Objective – To measure satisfaction with Community Mental Health Service (CSM) in patients and to check if it will be associated with some selected demographic and service variables. Design – This study compares data from satisfaction scale administration in patients who attended CSM at least once every two months during 1998 and services that them have benefited from. Setting – The Community Mental Health Service of Saragozza-Porto District in Bologna. Main outcome measures – Demographical, clinical and service variables taken from CSM informative systém and Verona Service Satisfaction Scale (VSSS-32), a multidimensional instrument which measures satisfaction with community-based psychiatric service. Results – Main results (145 subjects) pointed out higher satisfaction for technical and interpersonal skills of staff, information, drugs, help to get economical benefits and domiciliary care. Four issues stood out by comparing patients' satisfaction and their demographic, clinical and services' benefit features: 1) aged patients complained about high drugs costs and of contacts with other seriously ill patients into the waiting room; 2) relative's involvement was judged as insufficiently effective; 3) in young patients with serious mental disease high frequency of visits seemed to correlate with low satisfaction; 4) patients with complex pattern of intervention (including economical benefits) were the less satisfied ones with service's economical support. Conclusions – Patients' satisfaction differs according to their demographic and clinical features, but the pattern of intervention seems to influence their judgements too, sometimes in a incoherent way.

Objective - This paper reports on sensitivity, and content validity of the Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction Scale (VSSS), two newly developed, multidimensional instruments which measure expectations and satisfaction with community-based psychiatric services (CPS) in patients and their rela- tives. Instruments - VECS and VSSS consist of various sections and include questions eliciting spontaneous answers and an 82-item multidimensional questionnaire on various aspects of clients' interaction with psychiatric services. Setting - The South-Verona community-based psychiatric service. Subiects - The patients were selected among those who, ac- cording to the South-Verona Psychiatric Case Register, were living with their families in the South-Verona catchment area and had had more than 18 contacts with the South-Verona CPS in the three years preceeding the interview. For each patient, the relative identified by professionals and patients as primarily involved in caring for the patient in the given period was asked to participate. Results - We demonstrated the higher sensitivity of VECS and VSSS question- naires compared to unstructured interviews in measuring service expectations and satisfaction and the higher sensitivity of a domain-specific measurement vs. an overall one. VECS and VSSS proved to be sensitive to variation both between groups and across dimensions. Content validity of the questionnaires, according to patients and relatives views, was very good; moreover we demonstrated that a key-characteristic of content validity is the questionnaire's multidimension- ality. Conclusions - The findings presented in this and in a companion paper demonstrate that it is possible to measure subjective aspects of the interaction with a psychiatric service such as expectations and satisfaction in an acceptable, reliable, sensitive and valid way and that VECS and VSSS have good psychometric properties.

Objective - This paper reports on acceptability and test-retest reliability of the Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction Scale (VSSS), two newly developed, multidimensional instruments which measure expectations and satisfaction with community-based psychiatric services (CPS) in patients and their relatives. Instruments - VECS and VSSS consist of various sections and include questions eliciting spontaneous answers and an 82-item multidimensional questionnaire on various aspects of clients' interaction with psychiatric services. Setting - The South-Verona community-based psychiatric service. Subiects - The patients were selected among those who, according to the South-Verona Psychiatric Case Register, were living with their families in the South-Verona catchment area and had had more than 18 contacts with the South-Verona CPS in the three years preceeding the interview. For each patient, the relative identified by professionals and patients as primarily involved in caring for the patient in the given period was asked to participate. Results - Acceptability of VECS and VSSS to subjects was good: most items were easily understood and all subjects cooperated and gave accurate evaluations. The test-retest reliability (1-2 weeks interval) of VECS and VSSS was good in patients and relatives both when considering item-by-item percentage agreement and Cohen's weighted kappa in each dimension. Conclusions - The findings presented in this paper demonstrate that it is possible to measure subjective aspects of the interaction with a psychiatric service such as expectations and satisfaction in an acceptable and reliable way and that VECS and VSSS have good performance in the psychometric properties studied.