The Relatives Experience Questionnaire for Acute Inpatient Child and Adolescence Mental Health Services (REQ-AICAMHS): reliability and validity following a Norwegian survey

Introduction: Adolescents with mental health disorders represent a vulnerable group with complex care needs, yet their and their relatives experiences in acute inpatient mental health services remain poorly understood. While patient-reported experience measures (PREMs) are increasingly recognized as essential for improving healthcare quality, validated instruments for child and adolescent mental health inpatient settings are lacking--particularly from the perspective of relatives, who are often deeply involved in care. Objective: This study aims to develop and psychometrically evaluate the Relatives Experience Questionnaire for Acute Inpatient Child and Adolescent Mental Health Services (REQ-AICAMHS), the first instrument designed to capture relatives experiences in Norwegian acute inpatient mental health units for adolescents. Methods: The REQ-AICAMHS will be developed using the Norwegian Institute of Public Healths (NIPH) standard methodology, including a literature review, expert consultation, qualitative interviews, and cognitive testing with relatives. Data will be collected digitally from relatives of all adolescents admitted to 17 acute inpatient child and adolescent mental health units across Norway. Descriptive statistics, exploratory factor analysis (EFA), and Item Response Theory (IRT) using the Generalized Partial Credit Model (GPCM) will be applied to assess data quality, factor structure, construct validity, and internal consistency. Open-ended responses will be analysed using both qualitative and machine learning methods to identify key themes and subdomains of experience. Results: Preliminary results will include descriptive statistics of respondents, item-level analysis (missing data, ceiling effects), factor loadings and reliability coefficients (Cronbachs alpha [≥]0.7), inter-item and scale correlations, construct validity testing, and IRT parameters (item discrimination and threshold estimates). Findings will inform the development of a shortened version of the questionnaire for broader implementation in quality improvement initiatives.