Measuring recovery in participants with a schizophrenia spectrum disorder: validation of the Individual Recovery Outcomes Counter (I.ROC).

BACKGROUND: To improve recovery in mental health, validated instruments are needed. AIMS: This study evaluates psychometric properties of the Individual Recovery Outcomes Counter (I.ROC) in a Dutch population of participants with a schizophrenia spectrum disorder (SSD). METHODS: 326 participants completed the I.ROC at baseline (n = 326), six months (n = 155) and twelve months (n = 84) as part of a routine outcome assessment. Reliability, validity, sensitivity to change, and internal factor structure were examined. RESULTS: Participants evaluated the I.ROC as comprehensive. Internal consistency of the I.ROC (α = 0.88) and test-retest reliability (r = .85, p < .001) are good. Negative moderate correlations with the total score of the PANSS (r=-.50, p < .001) and the HoNOS (r=-.52, p < .001) were found, and a small negative correlation with the FR tool (r=-.36, p < .001). Moderate positive correlation with the MANSA (r = .55, p < .001) and the RAS (r = .60, p < .001) were found. The mean total I.ROC scores increased significantly between time points (F(2,166) = 6.351, p < .005), although differences were small. Confirmatory factor analysis showed that fit indices for the one-, two-, and four-factor model are comparable. CONCLUSIONS: The I.ROC is a valid and reliable instrument, with sensitivity to change, to map recovery in participants with SSD.

Measuring personal recovery in a low-intensity community mental healthcare setting: validation of the Dutch version of the individual recovery outcomes counter (I.ROC).

BACKGROUND: Measuring progress in treatment is essential for systematic evaluation by service users and their care providers. In low-intensity community mental healthcare, a questionnaire to measure progress in treatment should be aimed at personal recovery and should require little effort to complete. METHODS: The Individual Recovery Outcome Counter (I.ROC) was translated from English into Dutch, and psychometric evaluations were performed. Data were collected on personal recovery (Recovery Assessment Scale), quality of life (Manchester Short Assessment of Quality of Life), and symptoms of mental illness and social functioning (Outcome Questionnaire, OQ-45) for assessing the validity of the I.ROC. Test-retest reliability was evaluated by calculating the Intraclass Correlation Coefficient and internal consistency was evaluated by calculating Cronbach's alpha. Exploratory factor analysis was performed to determine construct validity. To assess convergent validity, the I.ROC was compared to relevant questionnaires by calculating Pearson correlation coefficients. To evaluate discriminant validity, I.ROC scores of certain subgroups were compared using either a t-test or analysis of variance. RESULTS: There were 764 participants in this study who mostly completed more than one I.ROC (total n = 2,863). The I.ROC aimed to measure the concept of personal recovery as a whole, which was confirmed by a factor analysis. The test-retest reliability was satisfactory (Intraclass Correlation Coefficient is 0.856), as were the internal consistency (Cronbachs Alpha is 0.921) and the convergent validity. Sensitivity to change was small, but comparable to that of the OQ-45. CONCLUSIONS: The Dutch version of the I.ROC appears to have satisfactory psychometric properties to warrant its use in daily practice. Discriminant validity and sensitivity to change need further research.

Personally meaningful recovery in people with psychological trauma: Initial validity and reliability of the Individual Recovery Outcomes Counter (I.ROC).

Individual Recovery Outcomes Counter (I.ROC) is a brief tool measuring personal recovery designed for collaborative use within support. This study aimed to investigate the psychometric properties of a self-report version of the I.ROC within a trauma population. A total of 107 adults attending trauma interventions in an NHS service in Scotland completed I.ROC alongside measures of self-esteem, mental illness symptoms, and functional impairment. Scores on each measure were compared to evaluate the convergent validity of I.ROC. Internal consistency and factor analytical techniques were also used to assess the structural validity and reliability of the measure. Results of internal consistency, convergent validity, and factor analysis provide preliminary support for I.ROC's validity within a trauma population. Previously proposed models were a poor fit for the current sample; principal components analysis suggested a three-factor structure with acceptable internal consistency, comprising ten of the original twelve items (I.ROC-10). Correlations with all measures reached significance for the original and modified I.ROC and its subscales. I.ROC appears to be a valid and reliable tool for use in measuring recovery within a trauma population, but further research is needed to examine the structural validity of I.ROC.

Measuring Recovery in Deaf, Hard-of-Hearing, and Tinnitus Patients in a Mental Health Care Setting: Validation of the I.ROC.

