1
|
Werkkala C, Välimäki M, Anttila M, Pekurinen V, Bressington D. Validation of the Finnish Health Improvement Profile (HIP) with patients with severe mental illness. BMC Psychiatry 2020; 20:112. [PMID: 32160873 PMCID: PMC7065367 DOI: 10.1186/s12888-020-02511-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 02/24/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Physical health among people with severe mental illness (SMI) is a global concern. However, many people with SMI do not receive regular comprehensive health checks. There is currently no validated physical health check instrument systematically used in Finnish mental health services. Therefore, this study aims to validate and establish the potential clinical utility of the translated Health Improvement Profile (HIP) tool for Finnish patients with SMI and compare differences in physical health risk items across genders. METHODS The content validity of the two-way translated Finnish HIP (HIP-F) was evaluated by five nurses and four patients with SMI using cognitive debriefing (to assess the clarity and relevance of each item and the recommended actions of the HIP tool). The potential clinical utility was assessed using a pilot test involving 47 patients. The prevalence of red-flagged (risk) items in the whole sample, across female and male participants, and the frequencies of any type of missing item response were calculated and analysed using descriptive statistics. A chi-square test was used to determine differences in frequencies of red-flagged items across genders. RESULTS Based on the cognitive debriefing, the HIP-F was found to have moderate content validity regarding the clarity and relevance of the items and recommended actions (the average scale level content validity index, S-CVI/Ave, 0.74). In the pilot test, some missing item responses were identified, but in the sample, nurses identified 399 areas of health and health behaviour risks (mean 8.6 per patient) using the HIP-F. The most frequently red-flagged items were body mass index (BMI) and waist circumference (83.0%), smoking status (48.9%) and lipid levels (46.8%). Female patients had a higher frequency of red-flagged items than males in BMI (92.6% vs. 70.0%, p = 0.04) and waist circumference (96.3% vs. 65.0%, p = 0.01). CONCLUSIONS The results demonstrate that the Finnish HIP has moderate content validity and preliminary clinical utility for evaluating the physical health and health behaviours of people with SMI. The HIP-F findings help to sign-post evidence-based interventions for identified areas of concern. Additional nurse training may be necessary to realise the potential clinical utility of the tool in Finland.
Collapse
Affiliation(s)
- Camilla Werkkala
- Department of Nursing Science, University of Turku, Joukahaisenkatu 3-5, 20014, Turku, Finland.
| | - Maritta Välimäki
- grid.1374.10000 0001 2097 1371Department of Nursing Science, University of Turku, Joukahaisenkatu 3-5, 20014 Turku, Finland ,grid.16890.360000 0004 1764 6123The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Minna Anttila
- grid.1374.10000 0001 2097 1371Department of Nursing Science, University of Turku, Joukahaisenkatu 3-5, 20014 Turku, Finland
| | - Virve Pekurinen
- grid.1374.10000 0001 2097 1371Department of Nursing Science, University of Turku, Joukahaisenkatu 3-5, 20014 Turku, Finland
| | - Daniel Bressington
- grid.16890.360000 0004 1764 6123The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| |
Collapse
|
2
|
Azaiez C, Millier A, Lançon C, Clay E, Auquier P, Llorca PM, Toumi M. Health related quality of life in patients having schizophrenia negative symptoms - a systematic review. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2018; 6:1517573. [PMID: 30275939 PMCID: PMC6161588 DOI: 10.1080/20016689.2018.1517573] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/14/2018] [Accepted: 08/21/2018] [Indexed: 05/07/2023]
Abstract
Background: Schizophrenia negative symptoms (SNS) contribute substantially to poor functional outcomes, loss in productivity and poor quality of life. It is unclear which instruments may be used for assessing quality of life in patients with SNS. Objective: The objective of this review was to identify instruments assessing health-related quality of life (HRQoL) validated in patients with SNS and to assess their level of validation. Data sources: We conducted a systematic literature review in Medline and the ISPOR database in March 2016 to identify studies on the quality of life in patients with SNS published by March 2016. Data extraction: Psychometric properties and validation steps. Data synthesis: After applying inclusion/exclusion criteria, 49 studies were selected for the analysis of HRQoL instruments; however, none of these instruments only addressed patients with SNS. Of these, 19 HRQoL instruments used in patients with schizophrenia or including patients with SNS among others, in the context of instrument validation, were identified (4 generic, 10 non-specific mental health, 5 schizophrenia-specific). Conclusion: No HRQoL instrument has been validated in patients with SNS only; for the remaining instruments identified, it remains unclear whether they were intended to capture HRQoL in patients with SNS.
