Presentation of the HoNOS-Secure French Version, an Outcome Measure for Users of Secure and Forensic Mental Health Services
Journal Title: Journal of Forensic Science & Criminology - Year 2015, Vol 3, Issue 4
Abstract
Background: Despite a number of instruments designed for the assessment of dangerousness, standardized outcome measures for forensic psychiatric patients are lacking, especially in other languages than English. Aim: To validate the French version of HoNOS-secure, the Health of the Nation Outcome Scales for users of forensic services. Method: The psychometric properties of HoNOS-secure-French were evaluated in 66 patients rated independently by two clinicians on two occasions, 6 to 8 weeks apart. There were 7 raters in total, both psychiatrists and psychologists. Results: Internal consistency was acceptable for all 4 assessments of the HoNOS security scale and 3 of 4 assessments of the clinical scale (Cronbach’s alpha ≥ 0.70). Inter-rater reliability of single ratings was moderate for the security scale (ICC 0.48-0.56) and fair to moderate for the clinical scale (ICC 0.37-0.60). Test-retest reliability was substantial for both the security (ICC 0.69) and clinical scales (ICC 0.73) when patients were rated by their attending therapists. It was substantial for the security scale (ICC 0.80), but only fair for the clinical scale (ICC 0.28) when raters were less familiar with the patient’s condition. Increased needs for secure measures (security scale) and for care (clinical scale) were significantly associated with higher severity of psychopathology (Clinical Global Impression) and lower self-perceived physical health (Medical Outcomes Study 36-Item Short Form Health Survey). Conclusions: The value of the HoNOS-secure-F for routine outcome monitoring deserves closer examination. Some of its psychometric properties might be less than optimal. Therefore, we cannot recommend relying solely on its scores for medico-legal decisions.
Authors and Affiliations
Eytan A
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