This study was aimed at validating the Individual Recovery Outcomes Counter (I.ROC) for deaf, hard-of-hearing, and tinnitus patients in a mental health care setting. There is a need for an accessible instrument to monitor treatment effects in this population. The I.ROC measures recovery, seeing recovery as a process of experiencing a meaningful life, despite the limitations caused by illness or disability. A total of 84 adults referred to 2 specialist mental health centers for deaf, hard-of-hearing, and tinnitus adults in the Netherlands completed the Dutch version of I.ROC and 3 other instruments. A total of 25 patients refused or did not complete the instruments: 50% of patients using sign language and 18% of patients using spoken language. Participants completed the measures at intake and then every 3 months. In this sample I.ROC demonstrated good internal consistency and convergent validity. Sensitivity to change was good, especially over a period of 6 or 9 months. This study provides preliminary evidence that the I.ROC is a valid instrument measuring recovery for hard-of-hearing and tinnitus patients using spoken language. For deaf patients using sign language, specifically those with limited language skills in spoken and written Dutch, more research is needed.

Factor validation and Rasch analysis of the individual recovery outcomes counter.

OBJECTIVE: The individual recovery outcomes counter is a 12-item personal recovery self-assessment tool for adults with mental health problems. Although widely used across Scotland, limited research into its psychometric properties has been conducted. We tested its' measurement properties to ascertain the suitability of the tool for continued use in its' present form. MATERIALS AND METHODS: Anonymised data from the assessments of 1743 adults using mental health services in Scotland were subject to tests based on principles of Rasch measurement theory, principal components analysis and confirmatory factor analysis. RESULTS: Rasch analysis revealed that the six-point response structure of the individual recovery outcomes counter (I.ROC) was problematic. Re-scoring on a four-point scale revealed well-ordered items that measure a single, recovery-related construct, and has acceptable fit statistics. Confirmatory factor analysis supported this. Scale items covered around 75% of the recovery continuum; those individuals least far along the continuum were least well addressed. CONCLUSIONS: A modified tool worked well for many, but not all, service users. The study suggests specific developments are required if the I.ROC is to maximise its' utility for service users and provide meaningful data for service providers. Implications for Rehabilitation Agencies and services working with people with mental health problems aim to help them with their recovery. The individual recovery outcomes counter has been developed and is used widely in Scotland to help service users track their progress to recovery. Using a large sample of routinely collected data we have demonstrated that a number of modifications are needed if the tool is to adequately measure recovery. This will involve consideration of the scoring system, item content and inclusion, and theoretical basis of the tool.

Computerized Self-Administered Measures of Mood and Appetite for Older Adults: The Novel Assessment of Nutrition and Ageing Toolkit.

The "Novel Assessment of Nutrition and Ageing" (NANA) toolkit is a computerized system for collecting longitudinal information about older adults' health and behavior. Here, we describe the validation of six items for measuring older adults' self-reported mood and appetite as part of the NANA system. In Study 1, 48 community-living older adults (aged 65-89 years) completed NANA measures of their current mood and appetite alongside standard paper measures, on three occasions, in a laboratory setting. In Study 2, 40 community-living older adults (aged 64-88 years) completed daily NANA measures of momentary mood and appetite in their own homes, unsupervised, alongside additional measures of health and behavior, over three 7-day periods. The NANA measures were significantly correlated with standard measures of mood and appetite, and showed stability over time. They show utility for tracking mood and appetite longitudinally, and for better understanding links with other aspects of health and behavior.

Computer-based tools for assessing micro-longitudinal patterns of cognitive function in older adults.

Patterns of cognitive change over micro-longitudinal timescales (i.e., ranging from hours to days) are associated with a wide range of age-related health and functional outcomes. However, practical issues of conducting high-frequency assessments make investigations of micro-longitudinal cognition costly and burdensome to run. One way of addressing this is to develop cognitive assessments that can be performed by older adults, in their own homes, without a researcher being present. Here, we address the question of whether reliable and valid cognitive data can be collected over micro-longitudinal timescales using unsupervised cognitive tests.In study 1, 48 older adults completed two touchscreen cognitive tests, on three occasions, in controlled conditions, alongside a battery of standard tests of cognitive functions. In study 2, 40 older adults completed the same two computerized tasks on multiple occasions, over three separate week-long periods, in their own homes, without a researcher present. Here, the tasks were incorporated into a wider touchscreen system (Novel Assessment of Nutrition and Ageing (NANA)) developed to assess multiple domains of health and behavior. Standard tests of cognitive function were also administered prior to participants using the NANA system.Performance on the two "NANA" cognitive tasks showed convergent validity with, and similar levels of reliability to, the standard cognitive battery in both studies. Completion and accuracy rates were also very high. These results show that reliable and valid cognitive data can be collected from older adults using unsupervised computerized tests, thus affording new opportunities for the investigation of cognitive.