ensure better care provision. The aim of this study was to describe and compare perceptions of quality of care among patients and staff in community mental health services and to determine possible relationships between these perceptions and other study variables. A comparative cross-sectional descriptive study was conducted in a sample of 200 patients and 260 staff from community psychiatric care services in the area of Barcelona (Spain). The results showed high overall levels of quality of care from patient (m = 104.35 ± 13.57) and staff (m =102.06 ± 8.80) perspectives. Patients and staff both gave high scores to Encounter and Support factors, while factors concerning patient Participation and Environment received the lowest scores. Continuous assessment of the quality of psychiatric care in the community setting is essential to ensure the highest quality of care, taking the perspectives of those involved into account.