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Health of the Nation Outcome Scales

Results of the Victorian field trial

Published online by Cambridge University Press:  03 January 2018

Tom Trauer ,
Tom Callaly ,
Paul Hantz ,
John Little ,
Robert B. Shields  and
Jenny Smith
Tom Trauer*
Affiliation:
The Alfred Hospital, and Department of Psychological Medicine, Monash University, Victoria
Tom Callaly
Affiliation:
Division of Psychiatry, Geelong Hospital, Victoria
Paul Hantz
Affiliation:
Division of Psychiatry, Geelong Hospital, Victoria
John Little
Affiliation:
Grampians Psychiatric Service, Victoria
Robert B. Shields
Affiliation:
Central East Mental Health Service, Victoria
Jenny Smith
Affiliation:
Inner West Area Mental Health Service, The Royal Melbourne Hospital, Victoria, Australia
*
Dr Tom Trauer, Department of Psychological Medicine, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia, Tel: 61 39550 1479; fax: 61 39550 1449; e - mail: trauer@vaxc.cc.monash.edu.au
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Abstract

Background

In Victoria, Australia, systematic assessment of outcomes in mental health services are being instituted.

Aims

To carry out a large-scale field trial of the Health of the Nation Outcome Scales (HoNOS).

Method

2137 clients were rated by mental health workers on the HoNOS, and about half were rated again within a few months.

Results

While interrater reliability of the total score was satisfactory, that of some individual items was unacceptable. Significant associations with age and gender were found, and clients with non-psychotic disorders obtained higher (i.e. worse) ratings than those with psychotic disorders. There were relationships between service use and HoNOS total score. For the group as a whole, total scores had not changed at the second rating, but admissions and discharges were associated with increases and decreases in total score. Among clients in the community, there was no relationship between change in HoNOS total score and frequency of contacts.

Conclusions

Certain items, notably 11 and 12, were unreliable. The absence of evidence of sensitivity to change may be due to the short re-rating interval, little real change in the clients, or the characteristics of the scale itself.

Type
HoNOS Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 5 , May 1999 , pp. 380 - 388
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

None.

