The relationship between clinical and recovery dimensions of outcome in mental health

Background: Little is known about the empirical relationship between clinical and personal recovery. Aims: To examine whether there are separate constructs of clinical recovery and personal recovery dimensions of outcome, how they change over time and how they can be assessed. Method: Standard...

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Main Authors: Macpherson, Rob, Pesola, Francesca, Leamy, Mary, Bird, Victoria, Le Boutillier, Clair, Williams, Julie, Slade, Mike
Format: Article
Published: Elsevier 2015
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Online Access:https://eprints.nottingham.ac.uk/31580/
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author Macpherson, Rob
Pesola, Francesca
Leamy, Mary
Bird, Victoria
Le Boutillier, Clair
Williams, Julie
Slade, Mike
author_facet Macpherson, Rob
Pesola, Francesca
Leamy, Mary
Bird, Victoria
Le Boutillier, Clair
Williams, Julie
Slade, Mike
author_sort Macpherson, Rob
building Nottingham Research Data Repository
collection Online Access
description Background: Little is known about the empirical relationship between clinical and personal recovery. Aims: To examine whether there are separate constructs of clinical recovery and personal recovery dimensions of outcome, how they change over time and how they can be assessed. Method: Standardised outcome measures were administered at baseline and one-year follow-up to participants in the REFOCUS Trial (ISRCTN02507940). An exploratory factor analysis was conducted and a confirmatory factor analysis assessed change across time. Results: We identified three factors: patient-rated personal recovery, patient-rated clinical recovery and staff-rated clinical recovery. Only the personal recovery factor improved after one year. HHI, CANSAS-P and HoNOS were the best measures for research and practice. Conclusions: The identification of three rather than two factors was unexpected. Our findings support the value of concurrently assessing staff and patient perceptions of outcome. Only the personal recovery factor changed over time, this desynchrony between clinical and recovery outcomes providing empirical evidence that clinical recovery and personal recovery are not the same. We did not find evidence of a trade-off between clinical recovery and personal recovery outcomes. Optimal assessment based on our data would involve assessment of hope, social disability and patient-rated unmet need.
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spelling nottingham-315802020-05-04T17:18:21Z https://eprints.nottingham.ac.uk/31580/ The relationship between clinical and recovery dimensions of outcome in mental health Macpherson, Rob Pesola, Francesca Leamy, Mary Bird, Victoria Le Boutillier, Clair Williams, Julie Slade, Mike Background: Little is known about the empirical relationship between clinical and personal recovery. Aims: To examine whether there are separate constructs of clinical recovery and personal recovery dimensions of outcome, how they change over time and how they can be assessed. Method: Standardised outcome measures were administered at baseline and one-year follow-up to participants in the REFOCUS Trial (ISRCTN02507940). An exploratory factor analysis was conducted and a confirmatory factor analysis assessed change across time. Results: We identified three factors: patient-rated personal recovery, patient-rated clinical recovery and staff-rated clinical recovery. Only the personal recovery factor improved after one year. HHI, CANSAS-P and HoNOS were the best measures for research and practice. Conclusions: The identification of three rather than two factors was unexpected. Our findings support the value of concurrently assessing staff and patient perceptions of outcome. Only the personal recovery factor changed over time, this desynchrony between clinical and recovery outcomes providing empirical evidence that clinical recovery and personal recovery are not the same. We did not find evidence of a trade-off between clinical recovery and personal recovery outcomes. Optimal assessment based on our data would involve assessment of hope, social disability and patient-rated unmet need. Elsevier 2015-10-31 Article PeerReviewed Macpherson, Rob, Pesola, Francesca, Leamy, Mary, Bird, Victoria, Le Boutillier, Clair, Williams, Julie and Slade, Mike (2015) The relationship between clinical and recovery dimensions of outcome in mental health. Schizophrenia Research . ISSN 1573-2509 clinical recovery personal recovery http://www.sciencedirect.com/science/article/pii/S0920996415300311 doi:10.1016/j.schres.2015.10.031 doi:10.1016/j.schres.2015.10.031
spellingShingle clinical recovery
personal recovery
Macpherson, Rob
Pesola, Francesca
Leamy, Mary
Bird, Victoria
Le Boutillier, Clair
Williams, Julie
Slade, Mike
The relationship between clinical and recovery dimensions of outcome in mental health
title The relationship between clinical and recovery dimensions of outcome in mental health
title_full The relationship between clinical and recovery dimensions of outcome in mental health
title_fullStr The relationship between clinical and recovery dimensions of outcome in mental health
title_full_unstemmed The relationship between clinical and recovery dimensions of outcome in mental health
title_short The relationship between clinical and recovery dimensions of outcome in mental health
title_sort relationship between clinical and recovery dimensions of outcome in mental health
topic clinical recovery
personal recovery
url https://eprints.nottingham.ac.uk/31580/
https://eprints.nottingham.ac.uk/31580/
https://eprints.nottingham.ac.uk/31580/