A. Gigantesco, A. Picardi, G. de Girolamo, P. Morosini - Vol. 11, March 2005, Issue 1
Testo Immagini Bibliografia Immagini IndiceValidità discriminante della Health
of the Nation Outcome Scales nelle strutture residenziali psichiatriche
italiane
Discriminant validity of the Health of the Nation Outcome Scales in
Italian psychiatric residential facilities
Introduction
The Health of the Nation Outcome Scales (HoNOS) was developed in the mid-1990s
as a comprehensive short instrument to measure patient outcomes in mental
health services. The opinions about the reliability and validity of the HoNOS
are very controversial.
Objectives
To analyse the convergent and discriminant validity of the HoNOS in a
large, national representative sample of psychiatric patients living in residential
facilities.
Method
A wide sample of patients with psychotic disorders, admitted to 265 Italian
Residential Facilities (RFs), were rated by trained research assistants and
local staff on the HoNOS, Social and Occupational Functioning Assessment Scale
(SOFAS), Life Skill Profile (LSP), Physical Health Index (PHI) and presence
of positive symptoms. Discriminant function analysis was employed to analyse
the ability of the HoNOS items to correctly classify patients belonging to
4 groups defined according to the presence of positive symptoms and considerable
psychosocial or physical disability. The convergent validity of the HoNOS
with the above-mentioned established measures was examined by means the Pearson
correlation coefficient.
Results
On the whole, the pattern of correlations between HoNOS and the other
corresponding measures was found to be coherent. Yet the correlations had
modest or moderate values, except the correlation between the HoNOS subscale
Social Problems and SOFAS that was 0.59.
In discriminant function analysis, the classification procedure correctly
classified 55.7% of the patients.
Conclusions
Although HoNOS has many advantages with regard to brevity, it may lack
sufficient discriminant power for certain patient groups. Further, it correlates
modestly with a major measure of disability, and poorly with a major measure
of physical health status. As such, it is concluded that the properties of
the HoNOS do not warrant its use as a routine measure without supplementary
measures