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

Soc Psychiatry Psychiatr Epidemiol. 2006 Mar;41(3):215-20. doi: 10.1007/s00127-005-0019-x. Epub 2006 Jan 19.

Abstract

Objectives: 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.

Method: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Female
  • Health Services Needs and Demand*
  • Humans
  • Male
  • Mental Disorders / therapy*
  • Mental Health Services / standards*
  • Mental Health Services / statistics & numerical data
  • Netherlands
  • Surveys and Questionnaires