Recovery Assessment Scale - Domains and Stages (RAS-DS): Its feasibility and outcome measurement capacity

Nicola Hancock, Justin Newton Scanlan, Anne Honey, Anita C Bundy, Katrina O'Shea, Nicola Hancock, Justin Newton Scanlan, Anne Honey, Anita C Bundy, Katrina O'Shea

Abstract

Objective: A self-report instrument of mental health recovery is needed both to facilitate collaborative, recovery-oriented practice and measure recovery-focused outcomes. The Recovery Assessment Scale - Domains and Stages (RAS-DS) has been developed to simultaneously fulfill these goals. The aim of this study was to test the feasibility and measurement properties of the RAS-DS.

Method: Feasibility was examined by 58 consumer-staff pairs volunteering from 3 non-government organisations. Consumers completed the RAS-DS, discussed it with staff, and then both completed Usefulness Questionnaires. The psychometric properties were examined using Rasch analysis with the data from these consumer participants and from additional participants recruited from two Partners in Recovery programs (N=324).

Results: Over 70% of consumers reported taking 15 minutes or less to complete the RAS-DS and rated the instrument as easy or very easy to use. Qualitative data from both consumers and staff indicated that, for most, the RAS-DS was an easy to use, meaningful resource that facilitated shared understandings and collaborative goal setting. However, for a very small number of consumers, the instrument was too confronting and hard to use. Rasch analysis demonstrated evidence for excellent internal reliability and validity. Raw scores were highly correlated with Rasch-generated overall scores and thus no transformation is required, easing use for clinicians. Preliminary evidence for sensitivity to change was demonstrated.

Conclusions: The results provide evidence of the feasibility and psychometric strengths of the RAS-DS. Although further research is required, the RAS-DS shows promise as a potential addition to the national suite of routine outcome measures.

Keywords: Measure; feasibility; instrument development; mental illness; recovery.

Conflict of interest statement

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

© The Royal Australian and New Zealand College of Psychiatrists 2014.

Figures

Figure 1.
Figure 1.
Hierarchy of People and Items. M = mean, S = 1 standard deviation, T = 2 standard deviations, # refers to 3 participants, . refers to 1 or 2 participants.

