Measuring the quality of mental health services from the patient perspective in China: psychometric evaluation of the Chinese version of the World Health Organization responsiveness performance questionnaire

Figures & data

Table 1. The Chinese version of the responsiveness performance questionnaire for hospital mental health services

Domains	Brief description of items	Selection sources
Dignity	Q1. When you received outpatient/inpatient mental health services, how would you rate your experience of being treated with respect? ^a	WHS and MCSS
	Q2. When you received outpatient/inpatient mental health services, how would you rate the way your privacy was protected during physical examination and treatments? ^a	WHS and MCSS
Confidentiality	Q3. When you received outpatient/inpatient mental health services, how often were your talks with mental health professionals done privately, without overhearing? ^b	WHS and MCSS
	Q4. How would you rate the way your personal information was kept confidential by mental health professionals? ^a	WHS and MCSS
Communication	Q5. How often did mental health professionals communicate things in a way you could understand ? ^b	WHS and MCSS
	Q6. When you received outpatient/inpatient mental health services, how often did mental health professionals give you enough time to ask questions? ^b	WHS and MCSS
Autonomy	Q7. How often did mental health professionals provide you with information of other types of treatments or tests? ^b	WHS
	Q8. How often did mental health professionals ask your opinions when making decision related to treatment? ^b	WHS and MCSS with wording change
Choice	Q9. How often could you choosing hospitals or clinicians you were happy with for appointment (outpatient)/for hospitalization (inpatient) ^b	WHS and MCSS with wording change
Quality of basic amenities	Q10. How would you rate the cleanliness of the place (including toilets) of the outpatient mental health department/ of the inpatient ward? ^a	WHS and MCSS
	Q11. How would you rate the overall comfortableness of the outpatient mental health department/ the inpatient ward? ^a	MCSS with wording change
Prompt attention	Q12. How would you rate your travelling time to the hospital with an outpatient/inpatient mental health department? ^a	WHS
	Q13. How would you rate your waiting time for making appointments and being attended at an outpatient mental health department/for being admitted to an inpatient mental health department? ^a	WHS with wording change
Social support*	Q14. How difficult was it to have your family and friend visits during your hospitalization in an inpatient mental health department? ^c	WHS
	Q15. How difficult was it to stay in contact with the outside during your hospitalization in an inpatient mental health department? ^c	WHS

^aResponse options: very poor (1), poor (2), moderate (3), good (4), very good (5)

^bResponse options: never (1), seldom (2), sometimes (3), usually (4), always (5)

^cResponse options: extremely difficult (1), difficult (2), moderate (3), little difficult (4), no difficulty (5)

*The domain of social support and its items were not included in the outpatient module.

Table 2. Characteristics of the outpatient and inpatient participants

Variables	Outpatients (n = 193)	Inpatients (n = 168)
Age, Mean(sd)	27.7 (8.4)	35.3 (14.0)
Male, n(%)	82 (42.5)	83 (49.4)
Marital status*, n(%)
Married	65 (33.7)	90 (53.6)
Unmarried	128 (66.3)	78 (46.4)
Education, n(%)
≤Primary school	6 (3.1)	12 (7.1)
Junior high school	22 (11.4)	39 (23.2)
Senior high school	40 (20.7)	49 (29.2)
≥University	125 (64.8)	68 (40.5)
Employment, n(%)
Employed	96 (49.7)	69 (41.1)
Unemployed	97 (50.3)	99 (58.9)
Diagnosis, n(%)
Schizophrenia and other psychotic disorders	19 (9.8)	35 (20.8)
Mood disorders	66 (34.2)	81 (48.2)
Anxiety disorders	70 (36.3)	31 (18.5)
Others**	33 (17.1)	21 (12.5)
Unknown	5 (2.6)	0 (0)
Treatment in different mental health facilities in the past one year (outpatient)/past three years (inpatient)	77(39.9)	50 (29.9)

*Married includes married and cohabited, unmarried includes single, divorced, and widowed.

**Others include somatoform disorders, eating disorders, and sleeping disorders.

Table 3. Psychometric tests of the outpatient and inpatient modules

		Item missing rate (%)	Average Inter-item correlation		Factor loadings
Domain	Item	Inpatient	Outpatient	Inpatient	Outpatient	Inpatient
Dignity	Q1. Treating with respect	0	0.752	0.564	0.823	0.711
	Q2. Physical privacy protection	1.19			0.914	0.795
Confidentiality	Q3. Talking privately	1.79	0.256	0.281	0.297	0.357
	Q4. Keeping information confidential	1.19			0.863	0.786
Communication	Q5. Communication understandable	0	0.474	0.361	0.541	0.589
	Q6. Time for questioning	0.6			0.876	0.617
Autonomy	Q7. Information on alternatives	1.79	0.590	0.462	0.687	0.669
	Q8. Asking patients’ opinions	2.38			0.859	0.692
Choice	Q9. Choosing a healthcare provider	4.17	n/a	n/a	1.000	1.000
Quality of basic amenities	Q10. Cleanliness	2.41	0.625	0.536	0.812	0.733
	Q11. Overall comfortableness	2.29			0.770	0.732
Prompt attention	Q12. Travelling time	2.98	0.505	0.215	0.530	0.745
	Q13. Waiting time	5.95			0.954	0.290
Social Support	Q14. Family/friend visits	2.98	n/a	0.522	n/a	0.715
	Q15. Contacting outside	3.57			n/a	0.727