Abstract
BackgroundThere is no generic psychotherapy outcome measure validated for Kenyan populations. The objective of this study was to test the acceptability and factor structure of the Clinical Outcomes in Routine Evaluation – Outcome Measure in patients attending psychiatric clinics at two state-owned hospitals in Nairobi.MethodsThree hundred and forty-five patients filled out the CORE-OM after their initial therapy session. Confirmatory and Exploratory Factor Analysis (CFA/EFA) were used to study the factor structure of the CORE-OM.ResultsThe English version of the CORE-OM seemed acceptable and understandable to psychiatric patients seeking treatment at the state-owned hospitals in Nairobi. Factor analyses showed that a model with a general distress factor, a risk factor, and a method factor for positively framed items fit the data best according to both CFA and EFA analysis. Coefficient Omega Hierarchical showed that the general distress factor was reliably measured even if differential responding to positively framed items was regarded as error variance.ConclusionsThe English language version of the CORE-OM can be used with psychiatric patients attending psychiatric treatment in Nairobi. The factor structure was more or less the same as has been shown in previous studies. The most important limitation is the relatively small sample size.
Highlights
There is no generic psychotherapy outcome measure validated for Kenyan populations
In addition to the use of model fit criteria, which tend to be hard for factor models with many indicators to achieve [15], we evaluated the practical significance of our models using Explained Common Variance (ECV; [16]) which is a measure of “essential unidimensionality” that can be used as criterion for when a model with a strong G-factor is unidimensional enough to be used as such in practice
Results of the present study indicate that the English version of the CORE-OM was acceptable to patients attending hospital based psychiatric care in urban Nairobi
Summary
There is no generic psychotherapy outcome measure validated for Kenyan populations. The objective of this study was to test the acceptability and factor structure of the Clinical Outcomes in Routine Evaluation – Outcome Measure in patients attending psychiatric clinics at two state-owned hospitals in Nairobi. Most psychiatric and public health facilities during colonial rule (Kenya got independence only around 1963) were earmarked for Europeans, followed by Indians who were brought to serve in colonial administration, and native Kenyans were neglected with limited care or consideration of their distress [1] To this day, Kenyan people visit psychiatric hospitals or seek services only when they are in tremendous adversity where either their livelihood or everyday functioning is severely impacted. In 2011 the Kenya National Commission on Human Rights (KNCHR) conducted a human rights-focused audit of the mental health system They concluded that “as a result of stigma and discrimination against mental illness and persons with mental disorder, the policies and practices of the Government of Kenya have been inadequate and resulted in a mental health system that is woefully under-resourced and unable to offer quality inpatient and outpatient care to the majority of Kenyans who need it” One step in this direction is to start using psychometrically sound instruments for tracking the course of psychological problems, well-being, and functioning of patients undergoing psychological and psychiatric treatments
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