Psychometric properties of the Providers Survey in the Brazilian context of mental health: a validation study

Lacerda, Mayara Karoline Silva; Vieira, Maria Aparecida; Marques, Fabrine Costa; Alves, Juliana Pereira; Pereira, Matheus Mendes; Carmo, Andreia Cristina Feitosa do; Costa, Mark Napoli; Caldeira, Antônio Prates; Sampaio, Cristina Andrade

doi:10.1590/1516-3180.2022.0444.R3.010623

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Sao Paulo Medical Journal

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Original Article • Sao Paulo Med. J. 142 (2) • 2024 • https://doi.org/10.1590/1516-3180.2022.0444.R3.010623 copy

Psychometric properties of the Providers Survey in the Brazilian context of mental health: a validation study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND:

Precisely determining the aspects related to an instrument's validity and reliability measures allows for greater assurance of the quality of the results.

OBJECTIVES:

To analyze the psychometric properties of The Providers Survey in the Brazilian context of mental health services.

DESIGN AND SETTING:

The instrument validation study was conducted in Montes Claros, Minas Gerais, Brazil.

METHODS:

The validation study was conducted using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist to analyze its validity and reliability.

RESULTS:

A committee of expert judges performed content validation after which the Content Validity Index was calculated. Construct validation took place through Exploratory Factor Analysis using the Kaiser-Meyer-Olkin Test criterion and Bartlett's Sphericity Test. Reliability was verified using test-retest reliability. The significance level adopted for the statistical tests was 5% (P < 0.05). The final instrument comprised 54 questions. The Content Validity Index was 97%. Exploratory Factor Analysis identified a Kaiser-Meyer-Olkin index of 0.901 and Bartlett's Sphericity Test with P < 0.001. We obtained a Cronbach's alpha coefficient of 0.95 and an intraclass correlation coefficient of 0.849.

CONCLUSIONS:

The Providers Survey, translated and adapted into Portuguese, was named the Work Assessment Instrument for the Recovery of Mental Health. It presented adequate psychometric properties for evaluating work-related practices for the recovery of psychosocial care network users.

KEY WORDS (MeSH terms):
Validation study [publication type]; Mental health recovery; Reproducibility of results; Data management

AUTHORS’ KEY WORDS:
Health professionals; Psychometric properties; Instrument validation

Specialist	Academic education	Experience in the field of Mental Health
1	Psychologist. Mental Health Specialist.	Preceptor of the Multiprofessional Residency in Family Health. Works in Primary Care. She served as a psychologist in Psychosocial Care Center.
2	Psychologist. Family Health Specialist.	Preceptor of the Multiprofessional Residency in Family Health. Works in Primary Care. Worked as a Psychosocial Care Center.
3	Psychologist. Family Health Specialist.	Preceptor of the Multiprofessional Residency in Family Health. Works in Primary Care.
4	Psychologist. Mental Health Specialist.	Preceptor of the Multiprofessional Residency in Family Health and Mental Health. Works in Primary Care. Worked as a Psychosocial Care Center.
5	Nurse. Family Health Specialist. Master in Primary Health Care.	Preceptor of the Multiprofessional Residency in Family Health. Works in Primary Care service.
6	Doctor. Specialist in Psychiatry and Psychotherapy.	Coordinator of the Residency in Psychiatry. Operates in the private network. Professor at the Department of Medicine at the State University of Montes Claros.
7	Psychologist. Doctor in Psychology. Master in Public Health.	Professor at the Department of Mental Health and Collective Health at the State University of Montes Claros.
8	Psychologist. Mental Health Specialist.	Works in Primary Care. Worked as an intern at Psychosocial Care Center.
9	Dentist surgeon. Family Health Specialist.	Preceptor of the Multiprofessional Residency in Family Health. Works in Primary Care service.
10	Doctor. Specialist in Family and Community Medicine.	Preceptor of the Residency in Family and Community Medicine. Works in Primary Care service.

