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Tijdschrift voor Psychiatrie 46 (2004) 5, 273 - 284

New research

The Health of the Nation Outcome Scales (honos) in Dutch translation as an instrument for Routine Outcome Assessment

C.L. Mulder, A.B.P. Staring, J. Loos, V.J.A. Buwalda, D. Kuijpers, S. Sytema, A.I. Wierdsma

background The Health of the Nation Outcome Scales (HoNOS) is a scaling device routinely used by the mental health services in Anglo-Saxon countries in order to map a patient's mental state and any changes that may have occurred in it. Up till recently the scaling device had not been applied in the Netherlands.
aim To investigate the usefulness and the psychometric qualities of the HoNOS in Dutch translation as an instrument for 'routine outcome assessment'.
method Trained personnel used the honos to find the scores of 559 patients in various institutions in the Netherlands. The HoNOS (12 items) measures behavioural problems, impairments, symptoms and social problems. The reliability, validity and structure of the honos were investi-gated.
results The reliability of the HoNOS was found to be fair to good. The validity was considered to be satisfactory for the following reasons: item patterns of various syndromes differed in the expected manner, total scores varied according to treatment intensities, and the honos related fairly well to other scales. Subscale analysis revealed a psychotic and a neurotic dimension.
conclusion The HoNOS provides insight at both individual and group level into the seriousness of problems in the areas of interest and into changes that have occurred in those areas. The HoNOS scaling device has reasonably good psychometric qualities, can be administrated in a short time, is not dependent on psychiatric diagnosis or language and is regarded as useful by both clinicians and patients. The subscale structure of the honos needs further investigation.

keywords Health of the Nation Outcome Scales, HoNOS, mental health services, outcome assessment, outcome measures