Wilma Elisabeth Swildens1, Ellen Visser2, Michiel Bähler3, Richard Bruggeman2, Philippe Delespaul4, Mark van der Gaag5, Lieuwe de Haan6, René Keet3, Yolanda Nijssen7, Jim van Os8, Gerdina Marieke Pijnenborg9, Cees Slooff10, Annerieke de Vos10, Jaap van Weeghel7, Lex Wunderink2, Cornelis Lambert Mulder11, Durk Wiersma2. 1. Altrecht Institute for Mental Health Care. 2. University Center for Psychiatry, Rob Giel Research Center, University Medical Center Groningen. 3. Community Mental Health Service GGZ Noord-Holland-Noord. 4. Faculty of Psychiatry & Neuropsychology, Maastricht University. 5. Department of Clinical Psychology, VU University. 6. Amsterdam UMC, Psychiatry, Department Early Psychosis, University of Amsterdam. 7. Tranzo Scientific Center for Care and Welfare, Department of Social and Behavioural Sciences, Tilburg University. 8. Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht. 9. Department of Clinical Psychology and Experimental Psychopathology, University of Groningen. 10. Department of Psychotic Disorders, Mental Health Organization GGZ Drenthe. 11. Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Center.
Abstract
OBJECTIVE: This article describes the development and testing of the Functional Recovery tool (FR tool), a short instrument for assessing functional recovery during routine outcome monitoring of people living with serious mental illnesses. METHODS: To assess functional recovery, mental health professionals conducted semistructured interviews with people living with serious mental illnesses on three areas of social functioning: daily living and self-care, work and study, and social contacts. Functioning in each of these areas over the past 6 months was rated on a 3-point scale: 0 (independent), 1 (partially independent), and 2 (dependent). The dichotomous overall outcome of the tool is defined as independent functioning in all areas. We analyzed interrater and test-retest reliability, sensitivity to change, and correlations with constructs that are assumed to be similar to the FR tool (quality of life in daily living, work, and social contacts) or divergent from it (symptomatic functioning). RESULTS: The FR tool was administered to 840 individuals with serious mental illnesses in Dutch mental health care services, 523 of whom were followed up for 1 year (response rate 62%). The tool was easy to complete and was appropriate for policy evaluation and practice. However, when it was combined with more elaborate instruments, it added little extra clinical information. Interrater and test-retest reliability, convergent and discriminant validity, and sensitivity to change were rated sufficient to good. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The FR tool could be a useful measure of functional recovery in addition to current measures of symptomatic remission and personal recovery in routine outcome monitoring. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
OBJECTIVE: This article describes the development and testing of the Functional Recovery tool (FR tool), a short instrument for assessing functional recovery during routine outcome monitoring of people living with serious mental illnesses. METHODS: To assess functional recovery, mental health professionals conducted semistructured interviews with people living with serious mental illnesses on three areas of social functioning: daily living and self-care, work and study, and social contacts. Functioning in each of these areas over the past 6 months was rated on a 3-point scale: 0 (independent), 1 (partially independent), and 2 (dependent). The dichotomous overall outcome of the tool is defined as independent functioning in all areas. We analyzed interrater and test-retest reliability, sensitivity to change, and correlations with constructs that are assumed to be similar to the FR tool (quality of life in daily living, work, and social contacts) or divergent from it (symptomatic functioning). RESULTS: The FR tool was administered to 840 individuals with serious mental illnesses in Dutch mental health care services, 523 of whom were followed up for 1 year (response rate 62%). The tool was easy to complete and was appropriate for policy evaluation and practice. However, when it was combined with more elaborate instruments, it added little extra clinical information. Interrater and test-retest reliability, convergent and discriminant validity, and sensitivity to change were rated sufficient to good. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The FR tool could be a useful measure of functional recovery in addition to current measures of symptomatic remission and personal recovery in routine outcome monitoring. (PsycINFO Database Record (c) 2018 APA, all rights reserved).