The Concurrent Validity and Sensitivity of Change of the German Version of the Health of the Nation Outcome Scales in a Psychiatric Inpatient Setting (original) (raw)
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International Journal of Methods in Psychiatric Research, 2010
The Health of the Nation Outcome Scales (HoNOS) is an internationally-established clinician-rating instrument for the differential assessment of the severity of patients with mental disorders. The aim of this study was to examine the validity of the German version of the HoNOS (HoNOS-D). Evaluation of validity, including factor validity, convergent and discriminant validity and sensitivity to change, was conducted on a large, virtually representative, clinical sample of patients with mental disorders in inpatient psychotherapy (Study 1, N = 3169). Additional assessment of criterion-based validity was completed using another clinical sample of patients with mental disorders (Study 2, N = 55). Although factor validity of the HoNOS-D and its total score could not be confirmed as expected, the majority of single items of the HoNOS-D proved to be valid in terms of convergent validity, criterion-based validity and sensitivity to change. Hence, single items, rather than the total score of the HoNOS-D, can be recommended for obtaining a picture of the impairment of patients with mental disorders in the clinical setting. Copyright © 2010 John Wiley & Sons, Ltd.
Validation of an outcome scale for use in adult psychiatric practice
Quality in health care : QHC, 2000
To clarify the usefulness, acceptability, sensitivity, and validity of version 4 of the Health of the Nation Outcome Scale (HoNOS), a scale developed to meet the requirement for a clinically acceptable outcome scale for routine use in mental illness services. Patients with a range of mental illnesses were rated on the HoNOS at the beginning and end of an episode by interviews with mental health professionals. 934 patients from eight diagnostic categories were rated by 129 mental health professionals at 17 sites; 250 were also rated on a range of comparison scales. Comparison of patients' scores at the beginning and end of an episode using individual item scores, dimensional subscores, and the total score. HoNOS scores decreased by almost 50% between the beginning and end of episodes. They varied with the severity of the setting and discriminant analysis showed that the HoNOS had a moderate level of discriminatory power. Correlation analysis showed acceptable levels of agreement ...
Validity of HoNOS in identifying frequently hospitalized patients with ICD-10 mental disorders
Acta Psychiatrica Scandinavica, 2006
Objective: To identify frequently hospitalized patients by using the outcome and severity measure Health of the Nation Outcome Scales (HoNOS) in combination with the International Classification of Diseases (ICD)-10 in patients consecutively admitted to a psychiatric hospital. Method: All full-time in-patients and all day-hospital patients were considered. Frequently hospitalized patients were defined as those with 10 or more hospitalizations. Results: The total HoNOS score at admission was found valid to discriminate between frequently and non-frequently hospitalized patients as well as in ranking the ICD-10 diagnosis by severity of symptoms and social problems. Frequently hospitalized patients were predominantly found within the diagnoses of schizophrenia and bipolar affective disorders. In these groups, high HoNOS scores were significantly associated with a longer stay in hospital. Improvement during hospitalization as measured by the HoNOS was significantly better for bipolar than for schizophrenic patients. Conclusion: HoNOS was found to be a clinically relevant supplement to ICD-10 in identifying frequently hospitalized patients.
Psychopathology, 2011
of patients with mental and behavioral disorders. Results: An analysis of the feasibility of the HoNOS-D showed a range of missing values between 1.3 and 4.5% for 11 of the 12 items. An item analysis showed that three items of the HoNOS-D are particularly positively skewed. In most instances, the individual items of the rating scale exhibited only slight correlations to each other. With regard to retest reliability, satisfactory intraclass correlations between 0.80 and 0.91 were seen for 9 of the 12 items. Conclusions: The authors of the original version of the HoNOS [Wing et al.: Br J Psychiatry 1998; 172: 11-18] primarily emphasized the feasibility of the instrument and the independence of the individual items and dimensions. The analysis of the missing values showed satisfactory results for feasibility. The intercorrelation matrix of the individual items also exhibited only few correlations 1 0.30. The retest reliability also proves to be satisfactory for the majority of the items. The narrow distribution of some of the items must be critically discussed in comparison to analyses of results in other countries (e.g. Great Britain) and other settings (e.g. inpatient psychiatric hospitals or outpatient psychotherapy).