Variables		n	%
Age (years)
	18–24	13	4.1
	25–34	162	50.9
	35–44	108	34.0
	45–54	28	8.8
	55–64	6	1.9
	65–74	1	0.3
Total		318	100.0
Gender
	Man	71	22.3
	Woman	247	77.7
Total		318	100.0
County
	Montes Claros	281	88.4
	Bocaiuva	3	0.9
	Janaúba	2	0.6
	Salinas	5	1.6
	Monte Azul	2	0.6
	Rather not answer	25	7.9
Total		318	100.0
Occupation area
	Service professionals not specialized in Mental Health	269	84.6
	Professionals of specialized services in Mental Health	46	14.5
	Rather not answer	3	0.9
Total		318	100.0
Office
	Social worker	12	3.8
	Dental surgeon	63	19.8
	Coordinator/Manager	15	4.7
	Nurse specialist in mental health	9	2.8
	Nurse not specialist in mental health	119	37.4
	Pharmaceutical	2	0.6
	Physician (not psychiatrist)	62	19.5
	Psychiatrist	2	0.6
	Workshop monitor	1	0.3
	Psychologist	29	9.1
	Occupational therapist	3	0.9
	Rather not answer	1	0.3
Total		318	100.0
Working time (years)
	Less than 1	26	8.2
	1–2	69	21.7
	3–5	84	26.4
	6–9	64	20.1
	10 or more	75	23.6
Total		318	100.0

Variables	Components
Variables	1	2	3
Hosting the user, their family, and/or companions	0.5	0.1	0.0
Recording a complete personal and family anamnesis/history	0.7	0.1	0.1
Conducting case follow-up	0.6	0.3	0.0
Providing a reference technician for case management	0.5	0.1	0.1
Offering counseling and/or guidance and/or psychotherapy or other psychological interventions	0.6	0.1	-0.1
Participating in the formulation of the diagnosis	0.6	0.1	-0.1
Prescribing and/or administering medication	0.5	0.0	0.1
Monitoring medication adherence	0.6	0.1	0.1
Providing guidance on the use of medications and the effect on the user's psychological condition for the user, their family members and/or companions	0.7	0.1	0.1
Identifying and addressing stigma and discrimination/prejudice	0.6	0.0	0.2
Referring users to medical care and assistance	0.6	0.2	0.0
Referring users to social support services to search for work/employment (legal associations and public services)	0.7	0.1	0.2
Providing job search support	0.6	0.0	0.3
Referring users to the treatment of alcoholism and/or the use of psychoactive substances	0.7	0.3	0.0
Providing treatment for alcoholism and/or the use of other psychoactive substances	0.6	0.2	0.0
Referring users to the housing support service	0.6	0.0	0.2
Providing housing search support	0.5	0.0	0.2
Referring users to socialization activities and recreational/leisure support	0.7	0.0	0.1
Providing socialization activities and recreational/leisure support	0.6	0.0	0.2
Referring users to legal support	0.5	-0.1	0.2
Involving family members in supporting users in mental distress	0.7	0.1	0.0
Providing peer support and guidance and/or therapeutic companion	0.7	0.1	0.1
Providing guidance on the self-care and well-being of users	0.7	0.3	0.0
Addressing issues related to the various forms of violence and/or other forms rights violations	0.7	0.1	0.2
Setting a goal for getting a job	0.2	0.1	0.6
Including users in work/employment support programs, regardless of the severity of their symptoms or other underlying difficulties	0.1	0.2	0.6
Conducting a job search as soon as the person shows interest in working	0.2	0.1	0.7
Integrating vocational support with clinical care for the user in an individualized way	0.2	0.1	0.8
Being aware of users’ preferences regarding a job/occupation	0.2	0.1	0.7
Identifying and addressing cases of discrimination at work/employment	0.2	0.1	0.7
Encouraging the person to seek employment	0.2	0.3	0.5
Identifying and addressing negative internalized views of themselves that make people believe they are incapable of working	0.2	0.3	0.6
Involving family members in supporting the user's efforts to seek or maintain employment	0.3	0.4	0.5
Engaging peers to support the user's efforts to seek or maintain work/job	0.3	0.3	0.6
Recognizing work/employment as an important need in the restoration of the user	0.2	0.4	0.6
Recognizing the job as a source of stress that should be avoided	-0.1	0.0	0.6
Recognizing employment as offering a valuable social role or as an important source of identity reinforcement	0.2	0.3	0.5
Recognizing employment as a factor that can increase the risk of relapse/crisis of users in mental suffering	-0.1	0.0	0.6
Being connected to something that goes beyond oneself (e.g., spirituality/religiosity)	0.0	0.3	0.3
Being hopeful	0.0	0.7	0.1
Having a life project	0.2	0.7	0.0
Having stable housing/place	0.1	0.7	0.2
Being abstinent from drugs and alcohol	0.1	0.5	0.2
Being employed in formal or informal work	0.1	0.4	0.4
Eliminating all psychiatric symptoms	0.0	0.2	0.4
Having family support	0.1	0.7	0.0
Having friends or people to trust and/or partner or spouse	0.2	0.7	0.0
Adhering to prescribed treatments	0.1	0.7	0.0
Adapting to psychiatric symptoms	0.0	0.2	0.4
Having a sense of belonging in the community and valuing their cultural and social identity	0.2	0.7	0.2
Taking control of one's own life/autonomy	0.1	0.6	0.3
Having something that gives meaning/meaning to life	0.1	0.6	0.2
Having quality medical care and/or multi-professional assistance	0.1	0.7	0.1
Believing in oneself as a capable person	0.1	0.8	0.0
Being financially independent	0.0	0.4	0.3
Participating in recreational/leisure social activities	0.1	0.6	0.2
Having a long period of stability (i.e., no crises)	0.0	0.5	0.1
Eating healthy and practicing physical activity	0.1	0.6	0.2
Questioning and rejecting social stereotypes of users in mental distress (e.g., “patient with mental illness” or addict)	0.0	0.3	0.3
Being valued for their activities in the community	0.1	0.7	0.2