Collapse
Affiliation(s)
- Chiraz Azaiez
- Public Health Department – Research Unit EA 3279, Aix-Marseille University, Marseille, France
| | | | - Christophe Lançon
- Psychiatry Department, Marseille University Hospital, Marseille, France
| | | | - Pascal Auquier
- Public Health Department – Research Unit EA 3279, Aix-Marseille University, Marseille, France
| | - Pierre-Michel Llorca
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Mondher Toumi
- Public Health Department – Research Unit EA 3279, Aix-Marseille University, Marseille, France
| |
Collapse
|
3
|
Senin T, Franz M, Deuschle M, Bergemann N, Kammerer-Ciernioch J, Lautenschlager M, Meyer T. QLiS-SF: Development of a short form of the quality of life in schizophrenia questionnaire. BMC Psychiatry 2017; 17:149. [PMID: 28449643 PMCID: PMC5408441 DOI: 10.1186/s12888-017-1307-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 04/11/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is a need for useful standardized Quality of Life (QoL) measures for people diagnosed with schizophrenia. Therefore, a short form of the self-administered Quality of Life in Schizophrenia (QLiS) scale was developed and validated. METHODS Four steps were taken to develop the abridged version using samples from the Clinical Analysis of the Treatment of Schizophrenia (CATS) study. Firstly, a model with second order scales was developed using exploratory factor analysis (EFA). Secondly, it was tested in an independent sample using confirmatory factor analysis (CFA). Thirdly, this model served as the basis for selecting items for the short form. Distributional properties, content reviews, and factor loadings were taken into account in this step. Fourthly, the resulting short form was validated through confirmatory factor analysis (CFA). Composite reliability scores were calculated for the new subscales. RESULTS Three second order scales were constructed: illness-related quality of life (QoL), social life and finances, and global subjective well-being. CFA of the new theoretical model resulted in a CFI of 0.67 and absolute fit indices of CMIN/df = 2.55, RMSEA = 0.08, SRMR = 0.09. The selected 13 items showed good statistical properties and good fit of content to subscale. Fit of the underlying theoretical model with the reduced number of items was tested in an independent sample. Absolute and fit indices of the short form model were satisfactory (CFI = 0.95, CMIN/df = 2.23, RMSEA = 0.06, SRMR = 0.04). Composite reliability scores for three subscales were above 0.70. CONCLUSIONS The short form of the QLIS (QLiS-SF) showed good model fit and reliability. It should only be considered for use if the application of the long version is not suitable.
