Article2005

Performance of Routine Outcome Measures in Adult Mental Health Care

Kathy Eagar · Tom Trauer · Graham W Mellsop

59 citations0/0 files storedAustralian & New Zealand Journal of Psychiatry

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Psychiatric care and mental health services Healthcare Decision-Making and Restraints Mental Health and Patient Involvement

Abstract

OBJECTIVE: To examine the performance of two widely used outcome measures in public adult mental health services. METHOD: As part of a larger study, clinical staff in eight New Zealand District Health Board areas collected consumer outcomes data for a period of 6 months. Among other measures, the Health of the Nation Outcome Scales (HoNOS) and Life Skills Profile (LSP-16) were completed at the start and end of episodes of care, as well as at 90-day reviews. RESULTS: The performance of these two measures was examined in relation to compliance with the data collection protocol, item completion rates, certain psychometric properties, the relationship between them and the relationship of each instrument to the age, sex, principal psychiatric diagnosis and legal status of the consumer. Compliance with the HoNOS was superior to the LSP-16, but the reverse was true for completion. The two instruments were strongly correlated, but not enough to suggest that one may substitute for the other. A five-subscale structure for the HoNOS was supported. Certain HoNOS subscales were associated with age, but the total score was not, and differences between the sexes were small. Some large diagnostic differences were observed on both instruments. All LSP-16 summary scores and all HoNOS summary scores apart from Depression were higher (worse) in involuntary episodes. Only one LSP-16 item, relating to work potential, was related to age and men generally scored higher (worse) than women. CONCLUSION: From a technical perspective, the HoNOS and LSP-16 appear suitable for routine collection. New Zealand has adopted the HoNOS for routine use but not the LSP-16 because of local concerns about its appropriateness and acceptability. The clinician-rated measures reported here need to be complemented by both consumer-rated and family/carer measures.

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References

1990Comparative fit indexes in structural models.1998Health of the Nation Outcome Scales (HoNOS)2002Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE–OM 1999Health of the Nation Outcome Scales 2002What Outcomes to Measure in Routine Mental Health Services, and How to Assess Them: A Systematic Review 2000The Reliability and Validity of the Health of the Nation Outcome Scales: Validation in Relation to Patient Derived Measures 1999The subscale structure of the Health of the Nation Outcome Scales (HoNOS)

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