Satisfaction with services is an important indicator of outcome and quality of care. Despite this, the issue of methodological requirements for adequate measurement of satisfaction has received little attention and development of well-validated questionnaires that are easy to administer has been rarely pursued in the field of psychiatry. The principal aim of this paper is to describe the development of reduced versions of the Verona Service Satisfaction Scale (VSSS)-82, a validated, multidimensional questionnaire which combines cross-setting satisfaction items for health services and setting-specific items for community based psychiatric services. The VSSS covers seven conceptual dimensions: Overall Satisfaction, Professionals' Skills and Behaviours, Information, Access, Efficacy, Types of Intervention, Relative's Involvement. The underlying structure in each of these dimensions was examined by means of factor analyses. A number of empirical factors emerged. Of special interest, for example, was the distinction patient respondents apparently made between nurses' and doctors' functioning in the professionals' skills and behaviour domain. Another example was found under the efficacy dimension, with a factor tapping general aspects of the service's help in coping with an illness, distinguished from two smaller factors made of setting-specific items, involving the service's efficacy in developing specific skills which have often been compromised by mental disability, such as self management and extra-family relationship skills. Factor analyses enabled the identification of a smaller set of items that gave good representation of the underlying content areas covered by the VSSS-82. Two reduced, multidimensional and easy to administer scales are here proposed: a 54-item scale, designed for application where detailed assessment of the separate domains is wanted, and a 32-item version, suitable for routine use in program evaluations where a validated, reliable, multidimensional satisfaction measure is required but detailed analyses of areas of greatest and least satisfaction are not of interest. Data previously obtained on content validity and test-retest reliability of the items, enabled supplemental information to be combined with the factor-analysis findings so as to assure high relevance and good stability for all items included in the refined scales. © 1996 by John Wiley & Sons. Ltd.
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