Personal Agency Support Questionnaire in Acute Psychiatric Inpatients: Development and Instrument Validation Study

Background Promoting personal agency may reduce perceived coercion and facilitate recovery in acute psychiatric care. However, no patient-reported tool currently exists to evaluate support for personal agency in this setting. Objective This study aimed to develop a patient-reported tool (the Personal Agency Support Questionnaire [PASQ]) to assess perceived support for personal agency and to evaluate its psychometric properties among inpatients in acute psychiatric wards. Methods We used a literature review and focus group interviews to generate a pool of items for the questionnaire, which was then refined using cognitive interviews and a pretest. We evaluated the construct validity, internal consistency, and test-retest reliability of the newly developed PASQ using a cross-sectional survey of inpatients in acute psychiatric wards. This study was conducted in collaboration with individuals who have lived experiences of mental illness. Results We analyzed data from 109 respondents (response rate: 109/178, 61.2%; mean age: 52.9, SD 16.9 years; women participants: 59/109, 54.1%; diagnosed with schizophrenia: 61/109, 56%). The 10-item PASQ demonstrated excellent convergent validity and acceptable discriminant validity. Internal consistency was high (Cronbach α=0.92), and test-retest reliability was moderate (intraclass correlation coefficient 0.68). Conclusions This PASQ is a valuable tool for assessing personal agency support in acute psychiatric wards, demonstrating promise for both clinical use in acute psychiatric wards and clinical research.