Spear Jon, Chawla Sudarshan, O'Reilly Maria, Rock Daniel
Peel and Rockingham-Kwinana Mental Health Service for Older People, PO Box 288, Goddard Street, Rockingham, Perth, Western Australia 6169, Australia.
Int J Geriatr Psychiatry. 2002 Mar;17(3):226-30. doi: 10.1002/gps.592.
A clinical indicator should demonstrate clinically meaningful change, be relevant, allow comparisons between services, be acceptable to clinicians, and have acceptable validity, reliability and sensitivity to change. The HoNOS 65+ has been suggested as a clinical outcome indicator. The sensitivity to change of the HoNOS 65+ is not known.
This is a prospective study using routine clinical data. A pilot cohort (n = 42) was used to measure the concurrent validity of the HoNOS 65+ with the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15) and Brief Agitation Rating Scale (BARS). The main cohort of 245 consecutive referrals to a community mental health service for older adults was used to assess sensitivity to change against the CIBIC+.
The HoNOS 65+ was acceptable to case managers, most HoNOS 65+ items had excellent interrater reliability and the HoNOS 65+ had good concurrent validity. Changes in the HoNOS 65+ scores between assessment and discharge had a moderate, but significant correlation with CIBIC+ scores.
The HoNOS 65+ meets the criteria for a clinical outcome indicator for community mental health services for older people. The HoNOS 65+ is sensitive to change.
一项临床指标应显示出具有临床意义的变化，具有相关性，便于不同服务之间进行比较，为临床医生所接受，并且具有可接受的效度、信度和对变化的敏感性。有人建议将《老年人精神状态与营养状况评定量表（65岁及以上版）》（HoNOS 65+）作为一项临床结局指标。但HoNOS 65+对变化的敏感性尚不清楚。
这是一项使用常规临床数据的前瞻性研究。一个试点队列（n = 42）用于测量HoNOS 65+与简易精神状态检查表（MMSE）、老年抑郁量表（GDS-15）和简明激越评定量表（BARS）的同时效度。245名连续转诊至社区老年人心理健康服务机构的主要队列用于评估与临床印象变化量表加量版（CIBIC+）相比的变化敏感性。
HoNOS 65+为个案管理员所接受，大多数HoNOS 65+项目具有出色的评分者间信度，且HoNOS 65+具有良好的同时效度。评估与出院之间HoNOS 65+评分的变化与CIBIC+评分存在中度但显著的相关性。
HoNOS 65+符合老年社区心理健康服务临床结局指标的标准。HoNOS 65+对变化敏感。
