The Recovering Quality of Life 10‐item (ReQoL‐10) scale in a first‐episode psychosis population: Validation and implications for patient‐reported outcome measures (PROMs)

Abstract

Aim This study aimed to examine the psychometric performance of the Recovering Quality of Life scale 10‐item version (ReQoL‐10) using a sample from a Singapore first‐episode psychosis intervention program, to explore its clinical and sociodemographic correlates, and to discuss its utility as a patient‐reported outcome measure (PROM). Methods Sociodemographic data, duration of untreated psychosis (DUP), and diagnosis were collected from 300 participants. Clinical data, which included baseline and current scores on the Patient Health Questionnaire 9‐item version, EuroQoL‐5 Dimension 3‐level version, Positive and Negative Syndrome Scale, and Global Assessment of Functioning scale, were extracted. The ReQoL‐10 was tested for structural validity, internal consistency, and construct validity, and a multiple linear regression determined if any of the baseline factors were statistically significant predictors of the total ReQoL‐10 scores. Results The mean (SD) total ReQoL‐10 score of the sample was 27.8 (7.8). Confirmatory factor analysis confirmed the bifactor model structure of the ReQoL‐10. The instrument demonstrated good internal consistency and adequate construct validity. Being older was associated with higher total ReQoL‐10 scores, while being married, having a highest educational level of vocational/diploma, longer DUP, and a diagnosis of affective psychosis were associated with lower total ReQoL‐10 scores. Conclusions This study has validated the ReQoL‐10 as suitable for routine use to measure recovery‐specific quality of life in a psychiatric setting among patients with first‐episode psychosis, and is a potential tool to initiate recovery conversations. As a PROM, it can facilitate shared decision making, in line with efforts to evaluate and improve quality of care.

Psychometric Evaluation of the Chinese Recovering Quality of Life (ReQoL) Outcome Measure and Assessment of Health-Related Quality of Life During the COVID-19 Pandemic

“…To address the issue of non-normal data, the robust distribution free weighted least squares (WLSMV) estimator was used (Ferrando and Lorenzo-Seva, 2000;Markon, 2019). Several a priori hypotheses about the relationship between the ReQoL-TC and the other HRQoL and mental health instruments were formulated to test the convergent validity of the ReQoL-TC (Keetharuth et al, 2018b;Chua et al, 2020;van Aken et al, 2020) (specific hypotheses are presented in Supplementary Table 1). The strength of the correlation was estimated using Pearson's correlation coefficient (r), where r ≥ 0.55 were interpreted as adequate.…”

“…A bifactor model of the ReQoL comprising a global factor and two local factors of negative and positive affects was reported by the developers ( Keetharuth et al, 2018a ). ReQoL has been translated into different languages and shown good reliability and validity ( Keetharuth et al, 2018b ; Chua et al, 2020 ; van Aken et al, 2020 ).…”

Psychometric evaluation of the German version of the Recovering Quality of Life (ReQoL) measures in patients with affective disorders

“…Furthermore, the ReQoL-10 was reliable in a sample with patients with psychosis and the ReQoL measures showed good convergent and known-group validity [17]. In a firstepisode psychosis population in Singapore, ReQoL-10 was found to have good internal consistency and adequate construct validity [30].…”

“…So far, the psychometric properties of the ReQoL measures have been assessed in patients with anxiety and depression in the United Kingdom [29], in patients with psychosis in the Netherlands [17] and Singapore [30], in the general population in the United Kingdom [15] and Hong Kong [25] as well as in a convenience sample in the Netherlands [17]. For the patient populations, the ReQoL measures showed good internal consistency and better responsiveness and construct validity compared with the EQ-5D-5L in patients with depression, but not in patients with anxiety [29,30]. Furthermore, the ReQoL-10 was reliable in a sample with patients with psychosis and the ReQoL measures showed good convergent and known-group validity [17].…”

The personal recovery movement in Singapore – past, present and future

“…In addition, literature examining the personal recovery approach also began to emerge in 2019 to 2020, exploring the lived experiences of people with psychosis 16 and hoarding, 17 evaluating peer support services, 18 and testing various recovery-oriented measurement tools. 19,20 It may be observed that the latter half of the 2010s was an indicator of an impending paradigm shift and the beginning of more personal recovery-oriented perspectives being seeded across the mental healthcare landscape in Singapore. Beyond these developments, there have not been any major/sustained efforts to introduce personal recovery principles into existing mental health services and research agendas.…”