Factor Structure and Psychometric Properties of the Danish Adaptation of the Instrument Quality in Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS)


There is a need for an internationally standardized and psychometrically tested instrument to measure the perceptions of staff members on the quality of forensic inpatient care provided. The aim of the present study was to adapt the Swedish instrument Quality of Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS) to the Danish context and to evaluate its psychometric properties and factor structure in this context. All permanently employed staff members at all 27 forensic inpatient wards in Denmark were invited to answer the Danish version of the QPC-FIPS. In total, 641 staff members participated, resulting in a response rate of 80%. The Danish version of the QPC-FIPS showed adequate psychometric properties and excellent goodness of fit of the hypothesised factor structure. Hence, the Danish QPC-FIPS is an excellent instrument for evaluating quality of forensic inpatient care both in clinical practice and in cross-cultural research. The members of staff generally reported that the care provided to patients was of high quality. The quality of the forensic-specific dimension was rated the highest, followed by the support, secluded environment, encounter, discharge and participation. The quality of the secure environment dimension was perceived to be the worst. The QPC-FIPS includes important aspects of staff members’ assessments of quality of care and offers a simple and inexpensive way to evaluate psychiatric forensic inpatient care. The QPC-FIPS can be used together with the Quality of Psychiatric Care-Forensic In-Patient (QPC-FIP) instrument, which covers the same items and dimensions as the QPC-FIPS, to identify patients’ and staff members’ views on quality of care and to improve the quality of forensic psychiatric care and benchmarking.