References

Allan, S. & McGonagle, I. (1997) A comparison of HoNOS with the Social Behaviour Schedule in three settings. Journal of Mental Health, 4, 117–124.Google Scholar
Andrews, G., Peters, L. & Teesson, M. (1994) The Measurement of Consumer Outcome in Mental Health. Canberra: Australian Government Publishing Service.Google Scholar
Australian Health Ministers (1992) National Mental Health Policy. Canberra: Australian Government Publishing Service.Google Scholar
Bachrach, L. L. (1982) Assessment of outcomes in community support systems: results, problems and limitations. Schizophrenia Bulletin, 8, 39–61.CrossRefGoogle ScholarPubMed
Boot, B., Hall, W. & Andrews, G. (1997) Disability, outcome and casemix in acute psychiatric inpatient units. British Journal of Psychiatry, 171, 242–246.CrossRefGoogle Scholar
Ciario, J. A. (1982) Accountability revisited: the arrival of client outcome evaluation. Evaluation and Program Planning, 5, 31–36.CrossRefGoogle Scholar
Dickerson, F. B. (1997) Assessing clinical outcomes: the community functioning of persons with serious mental illness. Psychiatric Services, 48, 897–902.Google ScholarPubMed
Epstein, A. M. (1990) The outcomes movement – will it get us where we want to go? New England Journal of Medicine, 323, 266–270.CrossRefGoogle ScholarPubMed
Fleiss, J. L. & Cohen, J. (1973) The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability. Educational and Psychological Measurement, 33, 613–619.CrossRefGoogle Scholar
Goldney, R. D., Fisher, L. J., Waimsiey, S. J., et al (1996) A pilot study of the Health of the Nation Outcome Scale as a measurement of outcome in a private psychiatric hospital. Australasian Psychiatry, 4, 319–321.CrossRefGoogle Scholar
Goldney, R. D., Fisher, L. J. & Waimsiey, S. J. (1998) The Health of the Nation Outcome Scales in psychiatric hospitalization: a multicentre study examining outcome and prediction of length of stay. Australian and New Zealand Journal of Psychiatry, 32, 199–205.CrossRefGoogle ScholarPubMed
Gordon, R. E., Plutzkey, M., Gordon, K. K., et al (1988) Using the Axis V scale to evaluate therapeutic outcome of psychiatric treatment. Canadian Journal of Psychiatry, 33, 194–196.CrossRefGoogle ScholarPubMed
Green, R. S. & Graceiy, E. J. (1987) Selecting a rating scale for evaluating services to the chronically mentally ill. Community Mental Health Journal, 23, 91–102.CrossRefGoogle Scholar
Hafner, H. & an der Heiden, W. (1991) Evaluating effectiveness and cost of community care for schizophrenic patients. Schizophrenia Bulletin, 17. 441–451.CrossRefGoogle ScholarPubMed
Haggard, E. A. (1958) Intraclass Correlation and the Analysis of Variance. New York: Dryden Press.Google Scholar
Hunter, C. E. & McFarlane, A. C. (1994) DRGs and Australian Psychiatry. Australian and New Zealand journal of Psychiatry, 28, 114–120.CrossRefGoogle ScholarPubMed
Kaplan, R. M. (1990) Behavior as the central outcome in health care. American Psychologist, 45, 1211–1220.CrossRefGoogle ScholarPubMed
Landis, J. R. & Koch, G. G. (1977) The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.CrossRefGoogle ScholarPubMed
McCrone, P. (1995) Predicting mental health service use: diagnosis based systems and alternatives. Journal of Mental Health, 1, 31–40.CrossRefGoogle Scholar
Mirin, S. M. & Namerow, M. J. (1991) Why study treatment outcome? Hospital and Community Psychiatry, 42, 1007–1013.Google ScholarPubMed
Morton, J. R. & Buckingham, B. (1994) Service Options for Clients with Severe or borderline Personality Disorders. Consultants Report. Melbourne: Psychiatric Services Branch, Victorian Department of Human Services.Google Scholar
Newman, F. L. (1980) Global scales: strengths, uses and problems of global scales as an evaluation instrument. Evaluation and Program Planning, 3, 257–268.CrossRefGoogle ScholarPubMed
Ogles, B. M. & Lunnen, K. M. (1996) Assessing outcome in practice. Journal of Mental Health, 5, 35–46.CrossRefGoogle Scholar
Rosenblatt, A. & Attkisson, C. C. (1993) Assessing outcomes for sufferers of severe mental disorder: a conceptual framework and review. Evaluation and Program Planning, 16, 47–363.CrossRefGoogle Scholar
Ruggeri, M. & Tansella, M. (1996) Individual patient outcomes. In Mental Health Service Evaluation (eds Knudsen, H. C. & Thornicroft, G.). Cambridge: Cambridge University Press.Google Scholar
Shrout, P. E. & Fleiss, J. L. (1979) Intraclass correlations: uses in assessing rater reliability. Psychological bulletin, 86, 420–428.CrossRefGoogle ScholarPubMed
Ventura, J., Green, M. F., Shaner, A. & Liberman, R. P. (1993) Training and quality assurance with the Brief Psychiatric Rating Scale: ‘the drift busters’. International Journal of Methods in Psychiatric Research, 3, 221–244.Google Scholar
Wing, J. (1994) Health of the Nation Outcome Scales HoNOS Field Trials. London: Royal College of Psychiatrists' Research Unit.Google Scholar
Wing, J., Curtis, R. H. & Beevor, A. S. (1996) HoNOS: Health of the Nation Outcome Scales: Report on Research and Development July 1993-December 1995. London: Royal College of Psychiatrists Research Unit.Google Scholar
Wing, J., Beevor, A. S., Curtis, R. H., et al (1998) Health of the Nation Outcome Scales (HoNOS): research and development. British Journal of Psychiatry, 172, 11–18.CrossRefGoogle ScholarPubMed
World Health Organization (1978) International Classification of Diseases (9th Revision) (ICD-9). Geneva: WHO.Google Scholar
Wykes, T. & Sturt, E. (1986) The measurement of social behaviour in psychiatric patients: An assessment of the reliability and validity of the SBS schedule. British Journal of Psychiatry, 148, 1–11.CrossRefGoogle ScholarPubMed
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