White Henry, Gonzalez Peter, Sashar Sagi, Silver Zoe, Scott Hannah, Novack Victor
Brookline Center for Community Mental Health, Brookline, MA, USA.
Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
BMC Health Serv Res. 2025 Jul 1;25(1):880. doi: 10.1186/s12913-025-13069-x.
The field of complex care management for patients with urgent health and social challenges has rapidly grown, leading to calls for improved tools for measuring quality and outcomes. Most available measures were not developed specifically for a clinical context with a population with complex needs. The Healthy Lives 5 Axis Scale (HL-5) was created to fulfill this role. This concise, multidimensional scale measures key domains, including health-related functioning, physical and social needs, capacity for self-care, access, and utilization. The purpose of this study was to determine the interrater and test-retest reliability and the construct and concurrent validity of the HL-5.
The study population included adults who attended an appointment with a primary care physician at an urban community health center. The reliability assessment of the HL-5 questionnaire included test-retest ratings by the same scorer and between two different scorers. Criterion convergent validity was evaluated by comparing the HL-5 domains with relevant domains of external questionnaires using Pearson correlation coefficients (r). The comparison measures have a strong evidence base, are widely used, and are nonproprietary.
There were 64 participants, with a mean age of 39.1. Test-Retest Reliability, measured by the intraclass coefficient (ICC), was greater than 0.8 for Functioning, Needs, Utilization, and Access, indicating very strong internal consistency and 0.754 for Self-Care, representing good internal consistency. Criterion Validity for the axes, assessed by each axis' correlations with a criterion measure, was statistically significant at of p < 0.05.
This study of the psychometric properties of the Healthy Lives 5 Axis Scale (HL-5) demonstrated its value for assessing patients' complex health and social needs. It showed high levels of reliability in a clinical setting with a diverse patient populations and strong correlations with well-established measures of functioning, needs, self-care, access, and utilization. HL-5 requires only a few minutes to complete and yields actionable results, demonstrating its potential for integration into the workflow of a primary care practice or care management program.
针对面临紧急健康和社会挑战的患者的复杂护理管理领域迅速发展，这引发了对改进质量和结果测量工具的需求。大多数现有测量方法并非专门针对有复杂需求人群的临床环境开发。“健康生活五轴量表”（HL - 5）就是为满足这一需求而创建的。这个简洁的多维量表测量关键领域，包括与健康相关的功能、身体和社会需求、自我护理能力、可及性和利用率。本研究的目的是确定HL - 5的评分者间信度、重测信度、结构效度和同时效度。
研究人群包括在城市社区健康中心预约看初级保健医生的成年人。HL - 5问卷的信度评估包括同一评分者的重测评分以及两名不同评分者之间的评分。通过使用皮尔逊相关系数（r）将HL - 5领域与外部问卷的相关领域进行比较，来评估标准收敛效度。这些比较测量方法有强有力的证据基础，被广泛使用且无专利限制。
共有64名参与者，平均年龄为39.1岁。通过组内相关系数（ICC）测量的重测信度，功能、需求、利用率和可及性方面大于0.8，表明内部一致性非常强；自我护理方面为0.754，代表良好的内部一致性。通过各轴与标准测量的相关性评估的轴的标准效度，在p < 0.05时具有统计学意义。
这项关于“健康生活五轴量表”（HL - 5）心理测量特性的研究证明了其在评估患者复杂健康和社会需求方面的价值。它在具有多样化患者群体的临床环境中显示出高度的可靠性，并且与已确立的功能、需求、自我护理、可及性和利用率测量方法有很强的相关性。HL - 5只需几分钟即可完成并产生可操作的结果，证明了其融入初级保健实践或护理管理计划工作流程的潜力。
