# User Satisfaction with Child and Adolescent Mental Health Services: Factor Structure of the Experience of Service Questionnaire (ESQ) in Norway and the UK

## TL;DR

This study examines how users in the UK and Norway rate their satisfaction with mental health services for children and adolescents.

## Contribution

The study provides new evidence supporting a general satisfaction factor in the ESQ questionnaire for CAMHS users.

## Key findings

- The ESQ showed strong psychometric properties in all samples.
- A bifactor model with general and specific satisfaction factors best fit the data in most cases.
- The Norwegian adolescent version was best represented by a unidimensional model.

## Abstract

Child and Adolescent Mental Health Services (CAMHS) are expected to track user satisfaction routinely, and to this end, the Experience of Service Questionnaire (ESQ) is increasingly being adopted worldwide. The literature is inconsistent concerning the underlying factor structure of satisfaction measures, and debate is ongoing regarding the evidence of a general satisfaction factor.

This study aimed to examine the factor structure and dimensionality of the parent/carer and adolescent versions of the ESQ in the UK and Norway.

Data were retrieved from routine CAMHS clinical practice in the UK and Norway. Three models suggested by the research group were tested through Confirmatory Factor Analysis (CFA) and reliability testing.

A series of CFAs revealed sound psychometric properties of the ESQ in all samples. A bifactor model with a general satisfaction factor and two specific factors of Satisfaction with Care and Satisfaction with Environment fitted the data best, except for the Norwegian adolescent version where a unidimensional model was kept.

The results support the continued use of the ESQ in CAMHS in the UK and Norway and significantly contribute to the literature on user satisfaction by adding evidence of a general satisfaction factor.