How are You Measure Recovery? Current Approaches in Practice and - - PowerPoint PPT Presentation
How are You Measure Recovery? Current Approaches in Practice and Research BC PSR Advanced Practice Webinar Skye Pamela Barbic 1-4 , PhD, OT 1 Department of Psychiatry, University of British Columbia, Vancouver, Canada 2 Department of Occupational
Skye Pamela Barbic1-4, PhD, OT
1 Department of Psychiatry, University of British Columbia, Vancouver, Canada 2Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada 3St-Paul’s Hospital, Vancouver, Canada 4Social Aetiology of Mental Illness Program, Centre for Addiction and Mental Health, Toronto, Canada
Canadian Institute of Health Research Centre for Addiction and Mental Health University of British Columbia University of Toronto/ McGill/Queen’s/University of Manitoba Granville Youth Health Clinic/St-Paul’s Hospital YMCA CAMH Vancouver-Burnaby Branch CAMH-TORONTO Wellington Centre, Douglas Institute-MONTREAL
Terry Krupa, Bonnie Kirsh, Kwame McKenzie, Stefan Cano, Jeremy Hobart, Jack Stenner, David Andrich,
Zachary Durisko, Sean Kidd, Catherine Backman, William Honer, Bill MacEwan, Chris Richardson, Donald Patrick, Todd Edwards, Michael Anhorn, Regina Casey, Mimi Rennie, Anthony Bailey, Howard Choodos, Stephen Epp, Jeff Massey, William Fisher, & Josh McGrane. Sarah Irving, Marie-eve Letellier, Pasqual Boutin
Affects approximately 6.7 million Canadians1, Results in reduced workplace productivity and over $50 billion in direct
Living with a serious mental illness may shorten one’s lifespan by
High rates of chronic illnesses as diabetes, obesity, heart ailments and
respiratory diseases
Vulnerability to homelessness, unemployment and alcohol consumption. 3
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38 year old woman diagnosed with schizophrenia at the age of 17. Referred to OT after 300 bed closer of hospital which she was admitted
to consecutively since age 19.
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Do they work? What tools do we have to promote recovery? How do we know if they worked?
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8 Clinical assessment
Hope, Empowerment, Quality of Life, Cognition, Apathy, Depression, Pain, Mastery, Locus of Control, Happiness, Motivation, Readiness for Change………
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Hope, Empowerment, Quality of Life, Cognition, Apathy, Depression, Pain, Mastery, Locus of Control, Happiness, Motivation, Readiness for Change………
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Single most targeted outcome in mental health
Individual treatment Group level System reform
Significant gap in the conceptual clarity of recovery and lack of
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Living a satisfying, hopeful, and contributing life, even
William Anthony, 1993
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See handout
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Need to be fit for purpose for your context of use Are you “measuring” to develop a recovery profile? Are you measuring to “measure recovery”
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Global Objective:
to assess the personal recovery needs of Canadians with severe mental
Specific objectives to:
(i) determine the feasibility of using available personal recovery PROs in a
community outpatient mental health setting;
(ii) describe the personal recovery profile of a Canadian outpatient sample,
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(iii) measure the extent to which the full range of the recovery is covered by
existing rating scales.
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Design:
Cross sectional survey Single city, Multi-site
We asked 228 people to fill in 3 commonly used questionnaires
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Specific objectives to:
(i) determine the feasibility of using available personal recovery PROs
224/228 people completed ALL of the questions. Questionnaire packs took between 10-30
minutes to complete. (ii) describe the personal recovery profile of a Canadian outpatient
(iii) measure the extent to which the full range of the recovery is covered by
existing rating scales.
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Progress Towards Personal Goals in the last 3 months
no goal not done anything little way pretty far finished
No GOAL Not done anything Pretty Far A little way Finished
1. Reduce Smoking 2. Clean apartment 3. Build a resume 4. Attend a program
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92 45 43 10 29 <2 3 TO 5 6 TO 15 16-30 30+
Time in structured roles (hours)
Affects approximately 6.7 million Canadians1, Results in reduced workplace productivity and over $50 billion in direct
Living with a serious mental illness may shorten one’s lifespan by
High rates of chronic illnesses as diabetes, obesity, heart ailments and
respiratory diseases
Vulnerability to homelessness, unemployment and alcohol consumption. 33
Specific objectives to:
(i) determine the feasibility of using available personal recovery PROs in a
(ii) describe the personal recovery profile of a Canadian outpatient sample,
and
(iii) measure the extent to which the full range of the recovery is covered
by existing rating scales.
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“The IMR/RAS/QPR demonstrates excellent psychometric properties”
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Rating scales should be developed from clear construct definitions to
Stenner, A., Burdick, H., Sandford, E., and Burdick, D. How accurate are lexile text emasures? J Applied Measurement, 2006; 7: 307-322.
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Range of Motion Speed Endurance Weight
Latent Outcomes
“Functional Ability” Quality of Life Depression (e.g. 335 measures) Pain Self-efficacy Recovery
Source: Massof, F. (2010). A clinically meaningful theory of outcome measures in rehabilitation. Journal of Applied Measurement 11(3): 253-70.
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i.e., Patient reported outcomes
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Personal ability Item Difficulty
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Measurement theory refers to a body of principles, ideas, rules, and
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You are training me to run a marathon.
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Walk a mile Run 5 miles Run 10 miles Run 20 miles Run marathon Run Boston Marathon
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2 1 1
e e e
2 1 1
e e e
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Conducted focus groups (n=2, total of 19 participants)
All participants reported a diagnosis of schizophrenia 9 females, 10 males
What did we do?
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Item bank: 40 item
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Questions to ask
I have lots of tools out there! Yahoo!!! Which one do I choose? What story do I want to tell? How can I tell it? Is the “best tool” out there fit for purpose for my practice? How can I use metrics to support the need for psychosocial rehabilitation
services to support people along their entire journey of recovery?
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Gather metrics for:
time use participation recovery
Advocate for the importance of helping individuals live full and
Advocate for mental health as an outcome for all.
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systematic review of the epidemiological literature. Psychological Medicine 43.
Journal of Geriatric Psychiatry 22: 207–210.
Internal Medicine 160: 3278-3285.
General Psychiatry 57: 285-290.
factors in 1990 and projected to 2020. Boston, MA: Harvard University Press.
than good. Frontiers in Psychology 3: 117.
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