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Lundqvist, L. , Riiskjaer, E. , Lorentzen, K. and Schröder, A. (2014) Factor Structure and Psychometric Properties of the Danish Adaptation of the Instrument Quality in Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS). Open Journal of Nursing, 4, 878-885. doi: 10.4236/ojn.2014.412093.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Mainz, J., Krog Randrup, B., Bjørnshave, B. and Bartels, P. (2004) Nationwide Continuous Quality Improvement Using Clinical Indicators: The Danish National Indicator Project. International Journal for Quality in Health Care, 16, 45-50. http://dx.doi.org/10.1093/intqhc/mzh031
[2] Petterson, I.-L. and Arnetz, B.B. (1997) Measuring Psychosocial Work Quality and Health: Development of Health Care Measures of Measurement. Journal of Occupational Health Psychology, 2, 229-241.
[3] Blendon, R.J., Schoen, C., Donelan, K., Osborn, R., DesRoches, C.M., Scoles, K., Davis, K., Binns, K. and Zapert, K. (2001) Physicians’ Views on Quality of Care: A Five-Country Comparison. Health Affairs, 20, 233-243.
[4] World Health Organization (2006) Quality of Care: A Process for Making Strategic Choices in Health Systems. WHO Press, Geneva.
[5] Schröder, A. and Lundqvist, L.-O. (2013) The Quality in Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS) Instrument: Psychometric Properties and Staff Views of the Quality of Forensic Psychiatric Services in Sweden. Open Journal of Nursing, 3, 330-341. http://dx.doi.org/10.4236/ojn.2013.33045
[6] Jung, H., Wensing, M. and Grol, R. (1997) What Makes a Good General Practitioner: Do Patients and Doctors Have Different Views? British Journal of General Practice, 47, 805-809.
[7] Hussey, P.S., Anderson, G.F., Osborn, R., Feek, C., McLaughlin, V., Millar, J. and Epstein, A. (2004) How Does the Quality of Care Compare in Five Countries? Health Affairs, 23, 89-99. http://dx.doi.org/10.1377/hlthaff.23.3.89
[8] DeMarco, R., Flaherty, L., Glod, C., Merril, N., Terk, K. and Plasse, M. (2004) Staff and Client Perceptions of Unit Quality: A Pilot Study. Journal of Psychosocial Nursing and Mental Health Service, 42, 36-43.
[9] Valenstein, M., Mitchinson, A., Ronis, D.L., Alexander, J.A., Duffy, S.A., Craig, T.J. and Lawton Barry, K. (2004) Quality Indicators and Monitoring of Mental Health Services: What Do Frontline Providers Think? American Journal of Psychiatry, 161, 146-153. http://dx.doi.org/10.1176/appi.ajp.161.1.146
[10] Cramer, J.A., Perrine, K., Devinsky, O., Bryant-Comstock, L., Meador, K. and Hermann, B. (1998) Development and Cross-Cultural Translations of a 31-Item Quality of Life in Epilepsy Inventory. Epilepsia, 39, 81-88.
[11] Henderson, C., Hales, H. and Ruggeri, M. (2003) Cross-Cultural Differences in the Conceptualisation of Patients’ Satisfaction with Psychiatric Services—Content Validity of the English Version of the Verona Service Satisfaction Scale. Social Psychiatry Psychiatric Epidemiology, 38, 142-148. http://dx.doi.org/10.1007/s00127-003-0606-7
[12] Ogloff, J.R.P., Roesch, R. and Eaves, D. (2000) International Perspective on Forensic Mental Health Systems. International Journal of Law & Psychiatry, 23, 429-431. http://dx.doi.org/10.1016/S0160-2527(00)00062-5
[13] Sartorius, N. and Helmchen, H. (1981) Aims and Implementation of Multi-Centre Studies. Modern Problems of Pharmacopsychiatry, 16, 1-8.
[14] Mainz, J., Hjulsager, M., Eriksen, M.T. and Burgaard, J. (2009) National Benchmarking between the Nordic Countries on the Quality of Care. Journal of Surgical Oncology, 99, 505-507. http://dx.doi.org/10.1002/jso.21204
[15] Schröder, A., Ågrim, J. and Lundqvist, L.-O. (2013) The Quality in Psychiatric Care-Forensic In-Patient Instrument: Psychometric Properties and Patient Views of the Quality of Forensic Psychiatric Services in Sweden. Journal of Forensic Nursing, 9, 225-234. http://dx.doi.org/10.1097/JFN.0b013e31827f5d2f
[16] Schröder, A. and Ahlström, G. (2004) Psychiatric Care Staff’s and Care Associates’ Perceptions of the Concept of Quality of Care: A Qualitative Interview Study. Scandinavian Journal of Caring Sciences, 18, 204-212.
[17] Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A. and Erikson, P. (2005) Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-reported Outcomes (PRO) Measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation. Value in Health, 8, 94-104.
[18] Cronbach, L.J. (1951) Coefficient Alpha and the Internal Structure of Tests. Psychometrika, 16, 297-334.
[19] Nunnally, J. and Bernstein, I. (1994) Psychometric Theory. 3rd Edition, McGraw-Hill, New York.
[20] Jöreskog, K.G. and Sörbom, D. (1996) LISREL 8: User’s Reference Guide. 2nd Edition, Scientific Software International, Chicago.
[21] Jöreskog, K.G. and Sörbom, D. (1988) PRELIS—A Program for Multivariate Data Screening & Data Summarization, a Preprocessor for LISREL. 2nd Edition, Scientific Software Inc., Chicago.
[22] Bentler, P.M. (1990) Comparative Fit Indexes in Structural Models. Psychological Bulletin, 107, 238-246.
[23] Browne, M.W. and Cudeck, R. (1993) Alternative Ways of Assessing Model Fit. In: Bollen, K.A. and Long, J.S., Eds., Testing Structural Equation Models, Sage Publications, Newbury Park, 136-162.
[24] Vandenberg, R.J. and Lance, C.E. (2000) A Review and Synthesis of the Measurement Invariance Literature: Suggestions, Practices, and Recommendations for Organizational Research. Organizational Research Methods, 3, 4-70.
[25] Kumpula, E. and Ekstrand, P. (2013) “Doing Things Together”: Male Caregivers’ Experiences of Giving Care to Patients in Forensic Psychiatric Care. Journal of Psychiatric & Mental Health Nursing, 20, 64-70.
[26] Adshead, G. (1998) Psychiatric Staff as Attachment Figures. Understanding Management Problems in Psychiatric Services in the Light of Attachment Theory. The British Journal of Psychiatry, 172, 64-69.
[27] Hofstede, G. (1983) The Cultural Relativity of Organizational Practices and Theories. Journal of International Business Studies, 14, 75-89.
[28] Haas, J.S., Cook, E.F., Puopolo, A.L., Burstin, H.R., Cleary, P.D. and Brennan, T.A. (2000) Is the Professional Satisfaction of General Internists Associated with Patient Satisfaction? Journal of General Internal Medicine, 15, 122-128.
[29] Lundqvist, L.-O., Lorentzen, K., Riiskjaer, E. and Schröder, A. (2014) A Danish Adaptation of the Quality in Psychiatric Care-Forensic In-Patient Questionnaire: Psychometric Properties and Factor Structure. Journal of Forensic Nursing, 10, 168-174. http://dx.doi.org/10.1097/JFN.0000000000000036

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