Wing J K, Beevor A S, Curtis R H, Park S B, Hadden S, Burns A
College Research Unit, University of Nottingham.
Br J Psychiatry. 1998 Jan;172:11-8. doi: 10.1192/bjp.172.1.11.
An instrument was required to quantify and thus potentially measure progress towards a Health of the Nation target, set by the Department of Health, "to improve significantly the health and social functioning of mentally ill people".
A first draft was created in consultation with experts and on the basis of literature review. This version was improved during four stages of testing: two preliminary stages, a large field trial involving 2706 patients (rated by 492 clinicians) and tests of the final Health of the Nation Outcome Scales (HoNOS), which included an independent study (n = 197) of reliability and relationship to other instruments.
The resulting 12-item instrument is simple to use, covers clinical problems and social functioning with reasonable adequacy, has been generally acceptable to clinicians who have used it, is sensitive to change or the lack of it, showed good reliability in independent trials and compared reasonably well with equivalent items in the Brief Psychiatric Rating Scales and Role Functioning Scales.
The key test for HoNOS is that clinicians should want to use it for their own purposes. In general, it has passed that test. A further possibility, that HoNOS data collected routinely as part of a minimum data set, for example for the Care Programme Approach, could also be useful in anonymized and aggregated form for public health purposes, is therefore testable but has not yet been tested.
需要一种工具来量化，从而有可能衡量朝着卫生部设定的“显著改善精神病患者的健康状况和社会功能”这一国家健康目标所取得的进展。
在与专家协商并基于文献综述的基础上创建了初稿。该版本在四个测试阶段得到改进：两个初步阶段、一项涉及2706名患者（由492名临床医生评定）的大型现场试验以及最终的国家健康结果量表（HoNOS）测试，其中包括一项关于可靠性以及与其他工具关系的独立研究（n = 197）。
最终形成的包含12个条目的工具使用简便，对临床问题和社会功能的涵盖较为充分，已使用该工具的临床医生普遍接受，对变化或缺乏变化敏感，在独立试验中显示出良好的可靠性，并且与简明精神病评定量表和角色功能量表中的等效条目相比表现相当不错。
HoNOS的关键测试在于临床医生是否愿意为自身目的使用它。总体而言，它通过了该测试。另一种可能性是，作为最小数据集的一部分常规收集的HoNOS数据，例如用于护理计划方法的数据，以匿名和汇总的形式用于公共卫生目的也可能有用，因此这是可测试的，但尚未进行测试。
