Recovering Quality of Life (ReQoL): a new generic self-reported outcome measure for use with people experiencing mental health difficulties

Anju Devianee Keetharuth, John Brazier, Janice Connell, Jakob Bue Bjorner, Jill Carlton, Elizabeth Taylor Buck, Thomas Ricketts, Kirsty McKendrick, John Browne, Tim Croudace, Michael Barkham, Anju Devianee Keetharuth, John Brazier, Janice Connell, Jakob Bue Bjorner, Jill Carlton, Elizabeth Taylor Buck, Thomas Ricketts, Kirsty McKendrick, John Browne, Tim Croudace, Michael Barkham

Abstract

Background: Outcome measures for mental health services need to adopt a service-user recovery focus. Aims To develop and validate a 10- and 20-item self-report recovery-focused quality of life outcome measure named Recovering Quality of Life (ReQoL).

Method: Qualitative methods for item development and initial testing, and quantitative methods for item reduction and scale construction were used. Data from >6500 service users were factor analysed and item response theory models employed to inform item selection. The measures were tested for reliability, validity and responsiveness.

Results: ReQoL-10 and ReQoL-20 contain positively and negatively worded items covering seven themes: activity, hope, belonging and relationships, self-perception, well-being, autonomy, and physical health. Both versions achieved acceptable internal consistency, test-retest reliability (>0.85), known-group differences, convergence with related measures, and were responsive over time (standardised response mean (SRM) > 0.4). They performed marginally better than the Short Warwick-Edinburgh Mental Well-being Scale and markedly better than the EQ-5D.

Conclusions: Both versions are appropriate for measuring service-user recovery-focused quality of life outcomes. Declaration of interest M.B. and J.Co. were members of the research group that developed the Clinical Outcomes in Routine Evaluation (CORE) outcome measures.

Figures

Fig. 1
Fig. 1
Development of the Recovering Quality of Life (ReQoL).