Collapse
Affiliation(s)
- T. Senin
- 0000 0000 9529 9877grid.10423.34Integrative Rehabilitation Research Unit, Institute on Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - M. Franz
- Vitos Klinikum Giessen-Marburg, Licherstraße 106, 35394 Giessen, Germany ,0000 0001 2165 8627grid.8664.cCentre for Psychiatry, Justus Liebig University, Giessen, Germany
| | - M. Deuschle
- 0000 0001 2190 4373grid.7700.0Central Institute of Mental Health Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Square J 5, 68159 Mannheim, Germany
| | - N. Bergemann
- Saxon Hospital Rodewisch, Center for Psychiatry, Psychotherapy, Psychosomatics, and Neurology, Bahnhofstraße 1, 08228 Rodewisch, Germany
| | - J. Kammerer-Ciernioch
- Klinik für Allgemeine Psychiatrie und Psychotherapie Ost, Klinikum am Weissenhof, 74189 Weinsberg, Germany
| | - M. Lautenschlager
- Department of Psychiatry and Psychotherapy Charité Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - T. Meyer
- 0000 0000 9529 9877grid.10423.34Integrative Rehabilitation Research Unit, Institute on Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| |
Collapse
|
4
|
Girard V, Tinland A, Bonin JP, Olive F, Poule J, Lancon C, Apostolidis T, Rowe M, Greacen T, Simeoni MC. Relevance of a subjective quality of life questionnaire for long-term homeless persons with schizophrenia. BMC Psychiatry 2017; 17:72. [PMID: 28212630 PMCID: PMC5314634 DOI: 10.1186/s12888-017-1227-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/01/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Increasing numbers of programs are addressing the specific needs of homeless people with schizophrenia in terms of access to housing, healthcare, basic human rights and other domains. Although quality of life scales are being used to evaluate such programs, few instruments have been validated for people with schizophrenia and none for people with schizophrenia who experience major social problems such as homelessness. The aim of the present study was to validate the French version of the S-QoL a self-administered, subjective quality of life questionnaire specific to schizophrenia for people with schizophrenia who are homeless. METHODS In a two-step process, the S-QoL was first administered to two independent convenience samples of long-term homeless people with schizophrenia in Marseille, France. The objective of the first step was to analyse the psychometric properties of the S-QoL. The objective of the second step was to examine, through qualitative interviews with members of the population in question, the relevance and acceptability of the principle quality of life indicators used in the S-QoL instrument. RESULTS Although the psychometric characteristics of the S-QoL were found to be globally satisfactory, from the point of view of the people being interviewed, acceptability was poor. Respondents frequently interrupted participation complaining that questionnaire items did not take into account the specific context of life on the streets. CONCLUSIONS Less intrusive questions, more readily understandable vocabulary and greater relevance to subjects' living conditions are needed to improve the S-QoL questionnaire for this population. A modular questionnaire with context specific sections or specific quality of life instruments for socially excluded populations may well be the way forward.
Collapse
Affiliation(s)
- V. Girard
- 0000 0001 2176 4817grid.5399.6Public Health Research Unit EA 3279, Aix-Marseille University, Marseille, France ,0000 0001 0407 1584grid.414336.7Community Mental Health Outreach Team, MARS (Movement and Action for Social Recovery), Public Hospital of Marseille (AP-HM), Marseille, France
| | - A. Tinland
- 0000 0001 2176 4817grid.5399.6Public Health Research Unit EA 3279, Aix-Marseille University, Marseille, France ,0000 0001 0407 1584grid.414336.7Community Mental Health Outreach Team, MARS (Movement and Action for Social Recovery), Public Hospital of Marseille (AP-HM), Marseille, France
| | - J. P. Bonin
- School of Nursing, University of Montreal and Fernand-Seguin Research Centre, Québec, Canada
| | - F. Olive
- 0000 0001 0407 1584grid.414336.7Community Mental Health Outreach Team, MARS (Movement and Action for Social Recovery), Public Hospital of Marseille (AP-HM), Marseille, France
| | - J. Poule
- 0000 0001 0407 1584grid.414336.7Community Mental Health Outreach Team, MARS (Movement and Action for Social Recovery), Public Hospital of Marseille (AP-HM), Marseille, France
| | - C. Lancon
- 0000 0001 2176 4817grid.5399.6Public Health Research Unit EA 3279, Aix-Marseille University, Marseille, France
| | - T. Apostolidis
