BACKGROUND: Little is known about the empirical relationship between clinical and personal recovery. AIMS: To examine whether there are separate constructs of clinical recovery and personal recovery dimensions of outcome, how they change over time and how they can be assessed. METHOD: Standardised outcome measures were administered at baseline and one-year follow-up to participants in the REFOCUS Trial (ISRCTN02507940). An exploratory factor analysis was conducted and a confirmatory factor analysis assessed change across time. RESULTS: We identified three factors: patient-rated personal recovery, patient-rated clinical recovery and staff-rated clinical recovery. Only the personal recovery factor improved after one year. HHI, CANSAS-P and HoNOS were the best measures for research and practice. CONCLUSIONS: The identification of three rather than two factors was unexpected. Our findings support the value of concurrently assessing staff and patient perceptions of outcome. Only the personal recovery factor changed over time, this desynchrony between clinical and recovery outcomes providing empirical evidence that clinical recovery and personal recovery are not the same. We did not find evidence of a trade-off between clinical recovery and personal recovery outcomes. Optimal assessment based on our data would involve assessment of hope, social disability and patient-rated unmet need.
BACKGROUND: Little is known about the empirical relationship between clinical and personal recovery. AIMS: To examine whether there are separate constructs of clinical recovery and personal recovery dimensions of outcome, how they change over time and how they can be assessed. METHOD: Standardised outcome measures were administered at baseline and one-year follow-up to participants in the REFOCUS Trial (ISRCTN02507940). An exploratory factor analysis was conducted and a confirmatory factor analysis assessed change across time. RESULTS: We identified three factors: patient-rated personal recovery, patient-rated clinical recovery and staff-rated clinical recovery. Only the personal recovery factor improved after one year. HHI, CANSAS-P and HoNOS were the best measures for research and practice. CONCLUSIONS: The identification of three rather than two factors was unexpected. Our findings support the value of concurrently assessing staff and patient perceptions of outcome. Only the personal recovery factor changed over time, this desynchrony between clinical and recovery outcomes providing empirical evidence that clinical recovery and personal recovery are not the same. We did not find evidence of a trade-off between clinical recovery and personal recovery outcomes. Optimal assessment based on our data would involve assessment of hope, social disability and patient-rated unmet need.
Authors: Laura Giusti; Donatella Ussorio; Anna Salza; Maurizio Malavolta; Annalisa Aggio; Valeria Bianchini; Massimo Casacchia; Rita Roncone Journal: Community Ment Health J Date: 2018-09-21
Authors: Robin Michael Van Eck; Thijs Jan Burger; Astrid Vellinga; Frederike Schirmbeck; Lieuwe de Haan Journal: Schizophr Bull Date: 2018-04-06 Impact factor: 9.306
Authors: Gemma Elizabeth Shields; Deborah Buck; Jamie Elvidge; Karen Petra Hayhurst; Linda Mary Davies Journal: Int J Technol Assess Health Care Date: 2019-07-22 Impact factor: 2.188