title: PIPEQ-OS--an instrument for on-site measurements of the experiences of inpatients at psychiatric institutions.
abstract: BACKGROUND
  The Psychiatric Inpatient Patient Experience Questionnaire (PIPEQ) was developed for post-discharge measurements of experiences, but the low response rates associated with post-discharge surveys restrict their usefulness. A new questionnaire was developed based on the PIPEQ for on-site measurements of patient experiences: the PIPEQ-OS. The aim of this study was to psychometrically test the PIPEQ-OS using data from a nationally representative survey conducted in Norway in 2014.
  
  
  METHODS
  Data were collected using a nationally representative patient-experience survey; 25% of the institutions in each of the 4 health regions in Norway were randomly selected, yielding a total of 26 institutions. The PIPEQ-OS questionnaire was completed by patients on-site on an agreed day in week 37 of 2014. Item missing and ceiling effects were assessed, and factor analysis was used to assess the structure of the items included in the PIPEQ-OS. The scales were tested for internal consistency reliability, test-retest reliability and construct validity.
  
  
  RESULTS
  The initial sample comprised 857 patients. Of these, 60 were excluded for ethical reasons and 57 were excluded because they were absent on the day of the survey. Of the remaining 740 patients, 552 (74.6% of the included population) returned the questionnaire. Low levels of missing or "not applicable" responses were found for 18 of the 21 items (<20%), and 20 of 21 items were below the ceiling-effect criterion. Psychometric testing identified three scales: structure and facilities (six items), patient-centred interaction (six items) and outcomes (five items). All scales met the criterion of 0.7 for Cronbach's alpha (range: 0.79-0.91) and test-retest reliability (range: 0.83-0.84). The construct validity of the scales was supported by 14 of 15 significant associations with variables known to be related to psychiatric inpatient experiences.
  
  
  CONCLUSIONS
  The PIPEQ-OS comprises three scales with satisfactory internal consistency reliability and construct validity. This instrument can be used for on-site assessments of psychiatric inpatient patient experiences, but further research is needed to evaluate its usefulness as basis for external quality indicators.
authors.affiliation: Department for Quality and Patient Safety, The Norwegian Knowledge Centre for the Health Services, Boks 7004 St Olavs Plass 0130, Oslo, Norway. oan@kunnskapssenteret.no.
authors.forename: Oyvind
authors.initials: O
authors.lastname: Bjertnaes
authors.affiliation: Department for Quality and Patient Safety, The Norwegian Knowledge Centre for the Health Services, Boks 7004 St Olavs Plass 0130, Oslo, Norway. hii@kunnskapssenteret.no.
authors.forename: Hilde Hestad
authors.initials: HH
authors.lastname: Iversen
authors.affiliation: Department for Quality and Patient Safety, The Norwegian Knowledge Centre for the Health Services, Boks 7004 St Olavs Plass 0130, Oslo, Norway. johanne.kjollesdal@kunnskapssenteret.no.
authors.forename: Johanne
authors.initials: J
authors.lastname: Kjollesdal
mesh_terms: D000328:Adult; D005163:Factor Analysis, Statistical; D005260:Female; D006778:Hospitals, Psychiatric / Q000592:standards*; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009664:Norway; D010351:Patient Discharge; D017060:Patient Satisfaction; D011594:Psychometrics; D019984:Quality Indicators, Health Care / Q000592:standards; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*