Validity and reliability of the Japanese version of the admission experience survey in individuals with mental illness

Developing effective strategies to reduce perceived coercion during psychiatric hospitalization requires systematic monitoring of patients' experiences. The Admission Experience Survey (AES) evaluates patients' perceptions of the psychiatric hospitalization process. This study aimed to develop a Japanese version of the AES (AES-J) and assess its reliability and validity in individuals with mental illness. We conducted a cross-sectional survey of individuals with mental illnesses who had experienced psychiatric hospitalization in Japan. The AES-J was developed and evaluated using confirmatory factor analysis (CFA) and multi-group CFA. Spearman's correlation coefficients were calculated to assess the validity against inpatient care experience, patient satisfaction, and mental distress. Cronbach's alpha and intraclass correlation coefficients (ICC) were computed to determine internal consistency and test-retest reliability. A total of 135 participants were enrolled, and 50 completed the AES-J twice. CFA supported the original three-factor structure (Perceived Coercion, Negative Pressures, and Process Exclusion). The strict invariance model demonstrated comparable goodness-of-fit indices to the scalar invariance model. Perceived Coercion and Process Exclusion were significantly correlated with inpatient care experience and patient satisfaction. Negative Pressures was correlated considerably with inpatient care experience but not patient satisfaction. Mental distress did not demonstrate significant correlations with any of the three subscales. Cronbach's alphas were 0.82-0.88, and ICCs were 0.77-0.89. This AES-J showed acceptable validity and reliability for assessing admission experiences among individuals with mental illness in Japan.