McClelland R, Trimble P, Fox M L, Stevenson M R, Bell B
Department of Mental Health, Queen's University of Belfast, UK.
Qual Health Care. 2000 Jun;9(2):98-105. doi: 10.1136/qhc.9.2.98.
To clarify the usefulness, acceptability, sensitivity, and validity of version 4 of the Health of the Nation Outcome Scale (HoNOS), a scale developed to meet the requirement for a clinically acceptable outcome scale for routine use in mental illness services.
Patients with a range of mental illnesses were rated on the HoNOS at the beginning and end of an episode by interviews with mental health professionals.
934 patients from eight diagnostic categories were rated by 129 mental health professionals at 17 sites; 250 were also rated on a range of comparison scales.
Comparison of patients' scores at the beginning and end of an episode using individual item scores, dimensional subscores, and the total score.
HoNOS scores decreased by almost 50% between the beginning and end of episodes. They varied with the severity of the setting and discriminant analysis showed that the HoNOS had a moderate level of discriminatory power. Correlation analysis showed acceptable levels of agreement with independent scales, although the accuracy of ratings of some items at the beginning of an episode was affected by information deficits.
The findings indicate that HoNOS is sensitive to change across time and to differences in illness type and severity, and has a sufficient degree of both construct and criterion related validity to fulfil the requirements of a mental health outcome scale for routine use in clinical settings.
阐明《国家健康结果量表》（HoNOS）第4版的实用性、可接受性、敏感性和有效性。该量表是为满足精神疾病服务中常规使用的临床可接受结果量表的要求而制定的。
通过心理健康专业人员的访谈，对一系列精神疾病患者在病程开始和结束时进行HoNOS评分。
来自八个诊断类别的934名患者由17个地点的129名心理健康专业人员进行评分；250名患者还接受了一系列比较量表的评分。
使用单个项目得分、维度子得分和总分比较患者在病程开始和结束时的得分。
在病程开始和结束之间，HoNOS得分下降了近50%。得分因病情严重程度而异，判别分析表明HoNOS具有中等水平的判别能力。相关分析显示与独立量表的一致性水平可接受，尽管病程开始时某些项目评分的准确性受到信息不足的影响。
研究结果表明，HoNOS对时间变化以及疾病类型和严重程度的差异敏感，并且具有足够程度的结构效度和效标效度，能够满足临床环境中常规使用的心理健康结果量表的要求。
