Recovering Quality of Life (ReQoL): a new generic self-reported outcome measure for use with people experiencing mental health difficulties

Anju Devianee Keetharuth,John Brazier,Michael Barkham,Jill Carlton,John Browne,Thomas Ricketts,Elizabeth Taylor Buck,Kirsty Mckendrick,Janice Connell,Tim Croudace,Jakob Bue Bjorner

doi:10.1192/bjp.2017.10

Abstract

Outcome measures for mental health services need to adopt a service-user recovery focus. Aims To develop and validate a 10- and 20-item self-report recovery-focused quality of life outcome measure named Recovering Quality of Life (ReQoL). Qualitative methods for item development and initial testing, and quantitative methods for item reduction and scale construction were used. Data from >6500 service users were factor analysed and item response theory models employed to inform item selection. The measures were tested for reliability, validity and responsiveness. ReQoL-10 and ReQoL-20 contain positively and negatively worded items covering seven themes: activity, hope, belonging and relationships, self-perception, well-being, autonomy, and physical health. Both versions achieved acceptable internal consistency, test-retest reliability (>0.85), known-group differences, convergence with related measures, and were responsive over time (standardised response mean (SRM) > 0.4). They performed marginally better than the Short Warwick-Edinburgh Mental Well-being Scale and markedly better than the EQ-5D. Both versions are appropriate for measuring service-user recovery-focused quality of life outcomes. Declaration of interest M.B. and J.Co. were members of the research group that developed the Clinical Outcomes in Routine Evaluation (CORE) outcome measures.

Highlights

Outcome measures for mental health services need to adopt a service-user recovery focus
Measures used in mental health services tend to be focused on specific symptoms such as depression (PHQ-9)[20] or anxiety (GAD-7),[21] both of which are used in the Improving Access to Psychological Therapies (IAPT) programme[22] and do not meet these guidelines
Known-group validity was examined in terms of whether the Recovering Quality of Life (ReQoL) measures were able to discriminate between the general population and those people with a variety of specific conditions

Summary

Background

Outcome measures for mental health services need to adopt a service-user recovery focus. Aims To develop and validate a 10- and 20-item self-report recoveryfocused quality of life outcome measure named Recovering Quality of Life (ReQoL). Method Qualitative methods for item development and initial testing, and quantitative methods for item reduction and scale construction were used. Data from >6500 service users were factor analysed and item response theory models employed to inform item selection. The measures were tested for reliability, validity and responsiveness

Results

Conclusions

Method

Discussion

Limitations