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Nation Outcome Scales (nation + outcome_scale)
Selected AbstractsConsumer attitudes towards the use of routine outcome measures in a public mental health service: A consumer-driven studyINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2008David Guthrie ABSTRACT:, In this study conducted by consumer consultants, 50 consumers who have a Barwon Health case manager (the majority of whom were nurses) were interviewed using a structured questionnaire to ascertain their attitudes towards the routine use of outcome measures. Forty participants (80% of those interviewed) reported they had been offered the Behaviour and Symptom Identification Scale (BASIS-32) to complete in routine care by their case managers and of those, 95% (n = 38) completed it. On those who completed the BASIS-32, 42% said their case manager had explained what the BASIS-32 would be used for, 45% said that the case manager had discussed their responses with them, 76% stated that completing the BASIS-32 had helped the case manager to understand them better and 66% believed that completing the BASIS-32 had led to them receiving better care. Only 30% of the group interviewed were aware that their case manager regularly completed a Health of the Nation Outcome Scales and Life Skills Profile. Feedback about the process of completing the BASIS-32 was obtained as well as suggestions on how the process may be improved. The results indicate that consumers see the benefit of routine outcome measurement and believe it leads to improved care. More information about outcome measures, including the clinician-rated outcome measures, needs to be provided to consumers if they are to be engaged constructively in this exercise. [source] Multilevel investigation of variation in HoNOS ratings by mental health professionals: a naturalistic study of consecutive referralsINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2004R. Ecob Episodes of mental healthcare in specialist psychiatric services often begin with the assessment of clinical and psychosocial needs of patients by healthcare professionals. Particularly for patients with complex needs or severe problems, ratings of clinical and social functioning at the start of each episode of care may serve as a baseline against which subsequent measures can be compared. Currently, little is known about service variations in such assessments on referrals from primary care. We set out to quantify variability in initial assessments performed by healthcare professionals in three CMHTs in Bristol (UK) using the Health of the Nation Outcome Scales (HoNOS). We tested the hypothesis that variations in HoNOS total and sub-scale scores are related to referral source (general practices), healthcare assessor (in CMHTs) and the assessor's professional group. Statistical analysis was performed using multilevel variance components models with cross-classified random effects. We found that variation due to assessor substantially exceeded that due to referral source (general practices). Furthermore, patient variance differed by assessor profession for the HoNOS , Impairment scores. Assessor variance differed by assessor profession for the HoNOS , Social scores. As HoNOS total and subscale scores show much larger variation by assessor than by referral source, investigations of HoNOS scores must take assessors into account. Services should implement and evaluate interdisciplinary training to improve consistency in use of rating thresholds; such initiatives could be evaluated using these extensions of multilevel models. Future research should aim to integrate routine diagnostic data with continuous outcomes to address selection effects (of patients to assessors) better. Copyright © 2004 Whurr Publishers Ltd. [source] Evaluation of a community-based mental health drug and alcohol nurse in the care of people living with HIV/AIDSJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2009J. ALLEN rn ba (hons) m psych (counselling psychology) There is a growing need for advanced practice mental health and drug and alcohol nursing roles in the care of people living with HIV/AIDS; however, limited publications address these domains. This study evaluated a community-based mental health drug and alcohol nurse role caring for people living with HIV/AIDS (Mental Health D&A Nurse) in a large not-for-profit district nursing organization providing care to people living with HIV/AIDS in an Australian city. Outcomes from a client assessment and 6,8-week follow-up by the Mental Health D&A Nurse are presented as captured by the Depression Anxiety Stress Scales (DASS 21), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Health of the Nation Outcome Scales (HONOS) and WHOQoL BREF. Mean scores and caseness were analysed, and significant differences were found on the ,impairment' and ,social problems' subscales of the HONOS. Results of semi-structured interviews with clients describe effective and supportive mental health care and health-promoting education following visits by the Mental Health D&A Nurse. These positive findings support continuing implementation of the role within this community setting and indicate that even greater benefits will ensue as the role develops further. Findings are of interest to clinicians and policy makers seeking to implement similar roles in community-based HIV/AIDS care. [source] The Health of the Nation Outcome Scales for Child & Adolescent Mental Health (HoNOSCA)CHILD AND ADOLESCENT MENTAL HEALTH, Issue 2 2000Simon Gowers The child and adolescent version of the Health of the Nation Outcome Scales (HoNOSCA) represents the first attempt at a routine outcome measure for Child and Adolescent Mental Health Services in the U.K. Extensive field trials suggested that the scales were both acceptable to clinicians from the various disciplines working in this area and