Measuring personal recovery in people with a psychotic disorder based on CHIME: A comparison of three validated measures

Int J Ment Health Nurs. 2020 Oct;29(5):808-819. doi: 10.1111/inm.12711. Epub 2020 Mar 9.

Abstract

Living well in spite of residual symptoms of mental illness is measured with the construct of personal recovery. The CHIME framework might be suitable to evaluate personal recovery measures and guide instrument choice. Three validated measures were evaluated in Dutch patients with a psychotic disorder (N = 52). We compared the Recovery Assessment Scale (RAS), the Mental Health Recovery Measure (MHRM), and the Netherlands Empowerment List (NEL). The measures were assessed on six criteria: content validity (based on CHIME), convergent validity with a social support measure, internal consistency, floor and ceiling effects, item interpretability, and ease of administration. The MHRM scored high on content validity with a balanced distribution of items covering the CHIME framework. The MHRM and the NEL showed moderate convergent validity with social support. In all three measures, internal consistency was moderate and floor and ceiling effects were absent. The NEL scores demonstrated a high degree of item interpretability. Ease of administration was moderate for all three measures. Finally, the CHIME framework demonstrated good utility as a framework in guiding instrument choice and evaluation of personal recovery measures. The MHRM showed the best overall result. However, differences between measures were minimal. Generalization of the results is limited by cultural and linguistic factors in the assessment for the subjective measures (i.e. content validity and item interpretability). The broad and multidimensional construct of personal recovery might lead to ambiguous interpretations. Scientific consensus on a well-defined personal recovery construct is needed.

Keywords: Schizophrenia spectrum and other psychotic disorders; mental health recovery; outcome assessment; psychometrics; psychosis.

MeSH terms

  • Humans
  • Netherlands
  • Psychometrics
  • Psychotic Disorders* / therapy
  • Reproducibility of Results
  • Social Support
  • Surveys and Questionnaires