References

    1. Williams J, Leamy M, Bird V, Le Boutillier C, Norton S, Pesola F, Slade M. Development and evaluation of the INSPIRE measure of staff support for personal recovery. Soc Psych Epid 2015; 50: 777–86.
    1. Shepherd G, Boardman J, Rinaldi M, Roberts G. Supporting Recovery in Mental Health Services: Quality and Outcomes. Implementing Recovery Through Organisational Change; 2014.
    1. Slade M, Longden E. Empirical evidence about recovery and mental health. BMC Psychiatry 2015; 15: 285.
    1. Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry 2011; 199: 445–52.
    1. Connell J, O'Cathain A, Brazier J. Measuring quality of life in mental health: are we asking the right questions? Soc Sci Med 2014; 120: 12–20.
    1. Brazier J, Connell J, Papaioannou D, Mukuria C, Mulhern B, Peasgood T, et al. A systematic review, psychometric analysis and qualitative assessment of generic preference-based measures of health in mental health populations and the estimation of mapping functions from widely used specific measures. Health Technol Assess 2014; 18: 34.
    1. Connell J, Brazier J, O'Cathain A, Lloyd-Jones M, Paisley S. Quality of life of people with mental health problems: a synthesis of qualitative research. Health Qual Life Outcomes 2012; 120: 12–20.
    1. Brazier J. Is the EQ–5D fit for purpose in mental health? Br J Psychiatry 2010; 197: 348–9.
    1. Saarni SI, Viertiö S, Perälä J, Koskinen S, Lönnqvist J, Suvisaari J. Quality of life of people with schizophrenia, bipolar disorder and other psychotic disorders. Br J Psychiatry 2010; 197: 386–94.
    1. Stewart-Brown S, Tennant A, Tennant R, Platt S, Parkinson J, Weich S. Internal construct validity of the Warwick-Edinburgh mental well-being scale (WEMWBS): a Rasch analysis using data from the Scottish health education population survey. Health Qual Life Outcomes 2009; 7: 1.
    1. Tennant R, Hiller L, Fishwick R, Platt S, Joseph S, Weich S, et al. The Warwick-Edinburgh mental well-being scale (WEMWBS): development and UK validation. Health Qual Life Outcomes 2007; 5: 1.
    1. National Institute for Health and Care Excellence. Guide to the Methods of Technology Appraisal 2013. NICE, 2013.
    1. Mulhern B, Mukuria C, Barkham M, Knapp M, Byford S, Soeteman D, et al. Using generic preference-based measures in mental health: psychometric validity of the EQ-5D and SF-6D. Br J Psychiatry 2014; 205: 236–43.
    1. Papaioannou D, Brazier J, Parry G. How valid and responsive are generic health status measures, such as EQ-5D and SF-36, in schizophrenia? A systematic review. Value Health 2011; 14: 907–20.
    1. Barton GR, Hodgekins J, Mugford M, Jones PB, Croudace T, Fowler D. Measuring the benefits of treatment for psychosis: validity and responsiveness of the EQ–5D. Br J Psychiatry 2009; 195: 170–7.
    1. Papaioannou D, Brazier J, Parry G. How to measure quality of life for cost-effectiveness analyses of personality disorders: a systematic review. J Pers Disord 2013; 27: 383.
    1. US Department of Health and Human Services Food and Drug Administration. Guidance for Industry: Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims. US Department of Health and Human Services Food and Drug Administration, 2009.
    1. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 2010; 19: 539–49.
    1. Rose D, Evans J, Sweeney A, Wykes T. A model for developing outcome measures from the perspectives of mental health service users. Int Rev Psychiatry 2011; 23: 41–6.
    1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9. J Gen Intern Med 2001; 16: 606–13.
    1. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166: 1092–7.
    1. Department of Health. IAPT Three-Year Report: The First Million Patients. Improving Access to Psychological Therapies; 2012.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (5th edn) (DSM-5). APA, 2013.
    1. Barkham M, Bewick B, Mullin T, Gilbody S, Connell J, Cahill J, et al. The CORE-10: a short measure of psychological distress for routine use in the psychological therapies. Couns Psychother Res 2013; 13: 3–13.
    1. Barkham M, Margison F, Leach C, Lucock M, Mellor-Clark J, Evans C, et al. Service profiling and outcomes benchmarking using the CORE-OM: toward practice-based evidence in the psychological therapies. J Consult Clin Psychol 2001; 69: 184.
    1. Evans C, Connell J, Barkham M, Margison F, McGrath G, Mellor-Clark J, et al. Towards a standardised brief outcome measure: psychometric properties and utility of the CORE—OM. Br J Psychiatry 2002; 180: 51–60.
    1. Streiner DL, Norman GR. Health Measurement Scales: A Practical Guide to their Development and Use. Oxford Medical Publications, 1989.
    1. Keetharuth AD, Brazier J, Connell J, Carlton J, Taylor Buck E, Ricketts T, et al. Development and Validation of the Recovering Quality of Life (ReQoL) Outcome Measures. EEPRU Technical Research Report 050. Policy Research Unit in Economic Evaluation of Health and Care Interventions, Universities of Sheffield and York, 2017. ().
    1. Conway K, Acquadro C, Patrick DL. Usefulness of translatability assessment: results from a retrospective study. Qual Life Res 2014; 23: 1199–210.
    1. Muthen LK, Muthen BO. Mplus User's Guide (7th edn). Muthen & Muthen; 1998–2015.
    1. Samejima F. Estimation of latent ability using a response pattern of graded scores. Psychometric Monograph Suppl 1969; 34: 100–14.
    1. Orlando M., Thissen D. Likelihood-based item fit indices for dichotomous item response theory models. Appl Psych Meas 2000; 24: 50–64.
    1. Cai L, Thissen D, du Toit S. IRTPRO for Windows. Scientific Software International, 2011.
    1. Zumbo BD. A Handbook on the Theory and Methods of Differential Item Functioning (DIF). National Defense Headquarters, 1999.
    1. Nagelkerke NJ. A note on a general definition of the coefficient of determination. Biometrika 1991; 78: 691–2.
    1. Bock RD, Aitkin M. Marginal maximum likelihood estimation of item parameters: application of an EM algorithm. Psychometrika 1981; 46: 443–59.
    1. Uebersax JS. Statistical modeling of expert ratings on medical treatment appropriateness. J Am Stat Assoc 1993; 88: 421–7.
    1. Fayers PM, Machin D. Quality of Life: The Assessment, Analysis and Interpretation of Patient – Reported Outcomes. John Wiley & Sons, 2013.
    1. Cohen J. Statistical Power Analysis for the Behavior Science. Lawrance Eribaum Association, 1988.
    1. World Health Organization. International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) Version for 2010. WHO, 2010. ().
    1. Crawford MJ, Robotham D, Thana L, Patterson S, Weaver T, Barber R, et al. Selecting outcome measures in mental health: the views of service users. J Ment Health 2011; 20: 336–46.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner