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Practical Information
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Instrument Name:
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Satisfaction Index-Mental Health (SIMH)
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Instrument Description:
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The instrument is designed to measure patient satisfaction with mental health care services. This was determined among patients with major mental illness with a 12-item scale adapted from a general health care satisfaction scale used by Hall et al. (1990, 1993) and by DiMatteo and Hays (1980). (Ref: 1)
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Price:
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Free (in public domain)
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Administration Time:
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5-10 minutes
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Publication Year:
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1998
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Item Readability:
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Flesch-Kincaid grade level of 7.6. Items contain simply structured sentences of approximately 15 words or less.
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Scale Format:
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12 items; 6-point scale; items alternate in polarity
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Administration Technique:
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Self-reported. No training required.
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Scoring and Interpretation:
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Higher total score reflects higher satisfaction with services.
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Forms:
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No information found on other forms.
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Research Contacts
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Instrument Developers:
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Lida Nabati, Nancy Shea, Linda McBride, Cristopher Gavin, Mark S. Bauer
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Instrument Development Location:
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Brown University
Department of Psychology
Providence, RI 02912
Veterans Affairs Medical Center
Mental Health and Behavior Sciences Service
830 Chalkstone Ave
Providence, RI 02908
Brown University
Department of Psychiatry and Human Behavior
Providence, RI 02912
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Instrument Developer Email:
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mark.bauer@va.gov
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Instrument Developer Website:
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No information found.
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Annotated Bibliography
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1. Nabati L, Shea N, McBride L, Gavin C, Bauer MS. Adaptation of a simple patient satisfaction instrument to mental health: psychometric properties. Psychiatry Res. 1998 Jan 16;77(1):51-6. [PMID: 10710175]
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Purpose: The authors’ aim was to adapt and test a patient satisfaction instrument for mental health services. |
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Sample: Administered to 163 Veterans having various psychiatric diagnoses. Mean age was 50±12 years and 94% were male. Subjects were approached in a VA waiting room and selected if it was their second visit to a mental health provider, regardless of diagnoses. |
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Methods: The instrument was administered to 163 patients, nineteen of which were excluded due to incomplete data. Test-retest and sensitivity to change were also determined. |
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Implications: The authors conclude that the instrument appears to be well tolerated given its low non-compliance rate and is suited for primary care populations.
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2. Hall JA, Feldstein M, Fretwell MD, Rowe JW, Epstein AM. Older patients' health status and satisfaction with medical care in an HMO population. Med Care. 1990 Mar;28(3):261-70. [PMID: 2314135]
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Purpose: The authors attempted to establish a relationship between health status and satisfaction among patients receiving HMO-based care. |
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Sample: 532 patients (out of an eligible 1,156) 70 years of age or older who were enrolled in an HMO in Providence, RI took part in the study. |
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Methods: Patients were interviewed by one of the female interviewers at home or at the HMO using closed-format questions or scaled items. In addition to demographic information, patients were asked about social contacts, emotional status, overall current health, functional status, cognitive function, and satisfaction (based on DiMatteo and Hays, 1980). Physician ratings of the patients and a chart audit was also performed. |
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Implications: The authors reported that the more satisfied patients had better health status, that satisfaction varied among dimensions and for differed for patients of differing physicians. |
3. Hall JA, Milburn MA, Epstein AM. A causal model of health status and satisfaction with medical care. Med Care. 1993 Jan;31(1):84-94. [PMID: 8417273]
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Purpose: A causal model relationship between satisfaction with health care services and health status was sought using several instruments. |
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Sample: 894 patients were approached until a sample of 600 was achieved from a large HMO population in Providence, RI. Eligible patients were based on the following criteria: older than 74 years of age and patients between 70 and 74 years of age who were rated by their physician as being very likely or probably likely to deteriorate or as having fair or worse overall health. |
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Methods: A three-person geriatric assessment team met with one-third of the patients, a second opinion internist met with another third and the control third was provided with HMO services. Selected items from multiple instruments were combined and administered to assess patient’s cognitive status, emotional health, social activity, functional abilities, overall self-perceived health, and satisfaction with medical care. A 12-item satisfaction scale (DiMatteo and Hays, 1980) was adapted for use here. The instruments were administered again after 1 year. |
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Implications: In the HMO sample, health status was found to be a causal determinant of satisfaction. Overall self-perceived health was found to be the most predictive variable in satisfaction.
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Factors and Norms
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Factor Analysis Work:
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Using principal component analysis, researchers provided evidence that the items represent a single dimension of satisfaction with mental health services. (Ref: 1)
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Normative Information Availability:
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No information found.
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Reliability Evidence
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Test-retest:
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Determination was made using correlation followed by t-test for paired samples. The instrument exhibited a correlation of r=0.79 (p=0.05) across two administrations with a time interval of 1-8 weeks. Researchers reported that the measure demonstrated no drift over time (mean ± S.D. = 61 ± 11 vs. 63 ± 8; t(17) = -1.2, p=0.26.) This was obtained by an n=18 convenience sample from the original group of participants. (Ref: 1)
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Inter-rater:
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No information found.
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Internal Consistency:
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The authors reported a Cronbach’s alpha of 0.90. (Ref: 1)
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Alternate Forms:
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No information found.
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Validity Evidence
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Construct/ Convergent/ Discriminant:
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No information found.
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Criterion-related/ Concurrent/ Predictive:
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No information found.
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Content:
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No information found.
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Responsiveness Evidence:
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Sensitivity to change based on treatment in a sub-sample was evaluated. Satisfaction score increased significantly compared to baseline for bipolar disorder (47 ± 12 vs. 59 ± 11; Wilcoxon p<0.0001). The authors also divided the sample into three groups based on time enrolled in general mental health clinic to determine if the change was due to time in clinic. The group means (after treatment) were 54 ± 12 (<6 months, n=19), 51 ± (6-12 months, n=9), 53 ± 15 (>12 months, n=85). Using one-way ANOVA with time as a grouping factor, the authors reported that time in clinic did not affect satisfaction (F(df=2) = 0.1, p=0.90.) (Ref: 1)
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Scale Application in VA Populations:
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Yes. 163 Veterans evaluated by the instrument. (Ref: 1)
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Scale Application in non-VA Populations:
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No information found.
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Comments
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This measure was developed specifically for use with veterans. Results of the principal components analysis indicate evidence for unidimensionality. The reported internal consistency estimate was high and indicates that this measure is reliable for use with groups of patients and possibly for use at the individual level. The test-retest reliability estimate was obtained from a very small sample with the time interval between test and retest varying from 1-8 weeks, so evidence for stability in this measure is not as convincing. No validity evidence was presented and further work to provide validity evidence is needed. The measure demonstrated adequate sensitivity evidence for detecting clinical changes from participation in a clinic-based education and somatotherapy treatment. Overall, initial evidence suggests that this measure has promise for assessing satisfaction with mental health services in veterans with mental health problems. Only one study evaluated the measurement properties of the measure, so further study will help determine whether it demonstrates similarly strong measurement properties in other populations.
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