Whose responsibility? Part 1 of 2: A scale to assess how stakeholders apportion responsibilities for addressing the needs of persons with mental health problems.
Whose responsibility? Part 1 of 2: A scale to assess how stakeholders apportion responsibilities for addressing the needs of persons with mental health problems.
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DOI：
10.1186/s13033-021-00510-x
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发表时间：
2022-01-10
影响因子：
3.6
通讯作者：
Malla A
中科院分区：
文献类型：
--
作者：
Iyer SN;Pope M;Taksal A;Mohan G;Rangaswamy T;Loohuis H;Shah J;Joober R;Schmitz N;Margolese HC;Padmavati R;Malla A
有心理健康问题的人有多种需求，但往往得不到充分满足。满足这些需求的责任通常由患者、其家属/护理人员和政府福尔斯承担。对于利益攸关方对谁应负责满足这些需求的看法知之甚少，也没有评估这一构想的措施。本研究的目的是提出新设计的谁的责任量表（WRS），评估利益相关者如何分配责任的人与精神健康问题，他们的家庭，和政府解决各种需求的人与精神健康问题，并报告其心理测量学特性。22项WRS要求受访者在7项支持需求方面，将相对责任分配给政府与有精神健康问题的人、政府与家庭、家庭与有精神健康问题的人。这些项目是以世界价值观调查项目为蓝本的，该项目比较了政府和人民在确保每个人都得到供养方面的责任。我们在印度钦奈和加拿大蒙特利尔的两个早期精神病项目中对57名患者、60名家庭成员和27名临床医生进行了英语、泰米尔语和法语版本的管理，评估了重测信度、内部一致性和易用性。还计算了内部一致性估计值，用于验证主要比较研究的较大样本。重测信度（类内相关系数）一般范围从优秀到公平的利益相关者（患者，家属和临床医生），设置（蒙特利尔和钦奈），和语言（英语，法语和泰米尔语）。在标准化和更大的验证性样本中，内部一致性估计（克朗巴赫α）的范围从可接受到优秀。WRS在容易理解和完成方面得分平均。分数分布在1-10之间，表明该量表反映了对如何分配满足需求的责任的不同看法。在选定的项目上，量表一端的分数从未得到认可，但这些分数反映了对具体需求的预期看法（例如，金奈的病人从来没有认可病人比家庭对住房需求负有更大的责任）。WRS是一个很有前途的措施，可用于跨地理文化背景，为心理健康政策提供信息，并促进利益相关者之间关于角色和责任的对话和问责制。它可以帮助研究人员研究利益相关者对责任的看法，以及这些观点如何形成以及如何被社会文化背景和精神卫生系统所塑造。在线版本包含补充材料，可通过10.1186/s13033-021-00510-x获得。
Individuals with mental health problems have multiple, often inadequately met needs. Responsibility for meeting these needs frequently falls to patients, their families/caregivers, and governments. Little is known about stakeholders' views of who should be responsible for these needs and there are no measures to assess this construct. This study’s objectives were to present the newly designed Whose Responsibility Scale (WRS), which assesses how stakeholders apportion responsibility to persons with mental health problems, their families, and the government for addressing various needs of persons with mental health problems, and to report its psychometric properties. The 22-item WRS asks respondents to assign relative responsibility to the government versus persons with mental health problems, government versus families, and families versus persons with mental health problems for seven support needs. The items were modelled on a World Values Survey item comparing the government’s and people’s responsibility for ensuring that everyone is provided for. We administered English, Tamil, and French versions to 57 patients, 60 family members, and 27 clinicians at two early psychosis programs in Chennai, India, and Montreal, Canada, evaluating test–retest reliability, internal consistency, and ease of use. Internal consistency estimates were also calculated for confirmatory purposes with the larger samples from the main comparative study. Test–retest reliability (intra-class correlation coefficients) generally ranged from excellent to fair across stakeholders (patients, families, and clinicians), settings (Montreal and Chennai), and languages (English, French, and Tamil). In the standardization and larger confirmatory samples, internal consistency estimates (Cronbach’s alphas) ranged from acceptable to excellent. The WRS scored average on ease of comprehension and completion. Scores were spread across the 1–10 range, suggesting that the scale captured variations in views on how responsibility for meeting needs should be distributed. On select items, scores at one end of the scale were never endorsed, but these reflected expected views about specific needs (e.g., Chennai patients never endorsed patients as being substantially more responsible for housing needs than families). The WRS is a promising measure for use across geo-cultural contexts to inform mental health policies, and to foster dialogue and accountability among stakeholders about roles and responsibilities. It can help researchers study stakeholders’ views about responsibilities, and how these shape and are shaped by sociocultural contexts and mental healthcare systems. The online version contains supplementary material available at 10.1186/s13033-021-00510-x.
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3.3
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