Abstract
Background: The importance of mental health services that support a recovery-oriented approach is increasingly recognized, and measures that evaluate this practice and promote change over time are needed. The INSPIRE measure is a 27-item questionnaire designed to assess service users' perceptions of the support received from health professionals in their personal recovery. This study aimed to validate the Portuguese version of INSPIRE and assess its psychometric properties as a measure of staff support for personal recovery. Methods: The questionnaire survey was conducted from October 2023 to February 2024. Service users completed the Portuguese version of INSPIRE, the Client Satisfaction Questionnaire (CSQ-8), and a demographic and clinical questionnaire. Internal consistency was assessed using Cronbach's alpha and McDonald's model-based Omega. Test-retest reliability was assessed through the intraclass correlation coefficient (ICC) and weighted kappa. Convergent validity was examined by assessing correlation with CSQ-8. Factor validity was evaluated using exploratory factor analysis (EFA), with confirmatory factor analysis (CFA) performed to test the fit of factor structures derived from the EFA. Results: The study included 165 participants from seven psychosocial rehabilitation units which primarily target persons with a severe mental illness. For test-retest evaluation, 52 participants completed the questionnaire a second time. Internal consistency was satisfactory across all subscales and dimensions of the Support subscale, except for the Identity domain, which had marginally acceptable values. INSPIRE demonstrated significant positive correlations with CSQ-8 scores, supporting its convergent validity. EFA identified five factors for the Support scale and one factor for the Relationship scale, explaining 62% and 59% of the cumulative variance, respectively. CFA confirmed a good model fit for the Relationship scale and all Support subscales, except for the Identity and Empowerment subscales. Conclusions: The Portuguese version of INSPIRE showed strong internal consistency, as well as convergent and factor validity. This validated instrument can be applied in research and clinical settings to assess staff support for personal recovery and promote recovery-oriented mental health practices. Clinical trial number: Not applicable.