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临床结局测量评估消费者定义的康复吗?

Do clinical outcome measures assess consumer-defined recovery?

机构信息

Illawarra Institute for Mental Health, University of Wollongong, NSW, Australia.

出版信息

Psychiatry Res. 2010 May 30;177(3):309-17. doi: 10.1016/j.psychres.2010.02.013. Epub 2010 Mar 15.

Abstract

There is an international call for mental health services to become recovery-oriented, and also to use evidence-based practices. Addressing this call requires recovery-oriented measurement of outcomes and service evaluation. Mental health consumers view recovery as leading as meaningful life, and have criticised traditional clinical measures for being too disability-oriented. This study compares three measures of consumer-defined recovery from enduring mental illness: the Recovery Assessment Scale, the Mental Health Recovery Measure and the Self-Identified Stage of Recovery, with four conventional clinical measures. Correlational analyses supported the convergent validity of the recovery measures, although certain subscales were unrelated to each other. More importantly, little relationship was found between consumer-defined recovery and the clinical measures. Analyses of variance revealed that scores on the recovery measures increased across self-identified stage of recovery, but scores on most clinical measures did not improve consistently across stage of recovery. The findings demonstrate the qualitative difference between the two types of measures, supporting the claim by consumers that clinical measures do not assess important aspects of recovery. There is a need for further research and refinement of recovery measurement, including assessment of stages of recovery, with the aim of including such measures as an adjunct in routine clinical assessment, service evaluation and research.

摘要

国际上呼吁精神卫生服务向康复为导向转变,并采用基于证据的实践。要实现这一目标,需要对结果和服务进行以康复为导向的衡量。精神卫生服务使用者将康复视为过上有意义的生活,他们批评传统的临床衡量标准过于以残疾为导向。本研究比较了三种从持久的精神疾病中定义的消费者定义的康复衡量标准:康复评估量表、心理健康康复衡量标准和自我认同的康复阶段,以及四个传统的临床衡量标准。相关性分析支持康复衡量标准的收敛有效性,尽管某些分量表彼此之间没有关联。更重要的是,在消费者定义的康复和临床衡量标准之间发现的关系很少。方差分析显示,在自我认同的康复阶段,康复衡量标准的得分增加,但大多数临床衡量标准的得分在康复阶段没有一致改善。这些发现表明了这两种类型的衡量标准之间的定性差异,支持了消费者的说法,即临床衡量标准并没有评估康复的重要方面。需要进一步研究和完善康复衡量标准,包括对康复阶段的评估,旨在将这些衡量标准作为常规临床评估、服务评估和研究的辅助手段。

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