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Leamy M, Foye U, Hirrich A, Bjørgen D, Silver J, Simpson A, Ellis M, Johan-Johanson K. A systematic review of measures of the personal recovery orientation of mental health services and staff. Int J Ment Health Syst 2023; 17:33. [PMID: 37849003 PMCID: PMC10580616 DOI: 10.1186/s13033-023-00600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 09/27/2023] [Indexed: 10/19/2023] Open
Abstract
PURPOSE This review aimed to update and extend the Williams and colleagues 2012 systematic review of measures of recovery-orientation of mental health services by examining whether any of the specific knowledge gaps identified in this original review had subsequently been addressed. METHODS A systematic review using CINAHL, ASSIA, Embase, PsycINFO, Medline and other sources, searched from 2012 until 2021. The conceptualisation of recovery and recovery-orientation of services was explored. Psychometric properties of measures were evaluated using quality criteria and according to ease of use. RESULTS Fourteen measures assessing aspects of the recovery orientation of services and staff were identified, of which ten met the eligibility. Psychometric properties were evaluated, and conceptualisations of recovery and recovery-orientation of services investigated. CONCLUSION After over a decade of research in the field of recovery outcome measurement, there remains a lack of a single gold-standard measure of recovery-orientation of mental health services. There is a need for researchers to develop a new gold standard measure of recovery-orientation of services that is psychometrically valid and reliable, demonstrates sensitivity to change and is easy to use. It needs to show a good fit to an underpinning conceptual model/ framework of both personal recovery and recovery-oriented services and/or systems, with different versions for stakeholders at each level of an organisation or system.
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Affiliation(s)
- Mary Leamy
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
| | - Una Foye
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Anne Hirrich
- KBT Competence Center for lived experience and service development, Trondheim, Norway
| | - Dagfin Bjørgen
- KBT Competence Center for lived experience and service development, Trondheim, Norway
| | | | - Alan Simpson
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Madeline Ellis
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Karl Johan-Johanson
- KBT Competence Center for lived experience and service development, Trondheim, Norway
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Goodman-Casanova JM, Cuesta-Lozano D, Alupoaei C, Grasa Bello EM, Herrera-Imbroda J, Mayoral-Cleries F, Guzman-Parra J. Psychometric validation of the 15-item Questionnaire about the Process of Recovery in Spain (QPR-15-SP). Front Psychol 2023; 14:1178341. [PMID: 37484089 PMCID: PMC10356816 DOI: 10.3389/fpsyg.2023.1178341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/04/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Reliable and valid instruments are needed to measure the impact of mental health services and programs on the journeys of recovery of service users. The aim of this study was to explore the psychometric properties of the cross-culturally adapted 15-item Questionnaire about the Process of Recovery in Spain (QPR-15-SP). Methods One hundred and ten participants from three locations in Spain (Málaga, Barcelona and Madrid), who were users of primary and specialized mental health services, were interviewed from October 2021 to June 2022. Results The internal consistency obtained was excellent: ω =.93 and α =.92. Temporal reliability using intraclass correlation coefficients was moderate (ICC=.684, p <.000). Regarding convergent validity, the QPR-15-SP had a moderate correlation with the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) (ρ =-.500, p <.000), a Visual Numeric Recovery Scale (VNRS) (ρ =.591, p <.000), and the Stages of Recovery Instrument (STORI) (r =.566, p <.000). Correlations between advanced stages of recovery and higher QPR-15-SP scores were found (Moratorium: ρ =-.579, p <.000; Awareness: ρ =-.130, p =.189; Preparation: r =-.043, P=.665; Rebuilding: r =.460, p <.000; Growth: ρ =.697, p <.000). In terms of divergent validity, the QPR-15-SP had low correlation with the DUKE-UNC Functional Social Support Scale (ρ =.273, p <.005). The confirmatory factor analysis of the 1-factor structure obtained reasonable goodness of fit indexes. Discussion The QPR-15-SP has acceptable psychometric properties, providing support for measuring recovery in Spain and allowing international comparison research.