PART 1
Please indicate how important the following activities are in your work with mentally ill users. Where: 1-Not important, 2-Somewhat important, 3-Not at all and not very important, 4-Important, 5-Very important, 6-Not part of my job).
DOMAIN	1	2	3	4	5	6
Hosting the user, their family, and/or companions
Recording a complete personal and family anamnesis/history
Conducting case follow-up
Providing a reference technician for case management
Offering counseling and/or guidance or psychotherapy/other psychological interventions
Participating in the formulation of the diagnosis
Prescribing and/or administering medication
Monitoring medication adherence
Guiding the use of medications and the effect on the user's psychic condition for the user, their family members, and/or companions
Identifying and addressing stigma and discrimination/prejudice
Referring users for medical attention and care
Referring users to social support services to search for work/employment (legal associations and public services)
Providing job search support
Referring users for treatment of alcoholism and/or the use of psychoactive substances
Providing treatment for alcoholism and/or the use of other psychoactive substances
Referring users to the housing support service
Providing housing search support
Referring users to socialization activities and recreational/leisure support
Providing socialization activities and recreational/leisure support
Referring users to legal support
Involving family members in supporting users in mental distress
Providing peer support and guidance and/or a therapeutic companion
Providing guidance on the self-care and well-being of users
Addressing issues related to forms of violence or forms rights violations.
PART 2
Please indicate how important the following components are to enabling users in mental distress to obtain and keep their jobs. Where: 1-Not important, 2-Somewhat important, 3-Not at all and not very important, 4-Important, 5-Very important, 6-I prefer not to answer.
DOMAIN	1	2	3	4	5	6
Setting a goal for getting a job
Including users in work/employment support programs, regardless of the severity of their symptoms or other underlying difficulties
Conducting a job search as soon as the person shows interest in working
Integrating vocational support with clinical care in an individualized way
Being aware of users’ preferences regarding a job/occupation
Identifying and addressing cases of discrimination at work/employment
Encouraging the person to seek employment
Identifying and addressing negative internalized views of themselves that make people believe they are incapable of working
Involving the family in supporting the user's efforts to seek or maintain employment
Engaging peers in supporting the user's efforts to seek or maintain work/job
Recognizing the work/job as important in the recovery of the user
Recognizing the job as a source of stress that should be avoided
Recognizing employment as offering a valuable social role or as an important source of identity reinforcement
Recognizing employment as a risk factor for relapse/crisis of users in mental suffering
PART 3
Indicate the degree of importance of the following components to promote the restoration/recovery of users in mental suffering. Where: 1-Not important, 2-Somewhat important, 3-Not at all and not very important, 4-Important, 5-Very important, 6-I prefer not to answer.
DOMAIN	1	2	3	4	5	6
Being hopeful
Having a life project
Having stable housing/place
Being abstinent from drugs and alcohol
Having family support
Having friends or people to trust and/or partner or spouse
Adhering to prescribed treatments
Having a sense of belonging in the community and value their cultural and social identity
Taking control of their own life/autonomy
Having something that gives meaning to life
Having quality medical care and/or multi-professional assistance
Believing in oneself as a capable person
Participating in recreational/leisure social activities
Having a long period of stability (i.e., no crises)
Eating healthy and practice physical activity
Being valued for their activities in the community

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[1] Address for correspondence: Mayara Karoline Silva Lacerda R. Sebastião Santos, 1.485 Prolongamento do Augusta Mota — Montes Claros (MG) — Brasil CEP 39403-223 Tel. (+55 38) 99863-0504 E-mail: mkslacerda@hotmail.com