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Validation of the Health of the Nation Outcome Scales

Published online by Cambridge University Press:  03 January 2018

Paul Bebbington*
Affiliation:
University College London Medical School, Department of Psychiatry and Behavioural Sciences
Terry Brugha
Affiliation:
University of Leicester Section of Social and Epidemiological Psychiatry, Leicester General Hospital, UK
Trevor Hill
Affiliation:
University of Leicester Section of Social and Epidemiological Psychiatry, Leicester General Hospital, UK
Lucy Marsden
Affiliation:
University College London Medical School, Department of Psychiatry and Behavioural Sciences
Suzanne Window
Affiliation:
University of Leicester Section of Social and Epidemiological Psychiatry, Leicester General Hospital, UK
*
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

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.

Type
HoNOS Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

This study was entirely funded by the Department of Health.

References

Cohen, J. A. (1960) A coefficient of agreement of nominal scale. Education and Psychological Measurement, 20, 3746.Google Scholar
Department of Health (1991) The Health of the Nation: a strategy for England. London: HMSO.Google Scholar
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.Google Scholar
Hurry, J., Sturt, E., Bebbington, P., et al (1983) Sociodemographic association with social disablement in a community sample. Social Psychiatry, 18, 113121.Google Scholar
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.Google Scholar
NHS Executive (1996) Planning and Priorities Guidance for the NHS, 1997/8. Leeds: Department of Health.Google Scholar
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.Google Scholar
Wing, J. K., Babor, T., Brugha, T., et al (1990) SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry, 47, 589593.Google Scholar
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.Google Scholar
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.Google Scholar
World Health Organization (1992a) SCAN Schedules for Clinical Assessment in Neuropsychiatry. Geneva: WHO.Google Scholar
World Health Organization (1992b) The ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines. 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, 111.Google Scholar
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.Google Scholar
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