Validity and reliability of the Health of the Nation Outcome Scales in psychiatric patients in the community

Br J Psychiatry. 1999 May:174:409-12. doi: 10.1192/bjp.174.5.409.

Abstract

Background: The Health of the Nation Outcome Scales (HoNOS) have been developed for assessing the effectiveness of mental health services.

Aims: To investigate the validity and reliability of the HoNOS in patients in contact with mental health services.

Method: Subjects (age range 19-64) came from day hospitals, acute in-patient units and out-patient clinics in general practice. We obtained the opinions of experienced professionals, advocacy groups and patient groups to evaluate consensual and content validity.

Results: One hundred patients were assessed using the package of rating scales. Interrater and test-retest reliability were good for some items and poor for others. The HoNOS had good criterion validity: acute in-patients had higher scores than day patients and out-patients. HoNOS also had good concurrent validity, correlating well with other scales. Comments suggested that the HoNOS was a useful and suitable scale for this population but psychotic symptoms and certain social factors were not sufficiently covered.

Conclusion: The HoNOS had good validity but variable reliability. It may be better than existing scales because of the wide range of areas which it covers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Community Mental Health Services / organization & administration*
  • Community Mental Health Services / standards
  • England
  • Feasibility Studies
  • Female
  • Health Status Indicators*
  • Humans
  • Male
  • Mental Disorders / therapy*
  • Middle Aged
  • Observer Variation
  • Outcome Assessment, Health Care*
  • Prospective Studies
  • Psychiatric Status Rating Scales / standards*
  • Sensitivity and Specificity
  • Social Behavior