In the past two decades, there has been a growing interest in the development of a more patient-centred approach to assessing treatment outcomes. This interest has resulted in the increasing use of patient-reported outcome measures (PROMs) in both clinical trials and usual clinical practice. To briefly discuss the paucity of efficacy and effectiveness studies in the field of mental health (exemplified by schizophrenia, depression and opioid dependence) that significantly incorporate the patient's perspective. The limited concordance between the perspectives of patients and clinicians in outcome assessment is also addressed. Finally, we propose a new PROM classification system based on the degree to which these instruments incorporate the patient's perspective. PROMs may differ little from traditional instruments unless they truly incorporate the patient's perspective and not just the perspectives of clinicians and researchers. Efforts to develop new PROMs that provide a more patient-centred outcome assessment should use qualitative and participatory methods to capture and incorporate patient perspectives and values.

The capacity of natural settings to promote psychological restoration has attracted increasing research attention, especially with regards to the visual dimension. However, there is a need to extend these studies to urban settings, such as squares, parks or gardens, due to the global trend towards urbanisation, and to integrate the dimension of sound into landscape. Such was the main aim of this study, in which 53 participants assessed four public spaces in Vitoria-Gasteiz (Spain) as part of the CITI-SENSE Project (137 observations were used for analysis). A smartphone application was used to simultaneously collect objective and subjective data. The results show that at the end of the urban environmental experience, there was a statistically significant reduction in negative emotions and perceived stress, and a slight increase in positive emotions. Emotional restoration was mainly associated with prior emotional states, but also with global environmental comfort and acoustic comfort. The soundscape characteristics that contributed to greater emotional restoration and a reduction in perceived stress were pleasantness, calm, fun and naturalness. Therefore, in agreement with previous research, the findings of the present study indicate that besides contributing to the quietness of the urban environment, the urban soundscape can promote psychological restoration in users of these spaces.

Background: Satisfaction with services represents a key component of the user's perspective, and user satisfaction surveys are the most commonly used approach to evaluate the aforementioned perspective. The aim of this discursive paper is to provide a critical overview of user satisfaction surveys in addiction treatment and harm reduction services, with a particular focus on opioid maintenance treatment as a representative case. Methods: We carried out a selective critical review and analysis of the literature on user satisfaction surveys in addiction treatment and harm reduction services. Results: Most studies that have reported results of satisfaction surveys have found that the great majority of users (virtually all, in many cases) are highly satisfied with the services received. However, when these results are compared to the findings of studies that use different methodologies to explore the patient's perspective, the results are not as consistent as might be expected. It is not uncommon to find that “highly satisfied” patients report significant problems when mixed-methods studies are conducted. To understand this apparent contradiction, we explored two distinct (though not mutually exclusive) lines of reasoning, one of which concerns conceptual aspects and the other, methodological questions. Conclusion: User satisfaction surveys, as currently designed and carried out in addiction treatment and harm reduction services, do not significantly help to improve service quality. Therefore, most of the enthusiasm and naiveté with which satisfaction surveys are currently performed and interpreted – and rarely acted on in the case of nonoptimal results – should be avoided. A truly participatory approach to program evaluation is urgently needed to reshape and transform patient satisfaction surveys.