also valid and reliable. A growing number of services are now using the scales in audit and research, supported by the national HoNOSCA base that provides training and co-ordinates further developments. [source] Implementing HoNOS: An eight stage approachCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 2 2001Derek Milne The Health of the Nation Outcome Scales (HoNOS) were developed as a brief way to quantify progress towards the national target of improving significantly the health and social functioning of mentally ill people (Wing et al., 1998). As an instrument, HoNOS was regarded as adequate for this purpose and so field testing was deemed to be the next task. However, the implementation of an outcome measure such as HoNOS under routine service conditions represents a significant implementation challenge. Therefore, we conducted an eight stage approach to implementation, with a sample of multi-disciplinary care managers from one county in the UK (N = 30). The results of shadowing and initial interviews indicated that significant barriers to implementation were insufficient staff and the high level of routine demands on staff for the completion of paperwork. These barriers outweighed the perceived boosters, including the favourable responses of colleagues and the benefits of data feedback from HoNOS. More staff, standardized training in the use of HoNOS, regular feedback and less paperwork were amongst ten suggestions for facilitating implementation. During a pilot period, staff received training, used HoNOS and were given graphical feedback of the HoNOS results. They were then re-interviewed, at which time they reported becoming fairly positive about the use of HoNOS and definitely valued the implementation approach. However, it is concluded that the routine use of HoNOS will require continued effort from staff and their managers (e.g. refresher training courses) and alternative or additional outcome measures may be necessary to provide useful clinical information. Copyright © 2001 John Wiley & Sons, Ltd. [source] Urban,rural differences in psychiatric rehabilitation outcomesAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2010Srinivasan Tirupati Abstract Objective:,Employing rural and urban patient populations, the aim of the study was to examine the differences in rehabilitation intervention outcomes, particularly in regard to the social and clinical determinants. Design:,The study employed a retrospective, cross-sectional analysis of patient outcome and characteristics. Setting:,Community-based psychiatric rehabilitation service in regional and rural Australia. Participants:,A total of 260 patients were included in the service evaluation phase of the study and 86 in the second part of the study. Participants were community-based and suffered from a chronic mental illness. Main outcome measure(s):,Clinical and functional outcomes were measured using the Health of Nations Outcome Scale and the 16-item Life Skills Profile. The outcome score employed was the difference between scores at intake and at the last complete assessment. Clinical and sociodemographic characters were recorded using a proforma developed for the study. Results:,Patients from rural Maitland had a significantly larger mean reduction in total scores and classified more often as ,Improved' on both the Health of Nations Outcome Scale and Life Skills Profile than patients from either of the urban areas (P < 0.01). Study of randomly selected patients showed that those from an urban area had a more complex illness with multiple needs and less often received family support than their rural counterparts. Conclusions:,For rural communities the improvement in rehabilitation outcomes might be attributable to a more benign form of the illness and the availability of higher levels of social capital. [source] Approach to treatment of mental illness and substance dependence in remote Indigenous communities: Results of a mixed methods studyAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2009Tricia Nagel Abstract Objective:,To develop and evaluate a culturally adapted brief intervention for Indigenous people with chronic mental illness. Design:,A mixed methods design in which an exploratory phase of qualitative research was followed by a nested randomised controlled trial. Setting:,Psycho-education resources and a brief intervention, motivational care planning (MCP), were developed and tested in collaboration with aboriginal mental health workers in three remote communities in northern Australia. Participants:,A total of 49 patients with mental illness and 37 carers were recruited to a randomised controlled trial that compared MCP (n = 24) with a clinical control condition (treatment as usual, n = 25). Intervention:,The early treatment group received MCP at baseline and the late treatment group received delayed treatment at six months. Main outcome measures:,The primary outcome was mental health problem severity as measured by the health of the nation outcome scales. Secondary measures of well-being (Kessler 10), life skills, self-management and substance dependence were chosen. Outcome assessments were performed at baseline, six-month, 12-month and 18-month follow up. Results:,Random effects regression analyses showed significant advantage for the treatment condition in terms of well-being with changes in health of the nation outcome scales (P < 0.001) and Kessler 10 (P = 0.001), which were sustained over time. There was also significant advantage for treatment for alcohol dependence (P = 0.05), with response also evident in cannabis dependence (P = 0.064) and with changes in substance dependence sustained over time. Conclusions:,These results suggest that MCP is an effective treatment for Indigenous people with mental illness and provide insight into the experience of mental illness in remote communities. [source] | |||||||||||||