Measuring Outcomes in Mental Health Services for Older People: An evaluation of the Health of the Nation Outcome Scales for elderly people (HoNOS65+)

Readiness for discharge from subacute mental health units for older people: Using available measures to support clinical decision‐making

“…There is a strong need to develop a suite of simple outcome measures, perhaps including the HoNOS65, that capture the information that patients, carers, clinicians, and managers require (Gee et al . ).…”

“…The HoNOS65 was found to have low sensitivity in this study, as well as low inter‐rater reliability in previous studies (Gee et al . ; Webster et al . ).…”

“…However, estimates of inter‐rater reliability across settings indicated areas of concern (Gee et al . ; Webster et al . ).…”

“…Although the HoNOS65 shows a large effect size for behavioural problems (Gee et al . ), ratings made by those involved in the older person's ongoing care might also be inflated by substantial bias. For example, ratings are made explicitly because the older person is scheduled for discharge, and therefore, clinicians are primed to expect improvement or to justify the decision to discharge.…”

“…The behaviour item has been found to correlate with the Brief Agitation Rating Scale (Canuto et al 2007;Spear et al 2002) and the Creighton Royal Behavioural Scale (Burns et al 1999). The generally moderate size of the associations with established measures, the focus on the most severe problem within each domain, and the restricted range of scores, suggest that the HoNOS65 behavioural subscale could be usefully supplemented or even replaced by more detailed outcome measures to support clinical and managerial decision-making (Gee et al 2010). Conversely, others have concluded that subscales within the HoNOS are not independent of each other and cannot be justifiably used independently, from a psychometric perspective (Speak & Muncer 2016).…”