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Continuity of Care: Validation of a Self-Report Measure to Assess Client Perceptions of Mental Health Service Delivery

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Abstract

The psychometric characteristics of an instrument to assess perceived continuity of care among mental health patients were examined. 441 adults with severe and persistent mental illness were recruited from 70 inpatient, outpatient, emergency and community treatment programs (n = 259 females; M age = 42.5, SD = 10.3 years) in Alberta, Canada. Respondents completed a 43-item self-report questionnaire to rate perceived continuity. Item quality was assessed by examining missing data and frequency distributions. In a randomly selected subsample (n = 171), exploratory factor analysis identified 3 dimensions: (1) perceived attentiveness to individual needs or changes in illness or life circumstances (Individualized Care; α = .64); (2) perceptions of a coherent system characterized by good communication between providers (Responsive System; α = .71); and (3) perceived responsiveness on the part of a primary provider (Responsive Caregiver; α = .52). In a second random subsample (n = 181), confirmatory factor analysis provided support for this 3-factor structure and the inclusion of a second-order “continuity” factor (α = .72), and informed further item reduction. Split-half reliability for the second-order factor was calculated. Associations between the factors and “objective” measures of continuity, as well as relevant clinical, quality of life, and service satisfaction variables, are reported. Use of the measure for clinical and research purposes and its limitations are considered.

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Acknowledgments

This research was supported by a research program grant from the Canadian Health Services Research Foundation, the Alberta Heritage Foundation for Medical Research, the Alberta Mental Health Board, the Institute for Health Economics, and an unrestricted grant from Eli Lilly (Canada), Inc.

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Authors and Affiliations

  1. Department of Psychiatry, University of Alberta, 1E3.24 Walter Mackenzie Health Sciences Centre, 8440-112 St., Edmonton, AB, T6G 2B7, Canada

    Anthony S. Joyce

  2. Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, AB, Canada

    Carol E. Adair

  3. Centre for Health Promotion Studies, School of Public Health, University of Alberta, Edmonton, AB, Canada

    T. Cameron Wild

  4. Department of Psychiatry, University of Calgary, Calgary, AB, Canada

    Gerald M. McDougall

  5. Department of Psychiatry, University of Alberta, Edmonton, AB, T6G 2B7, Canada

    Alan Gordon & Norman Costigan

  6. Department of Educational Psychology, University of Lethbridge, Lethbridge, AB, Canada

    Gloria Pasmeny

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  1. Anthony S. Joyce
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  2. Carol E. Adair
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  7. Gloria Pasmeny
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Correspondence to Anthony S. Joyce.

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Joyce, A.S., Adair, C.E., Wild, T.C. et al. Continuity of Care: Validation of a Self-Report Measure to Assess Client Perceptions of Mental Health Service Delivery. Community Ment Health J 46, 192–208 (2010). https://doi.org/10.1007/s10597-009-9215-6

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  • DOI: https://doi.org/10.1007/s10597-009-9215-6

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