- 0000 0001 2176 4817grid.5399.6Social Psychology Unit EA849, Aix-Marseille University, 13621 Aix-en-Provence, France
| | - M. Rowe
- 0000000419368710grid.47100.32Yale Program for Recovery and Community Health, Yale University, New Haven, USA
| | - T. Greacen
- Maison Blanche Hospital Research Laboratory, Paris, France
| | - M. C. Simeoni
- 0000 0001 2176 4817grid.5399.6Aix Marseille Université, LPS EA 849, 13621 Aix en Provence, France ,0000 0001 0407 1584grid.414336.7Service d’évaluation médicale, AP-HM, Conception, 13005 Marseille, France
| |
Collapse
|
5
|
Bullinger M, Quitmann J. Quality of life as patient-reported outcomes: principles of assessment. DIALOGUES IN CLINICAL NEUROSCIENCE 2015. [PMID: 25152653 PMCID: PMC4140508 DOI: 10.31887/dcns.2014.16.2/mbullinger] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Assessing quality of life (QoL) as a patient-reported outcome in adult psychiatry poses challenges in terms of concepts, methods, and applications in research and practice. This review will outline conceptually the construct of QoL, its dimensionality, and its representation across patient groups. Methodological challenges are examined, along with principles of QoL instrument development and testing, as well as across cultures. Application of instruments in epidemiological, clinical health economics, and health services research is reviewed based on pertinent literature. Validated measures for depression, psychosis, and anxiety disorders are available in adult psychiatry, and are increasingly used in research. Still, targeted measures are lacking for many mental health conditions and only rarely are tools applied in the practice context. Progress has been made in the development of instruments that are now ready for implementation. The information to be gained is valuable for identifying patient-reported needs for and benefits of treatment.
Collapse
Affiliation(s)
- Monika Bullinger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Quitmann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
6
|
Franz M, Fritz M, Gallhofer B, Meyer T. QLiS--development of a schizophrenia-specific quality-of-life scale. Health Qual Life Outcomes 2012; 10:61. [PMID: 22676639 PMCID: PMC3438130 DOI: 10.1186/1477-7525-10-61] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 04/23/2012] [Indexed: 11/13/2022] Open
Abstract
Background The aim of the project was to develop an instrument for the assessment of subjective quality of life specific to schizophrenic persons on the basis of patients’ views on their own life and on sound psychometric principles. Methods The project applied a six-step multiphase development process with six distinct studies. (1) The elicitation of schizophrenic persons’ views on their quality of life was based on open-ended interviews with interviewees from different settings (acute ward inpatients, long-term care patients, community care patients; n = 268). (2) A cross-sectional study with schizophrenic and healthy persons was conducted to quantify the relative importance of the various aspect of quality of life that emerged from the qualitative study (n = 143). (3) We conducted an empirical comparison of response formats with schizophrenic persons (n = 32). (4) A scale construction- and reliability-testing study was performed (n = 203) as well as (5) a test-retest reliability study (n = 49). (6) The final questionnaire (QLiS, quality of life in schizophrenia) was tested in an additional study on convergent and discriminant validity (n = 135). Results The QLiS comprises 52 items (plus 2 optional items related to work) in 12 subscales: social contacts, appreciation by others, relationship to family, appraisal of pharmacotherapy, appraisal of psychopathological symptoms, cognitive functioning, abilities to manage daily living, appraisal of accommodation/housing, financial situation, leading a ’normal‘ life, confidence, general life-satisfaction. An item response format with four response categories was preferred by the schizophrenic persons. The mean values of the subscales clustered around the theoretical mean of the subscales and only minimal ceiling effects were found. The reliability (test-retest-reliability and internal consistency) was with one exception > .70 for all subscales. Conclusion Taking the low numbers of items per subscale into account, the QLiS can be regarded as an accurate assessment instrument of subjective quality of life in schizophrenia with good content validity.
Collapse
Affiliation(s)
- Michael Franz
- Centre for Psychiatry, Justus-Liebig University, Giessen, Germany
| | | | | | | |
Collapse
|