Structured assessment of mental health status in psychogeriatrics: validity of the French HoNOS65+
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2007
To assess the reliability, validity, and feasibility of a French version of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+). Twenty mental health professionals completed the scale for 126 elderly patients. We assessed interrater reliability in inpatient and outpatient settings, together with construct and discriminant validity, as well as concurrent validity compared with several widely used clinical instruments. Excellent agreement among raters was observed in the outpatient subgroup (kappa range 0.77 to 1.00), whereas interrater reliability was modest in the inpatient subgroup (kappa values < 0.55). In cases where the patient-caregiver relationship lasted more than 1 month, the reliability of the scale improved. Construct validity analysis revealed no subscale structure. All items except "self-injury" displayed high concurrent validity (significant Spearman correlations with 8 other questionnaires). In terms of discriminant validity, the "co...
Clinical Psychology & Psychotherapy, 2010
Background: Monitoring psychotherapeutic progress requires valid and economic measures to detect change of clinical relevance. We addressed validity and sensitivity to change of the 'Klinisch Psychologisches Diagnosesystem 38' (KPD-38, Clinical Psychological Diagnosis System), an instrument for outcome monitoring and quality assurance. Methods: Data from an inpatient sample (n = 1.377) were used to investigate the concurrent validity, the sensitivity to change, and the criterion validity of the KPD-38 in comparison to the Outcome Questionnaire (OQ-45) and the Brief Symptom Inventory (BSI). Results: Sensitivity-specifi city analyses showed similar sensitivity and higher specifi city for the KPD-38 scales compared with the BSI and OQ total scores. Change rates on the KPD-38 distress scale (DIS) were found to be lower than on the BSI (KPD-38 DIS: 36.6%, GSI: 67.7%) and the OQ-45 (KPD-38 DIS: 44.3%, OQ tot: 57.1%) total scores. Concordance was low with the BSI ([κ = 0.24] and moderate with the OQ-45 [κ = 0.45]). Discussion: Implications for applications in the fi eld of outcome assessment and the challenge of further validation are discussed. The relation between sensitivity to change and criterion validity is highlighted.
The Psychiatric quarterly, 2017
The Health of the Nation Outcome Scale (HoNOS) (Lora et al. Epidemiol Psichiatr Soc 10(3):198-212, 2001) is widely used. However, clinicians have expressed concerns about its ability to describe severe mentally ill patients, as it does not consider some relevant clinical aspects. This study aims to develop and validate the HoNOS-Residential Facility (HoNOS-RF) in order to pursue a thorough assessment of patients admitted to psychiatric residential facilities (RFs). The final version of the HoNOS-RF was administered to 409 patients admitted to four RFs. Exploratory factor analysis, Cronbach' alpha (α), Intraclass Correlation Coefficients (ICC) were used to assess construct validity, internal consistency and reliability, respectively. Concurrent criterion validity was assessed through correlations with the Brief Psychiatric Rating Scale-Expanded Version (BPRS-E) (Roncone et al. Acta Psychiatric Scand 100(3):229-36, 1999), Personal and Social Performance Scale (PSP) (Morosini et al...
This article describes the current revision by the World Health Organization (WHO) of the International Classification of Diseases and Related Health Problems (ICD-10). ICD-10 is the basis for ICD-10-CM, which will be introduced in 2013 as the official U.S. system. U.S. psychologists will be required to use ICD-10-CM for all third-party billing and reporting, but are generally not familiar with the ICD or WHO’s role in global health classification. Although the U.S. lags behind other countries on the implementation of WHO’s international classification systems, psychologists and other health professionals will be affected by ICD-11, so it is important to understand its development. WHO views the current revision as an important opportunity to improve the clinical utility of the classification system for mental disorders. Serious problems with the clinical utility of both the ICD and the DSM are widely acknowledged. Clinical utility affects the daily lives of practitioners and is also a global public health issue. Most people with mental disorders worldwide receive no treatment. A diagnostic system with greater clinical utility can be a tool to improve identification and treatment, helping WHO member countries to reduce the disease burden of mental disorders. Consistent with this goal, WHO’s revision process is global, multilingual, and multidisciplinary and will produce different versions of the classification for clinical use, research, and primary care. A systematic program of studies being undertaken by WHO aimed at improving clinical utility is described.