The patient experience in community mental health services for older people: a concept mapping approach to support the development of a new quality measure.
BACKGROUND
The patient experience is a crucial part of the measurement of service quality. However, instruments to evaluate experiential quality in the community mental health care of older adults are lacking. Before designing a new instrument, clarity is needed about what is to be measured, and how care experiences are articulated by patients. The study aimed to construct a framework to describe older patients' experience of community mental health and social care.


METHODS
Concept mapping blends structured qualitative data collection with quantitative analysis in a mixed method approach. Five activities were undertaken. Patients first identified sentences describing the care experience; a card-sort exercise then grouped these thematically; multidimensional analysis portrayed these data in a map of clusters; interpretation was by patient advisers; finally a new questionnaire was designed. The research involved 22 older people with mental health problems and 29 mental health practitioners, from one region of England.


RESULTS
Sixty-seven statements were identified that described the care experience. Analysis of card sort data revealed seven clusters, which were interpreted by patient advisers to the study as: personal qualities and relationships; communication problems; feeling powerless; in-and-out care; bureaucracy; focus on life, not just mental health; and continuity of care. These themes and the component statements were used as a foundation for later work, developing a new measure of the care experience in mental health services for older people.


CONCLUSIONS
Concept mapping has many strengths as an empirical and participant-driven means for underpinning new measurement instruments. A group of older people identified 67 candidate statements that could act as questionnaire items grouped within seven themes. Future research will establish the psychometric properties of the new measure.
['Wilberforce|Mark|M|0000-0001-6977-4483', 'Batten|Eric|E|', 'Challis|David|D|', 'Davies|Linda|L|', 'Kelly|Michael P|MP|', 'Roberts|Chris|C|']
D000368:Aged D016000:Cluster Analysis D003156:Community Mental Health Services D000068598:Data Accuracy D004739:England D005260:Female D006299:Health Services for the Aged D006801:Humans D008297:Male D001523:Mental Disorders D017063:Outcome Assessment, Health Care D017060:Patient Satisfaction D010817:Physician-Patient Relations D058996:Quality Improvement D011795:Surveys and Questionnaires
Patient experience Community mental health Concept mapping Social care Dementia