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.