Skip to main content Accessibility help
×
Home

Validation of the Health of the Nation Outcome Scales

  • Paul Bebbington (a1), Terry Brugha (a2), Trevor Hill (a2), Lucy Marsden (a1) and Suzanne Window (a2)...

Abstract

Background

The Health of the Nation Outcome Scales (HoNOS) were developed to assess the outcome of severe mental disorders in relation to the Health of the Nation Strategy for England.

Aims

To validate the HoNOS.

Method

One hundred and fifteen patients were assessed by key workers using HoNOS, and by research workers using SCAN, SBS, and SRPS, and completing HoNOS in the light of this additional material. These assessments were repeated after 6 weeks.

Results

The performance of HoNOS in the hands of key workers was generally poor, in relation both to the research workers' rating of HoNOS and to the criterion instruments. Performance was particularly poor when the change in scores was used as a measure of outcome.

Conclusions

There are serious problems in using HoNOS as a routine measure of clinical status in busy psychiatric services. Its performance is probably related to the training and experience of key workers. Sequential ratings are not a good method for assessing outcome. Managers and planners should be cautious in adopting HoNOS, but it is worthy of consideration in developing a suite of locally agreed outcome measures.

Copyright

Corresponding author

Professor Paul Bebbington, Royal Free and University College Medical School, Department of Psychiatry and Behavioural Sciences, Archway Campus, Whittington Hospital, Highgate Hill, London N19 5NF

Footnotes

Hide All

Declaration of interest

This study was entirely funded by the Department of Health.

Footnotes

References

Hide All
Cohen, J. A. (1960) A coefficient of agreement of nominal scale. Education and Psychological Measurement, 20, 3746.
Department of Health (1991) The Health of the Nation: a strategy for England. London: HMSO.
Hurry, J. & Sturt, E. (1981) Social performance in a population sample: relation to psychiatric symptoms. In What is a Case? The Problem of Definition in Psychiatric Community Surveys (eds Bebbington, P. E., Robins, L. & Wing, J. K.), pp. 202213. London: Grant Maclntyre.
Hurry, J., Sturt, E., Bebbington, P., et al (1983) Sociodemographic association with social disablement in a community sample. Social Psychiatry, 18, 113121.
Hurry, J., Bebbington, P. E. & Tennant, C. (1987) Psychiatric symptoms and social disablement as determinants of illness behaviour. Australian and New Zealand Journal of Psychiatry, 21, 6874.
NHS Executive (1996) Planning and Priorities Guidance for the NHS, 1997/8. Leeds: Department of Health.
Wheatley, S. (1998) The Leicester Housing Schedule: background and questionnaire format. Working paper: Section of Social & Epidemiological Psychiatry, Dept of Psychiatry, University of Leicester, Leicester.
Wing, J. K., Babor, T., Brugha, T., et al (1990) SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry, 47, 589593.
Wing, J. K., 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.
Wing, J. K., Beevor, A. S., Curtis, R. H., et al (1998) Health of the Nation Outcome Scales (HoNOS). Research and development. British Journal of Psychiatry, 172, 1118.
World Health Organization (1992a) SCAN Schedules for Clinical Assessment in Neuropsychiatry. Geneva: WHO.
World Health Organization (1992b) The ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO.
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, 111.
Wykes, T. & Hurry, J. (1991) Social behaviour and psychiatric disorders. In Social Psychiatry: Theory, Methodology and Practice (ed. Bebbington, P. E.). New Brunswick, NJ: Transaction.

Related content

Powered by UNSILO

Validation of the Health of the Nation Outcome Scales

  • Paul Bebbington (a1), Terry Brugha (a2), Trevor Hill (a2), Lucy Marsden (a1) and Suzanne Window (a2)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.