References

    1. Amering M, Schmolke M. (2009) Recovery in mental health: reshaping scientific and clinical responsibilities. West Sussex: John Wiley & Sons.
    1. Andresen R, Caputi P, Oades L. (2006) The Stages of Recovery Instrument: Development of a measure of recovery from serious mental illness. Australian and New Zealand Journal of Psychiatry 40: 972–980.
    1. Andresen R, Caputi P, Oades L. (2010) Do clinical outcome measures assess consumer-defined recovery? Psychiatry Research 177: 309–317.
    1. Andrews G, Page AC. (2005) Outcome measurement, outcome management and monitoring. Australian and New Zealand Journal of Psychiatry 39: 649–651.
    1. Andrews G, Slade T. (2001) Interpreting scores on the Kessler psychological distress scale (K10). Australian and New Zealand Journal of Public Health 25: 494–497.
    1. Anthony W. (1993) Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal 16: 11–23.
    1. Australian Health Ministers’ Advisory Council’s National Mental Health Working Group (2009) 4th National Mental Health Plan: An agenda for collaborative government action in mental health 2009–2014.
    1. Baghaei P. (2008) The Rasch model as a construct validation tool. Rasch Measurement Transactions 22: 1145–1146.
    1. Bird V, Leamy M, Tew J, Le Boutillier C, Williams J, Slade M. (2014). Fit for purpose? Validation of a conceptual framework for personal recovery with current mental health consumers. Australian and New Zealand Journal of Psychiatry 48: 644–653.
    1. Bond TG, Fox CM. (2007) Applying the Rasch model: Fundamental measurement in the human sciences, Mahwah, NJ: Lawrence Earlbaum.
    1. Burgess P, Coombs T, Clarke A, et al. (2012) Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN). International Journal of Mental Health Systems 6: 4.
    1. Burgess P, Pirkis J, Coombs T, et al. (2011) Assessing the value of existing recovery measures for routine use in Australian mental health services. Australian and New Zealand Journal of Psychiatry 45: 267–280.
    1. Charmaz K. (2014) Constructing grounded theory (2nd ed). London: SAGE.
    1. Coombs T. (2005) Australian Mental Health Outcomes and Classification Network: Behaviour and Symptom Identification Scale (BASIS) - 32 Training Manual NSW Institute of Psychiatry.
    1. Corrigan P, Salzer M, Ralph RO. (2004) Examining the factor structure of the recovery assessment scale. Schizophrenia Bulletin 30: 1035–1041.
    1. Davidson L, O’Connell M, Tondora J, et al. (2006) The top ten concerns about recovery encountered in mental health system transformation. Psychiatric Services 57: 640–645.
    1. Davidson L, O’Connell MJ, Tondora J, et al. (2005) Recovery in Serious Mental Illness: A New Wine or Just a New Bottle? Professional Psychology - Research & Practice 36: 480–487.
    1. Department of Health (2007) Commissioning framework for health and well-being. Available at: .
    1. Dickens G, Weleminsky J, Onifade Y, et al. (2012) Recovery Star: validating user recovery. The Psychiatrist 36: 45–50.
    1. Fisher WP. (2007) Rating scale instrument quality criteria. Rasch Measurement Transactions 21:1095.
    1. Hancock N, Bundy A, Honey A, et al. (2012a) Measuring the Later Stages of the Recovery Journey: Insights Gained from Clubhouse Members. Community Mental Health Journal: 1–8.
    1. Hancock N, Bundy A, Honey A, et al. (2011) Improving measurement properties of the Recovery Assessment Scale with Rasch analysis. American Journal of Occupational Therapy 65: e77-e85.
    1. Hancock N, Bundy A, Tamsett S, et al. (2012b) Participation of mental health consumers in research: Training addressed and reliability assessed. Australian Occupational Therapy Journal 59: 218–224.
    1. Happell B. (2008) Determining the effectiveness of mental health services from a consumer perspective: Part 1: Enhancing recovery. International journal of mental health nursing 17: 116–122.
    1. Kightley M, Einfeld S, Hancock N. (2010) Routine outcome measurement in mental health: feasibility for examining effectiveness of an NGO. Australasian Psychiatry 18: 167–169.
    1. Killaspy H, White S, Taylor TL, et al. (2012) Psychometric properties of the Mental Health Recovery Star. The British Journal of Psychiatry 201: 65–70.
    1. Lakeman R. (2004) Standardized routine outcome measurement: Pot holes in the road to recovery. International Journal of Mental Health Nursing 13: 210–215.
    1. Linacre J. (2014) Winsteps® Rasch measurement computer program. Beaverton, Oregon: .
    1. Linacre JM. (1998) Do correlations prove scores linear? Rasch Measurement Transactions 12: 605–606.
    1. Patterson P, Matthey S, Baker M. (2006) Using mental health outcome measures in everyday clinical practice. Australasian Psychiatry 14: 133–136.
    1. Piat M, Lal S. (2012) Service providers’ experiences and perspectives on recovery-oriented mental health system reform. Psychiatric Rehabilitation Journal 35: 289.
    1. Piat M, Sabetti J, Bloom D. (2010) The transformation of mental health services to a recovery-orientated system of care: Canadian decision maker perspectives. International Journal of Social Psychiatry 56: 168–177.
    1. Pirkis J, Callaly T. (2010) Mental health outcome measurement in Australia. In: Trauer T (ed). Outcome Measurement in Mental Health: Theory and Practice. Cambridge: Cambridge University Press, pp.15–25.
    1. Shanks V, Williams J, Leamy M, et al. (2013) Measures of personal recovery: a systematic review. Psychiatric Services 64: 974–980.
    1. Sklar M, Groessl EJ, O’Connell M, et al. (2013) Instruments for measuring mental health recovery: a systematic review. Clinical Psychology Review 33: 1082–1095.
    1. Slade M, Amering M, Farkas M, et al. (2014) Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems. World Psychiatry 13: 12–20.
    1. Slade M, Thornicroft G, Glover G. (1999) The feasibility of routine outcome measures in mental health. Social psychiatry and psychiatric epidemiology 34: 243–249.
    1. Thornicroft G, Slade M. (2014) New trends in assessing the outcomes of mental health interventions. World Psychiatry 13: 118–124.
    1. Trauer T, Callaly T, Herrman H. (2009) Attitudes of mental health staff to routine outcome measurement. Journal of Mental Health 18: 288–297.
    1. Trauer T, Gill L, Pedwell G, et al. (2006) Routine outcome measurement in public mental health—what do clinicians think? Australian Health Review 30: 144–147.
    1. Wing J, Beevor A, Curtis R, et al. (1998) Health of the Nation Outcome Scales (HoNOS). Research and development. The British Journal of Psychiatry 172: 11–18.
    1. Wright BD, Masters GN. (2002) Number of person or item strata (4G11)/3. Rasch Measurement Transactions 16: 888.
    1. Wright BD, Stone M. (1999) Measurement essentials. Wilmington, Delaware: Wide Range, Inc.
    1. Wright BD, Linacre JM. (1994) Reasonable mean square fit values. Rasch Measurement Transactions 8: 370.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere