Abstract
PurposeThe aim of this study was to assess to what extent the recovery elements of the Recovery Enhancing Environment (REE) instrument measured the dimensions proposed by the CHIME framework, (Connectedness, Hope and optimism about future, Identity, Meaning in life and Empowerment dimensions), so as to evaluate personal recovery in people with severe mental illness.MethodsTwo processes were conducted. Firstly, five experts matched the elements of recovery evaluated by the REE items with the CHIME domains and subdomains. Then, the resulting structure from those experts agreement was analyzed with different confirmatory factor analyses (CFA) using responses to the recovery elements dimension of the REE of 312 mental health service users.ResultsThe percentage of agreements and the kappa coefficients were adequate taking into account the CHIME dimensions (κ = 0.57 to 0.69, total κ = 0.74); however, lower agreement was found at the subdimensions level. Some indexes of the CFA were acceptable for a second order factor analysis [χ 2 (242)= 346.03, p < 0.001, CFI= 0.931, RMSEA= 0.037 (0.028 to 0.046)] and the most adequate solution was obtained from the bi-factorial structure (χ 2 (223)=233.19, p=0.306, CFI= 0.993, RMSEA= 0.012 [0.000 to 0.027]).ConclusionsDespite the subjective and complex nature of the personal recovery construct, the REE measure can be a valid instrument to verify the existing CHIME conceptual framework, since two of the models tested have resulted in adequate indexes and were also congruent with the theoretical framework and the statistical solution. Thus, REE can be used to obtain a global index of Personal Recovery dimension, and the five indicators proposed by the CHIME framework.
Highlights
Personal recovery of people suffering from severe mental disorders (SMD) is receiving increasing attention from practitioners and mental health policy makers [1]
The capital letter indicates the CHIME dimension selected by the rater (C— Connectedness, H—Hope, I—Identity, M—Meaning and E— Empowerment)
In item 9, the five raters agreed it belonged to the Connectedness dimension (C) and the peer support and support groups subdimension (a)
Summary
Personal recovery of people suffering from severe mental disorders (SMD) is receiving increasing attention from practitioners and mental health policy makers [1]. The concept of Personal recovery, defined by Anthony [2] as “a way of living a satisfying, hopeful and contributing life, even with the limitations caused by the illness”(p. Progress has been made with regards to the personal recovery conceptual framework. The approach proposed by Leamy, Bird, Le Boutillier, Williams and Slade, summarized using the acronym CHIME [5], has been gaining importance [6, 7]. This conceptual framework is composed by five recovery processes: Connectedness, Hope and optimism about the future, Identity, Meaning in life, and Empowerment. The study conducted by Slade el al. has provided some international validity [8], and the work of Bird et al has validated the framework through deductive and inductive analyses with individuals using mental health services [9]
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