How are you? Further development of a generic quality of life outcome measure

Abstract

How Are You? is designed to meet the need for a broad-based self-report tool that integrates the recording of health and social problems and the measurement of quality of life outcomes within routine practice. This paper describes the process of revising the original How Are You? Utilizing a series of factor analyses, we hoped to confirm that items that were theoretically coherent aggregated empirically, with the goal of refining the measure for outcome analyses and comparisons with other outcomes measures, such as the BASIS-32. Based upon data from both the USA and the UK, the factor analyses confirmed the How Are You? theoretical structure and identified a new factor, referred to as 'Risk' that measures emotional dyscontrol and symptoms that can be associated with psychosis. The revised How Are You? now consists of 40 items. The advantages of the refined scale include shorter length, a broad set of quality of life domains and the instruction to the respondent to identify key problems that are of most concern. The revisions will allow for a more valid assessment of outcome and the use of the How Are You? as a tool to develop a collaborative care plan involving the service user and practitioner.