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Affiliation(s)
- Jessica Marian Goodman-Casanova
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Madrid, Spain
| | | | - Catalina Alupoaei
- Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Madrid, Spain
| | - Eva María Grasa Bello
- Mental Health, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBESAM), Madrid, Spain
| | - Jesús Herrera-Imbroda
- Grupo de Neuropsicofarmacología, Hospital Regional Universitario de Málaga - Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina–IBIMA Plataforma Bionand, Málaga, Spain
- Departamento Farmacología y Pediatría, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Fermin Mayoral-Cleries
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Jose Guzman-Parra
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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Sampietro HM, Rojo E, Gómez-Benito J. Recovery-oriented Care in Public Mental Health Policies in Spain: Opportunities and Barriers. CLÍNICA Y SALUD 2023. [DOI: 10.5093/clysa2023a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Goodman-Casanova JM, Cuesta-Lozano D, Garcia-Gallardo M, Duran-Jimenez FJ, Mayoral-Cleries F, Guzman-Parra J. Measuring mental health recovery: Cross-cultural adaptation of the 15-item Questionnaire about the Process of Recovery in Spain (QPR-15-SP). Int J Ment Health Nurs 2022; 31:650-664. [PMID: 35277913 PMCID: PMC9314871 DOI: 10.1111/inm.12985] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 11/27/2022]
Abstract
Mental health services need reliable and valid instruments to measure mental health recovery outcomes, and the only available one in Spanish is arduous. Adapting an instrument is more efficient than creating a new one as it enables international comparison research. The aim of this study was to conduct a cross-cultural adaptation of the 15-item Questionnaire about the Process of Recovery. Fifty-four participants engaged in a five-stage systematic and standardized process carried out from November 2019 to November 2020. Professional translators (n = 4) from the Translation Service Center for Foreign Languages of the Universidad de Alcalá participated in the direct translation, synthesis and back translation stages, and mental health professionals (n = 33) and service users (n = 17) from the Hospital Regional Universitario de Málaga and the Hospital Universitario Virgen de la Victoria in Andalucía (Spain), with an average of 19.2 (SD 12.86) years of experience in mental health, participated in the committee of experts and pilot debriefing stages. Additionally, legibility was assessed. Out of the 15-items of the questionnaire, three (20%) were equal amongst translations, three items (20%) of the back translations matched the original questionnaire and discrepancies identified were adapted accordingly. Seven items (46.7%) were approved online by experts and consensus of alternative translations was reached for the rest. The average time spent completing the questionnaire by service users during the face-to-face pilot was 4.12 min (SD 2.25). Internal consistency obtained was ω = 0.95 and α = 0.91. Debriefing findings reported the questionnaire as comprehensible (97.1%), adequate in wording (91.2%), formal in language (55.9%) and adequate in terms of length (100%). The questionnaire scored 65.53, 'normal' readability, on the Inflesz scale. The adapted instrument has conceptual, linguistic, cultural and metric equivalence to the original instrument.
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Affiliation(s)
- Jessica Marian Goodman-Casanova
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,Departamento de Enfermería y Fisioterapia, Universidad de Alcalá, Madrid, Spain
| | | | - Marta Garcia-Gallardo
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Francisco Javier Duran-Jimenez
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Fermin Mayoral-Cleries
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Jose Guzman-Parra
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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Penas P, Uriarte JJ, Gorbeña S, Slade M, Moreno-Calvete MC, Iraurgi I. Discrepancy between experience and importance of recovery components in the symptomatic and recovery perceptions of people with severe mental disorders. BMC Psychiatry 2021; 21:277. [PMID: 34059038 PMCID: PMC8168040 DOI: 10.1186/s12888-021-03287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/13/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and consequently in the orientation of mental health services. The objective of this study was to assess the personal recovery process in people using mental health services, and to clarify the role of variables such as symptomatology, self-stigma, sociodemographic and treatment. METHODS Standardised measures of personal recovery process, clinical recovery, and internalized stigma were completed by a sample of 312 participants in a Severe Mental Disorder program. RESULTS Users valued most the recovery elements of: improving general health and wellness; having professionals who care; hope; and sense of meaning in life. Significant discrepancies between perceived experience and relative importance assigned to each of the components of the REE were observed. Regression modeling (χ2 = 6.72, p = .394; GFI = .99, SRMR = .03) identified how positive discrepancies were associated with a higher presence of recovery markers (β = .12, p = .05), which in turn were negatively related to the derived symptomatology index (β = -.33, p < .001). Furthermore, the relationship between clinical and personal recovery was mediated by internalized stigma. CONCLUSIONS An improvement in psychiatric services should be focused on recovery aspects that have the greatest discrepancy between importance and experience, in particular social roles, basic needs and hope. Personal and clinical recovery are correlated, but the relationship between them is mediated by internalized stigma, indicating the need for clinical interventions to target self-stigma.
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Affiliation(s)
- Patricia Penas
- University of Deusto, Avda. de las Universidades 24, 48007, Bilbao, Spain.
| | - Jose-Juan Uriarte
- Biocruces Bizkaia Health Research Institute. Basque Health Service, Bizkaia Mental Health Network, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia Spain
| | - Susana Gorbeña
- grid.14724.340000 0001 0941 7046University of Deusto, Avda. de las Universidades 24, 48007 Bilbao, Spain
| | - Mike Slade
- grid.4563.40000 0004 1936 8868School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - María-Concepción Moreno-Calvete
- Biocruces Bizkaia Health Research Institute. Basque Health Service, Bizkaia Mental Health Network, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia Spain
| | - Ioseba Iraurgi
- grid.14724.340000 0001 0941 7046University of Deusto, Avda. de las Universidades 24, 48007 Bilbao, Spain
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