Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Quality of Life Research
Published in: Quality of Life Research 8/2019

Open Access 01-08-2019

Measuring broader wellbeing in mental health services: validity of the German language OxCAP-MH capability instrument

Authors: Agata Łaszewska, Markus Schwab, Eva Leutner, Marold Oberrauter, Georg Spiel, Judit Simon

Published in: Quality of Life Research | Issue 8/2019

Login to get access

Abstract

Purpose

The OxCAP-MH capabilities questionnaire was developed and validated in the UK for outcome measurement in mental health clinical studies. Its broader wellbeing construct or validity in routine mental health services so far has not been assessed. The objectives were to investigate the extent the OxCAP-MH measures broader wellbeing compared to the EQ-5D-5L and to test psychometric properties of the German language OxCAP-MH in routine mental health services in Austria.

Methods

Study sample consisted of patients in socio-psychiatric services (n = 159) assessed at baseline and 6-month follow-up. Underlying factors associated with quality-of-life/wellbeing concepts measured by the OxCAP-MH and EQ-5D-5L were identified in exploratory factor analysis (EFA). Responsiveness was assessed using anchor questionnaires and standardised response mean (SRM). For discriminant validity, subgroups of respondents were compared using t test and one-way ANOVA. Test–retest analysis was assessed for a period of maximum 30 days from the baseline assessment with intra-class correlation coefficient (ICC).

Results

EFA identified a two-factor structure. All EQ-5D-5L items and seven OxCAP-MH items loaded on one factor and nine remaining OxCAP-MH items loaded on a separate factor. Responsiveness was found for patients who improved in anchor questionnaire scores with large or moderate SRM statistics. OxCAP-MH discriminated between various groups in univariable and multivariable analyses. Reliability of the German language OxCAP-MH was confirmed by ICC of 0.80.

Conclusions

Besides providing evidence that the OxCAP-MH measures broader wellbeing constructs beyond traditional health-related quality of life, the study also confirms the validity of the instrument for implementation in routine evaluation of mental health services.
Appendix
Available only for authorised users
Literature
1.
Coast, J., Smith, R. D., & Lorgelly, P. (2008). Welfarism, extra-welfarism and capability: The spread of ideas in health economics. Social Science and Medicine,67(7), 1190–1198.PubMed
2.
Brazier, J. E., Rowen, D., Lloyd, A., & Karimi, M. (2019). Future directions in valuing benefits for estimating QALYs: Is time up for the EQ-5D? Value in Health,22(1), 62–68.PubMed
3.
Lorgelly, P. K., Lawson, K. D., Fenwick, E. A., & Briggs, A. H. (2010). Outcome measurement in economic evaluations of public health interventions: A role for the capability approach? International Journal of Environmental Research and Public Health,7(5), 2274–2289.PubMedPubMedCentral
4.
Coast, J., Kinghorn, P., & Mitchell, P. (2014). The development of capability measures in health economics: Opportunities, challenges and progress. Patient,8(2), 119–126.
5.
Brazier, J. (2010). Is the EQ-5D fit for purpose in mental health? British Journal of Psychiatry,197(5), 348–349.PubMed
6.
Coast, J., Smith, R., & Lorgelly, P. (2008). Should the capability approach be applied in health economics? Health Economics,17(6), 667–670.PubMed
7.
Simon, J., Anand, P., Gray, A., Rugkasa, J., Yeeles, K., & Burns, T. (2013). Operationalising the capability approach for outcome measurement in mental health research. Social Science and Medicine,98, 187–196.PubMed
8.
Mitchell, P. M., Al-Janabi, H., Richardson, J., Iezzi, A., & Coast, J. (2015). The relative impacts of disease on health status and capability wellbeing: A multi-country study. PLoS ONE,10(12), e0143590.PubMedPubMedCentral
9.
Lorgelly, P., Lorimer, K., Fenwick, E., & Briggs, A. (2008). The capability approach: Developing an instrument for evaluating public health interventions. Final report. Section of Public Health and Health Policy: University of Glasgow.
10.
Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. British Journal of Psychiatry,199(6), 445–452.PubMed
11.
Nussbaum, M. C. (2000). Women and human development: The capabilities approach. Cambridge: Cambridge University Press.
12.
Sen, A. (1993). Capability and well-being. In M. Nusbaum & A. Sen (Eds.), The quality of life (pp. 30–53). Oxford: Clarendon Press.
13.
Mitchell, P. M., Roberts, T. E., Barton, P. M., & Coast, J. (2017). Applications of the capability approach in the health field: A literature review. Social Indicators Research,133(1), 345–371.PubMed
14.
Vergunst, F., Jenkinson, C., Burns, T., Anand, P., Gray, A., Rugkasa, J., et al. (2017). Psychometric validation of a multi-dimensional capability instrument for outcome measurement in mental health research (OxCAP-MH). Health and Quality of Life Outcomes,15(1), 250.PubMedPubMedCentral
15.
Al-Janabi, H., Peters, T. J., Brazier, J., Bryan, S., Flynn, T. N., Clemens, S., et al. (2013). An investigation of the construct validity of the ICECAP-A capability measure. Quality of Life Research,22(7), 1831–1840.PubMed
16.
Makai, P., Beckebans, F., van Exel, J., & Brouwer, W. B. (2014). Quality of life of nursing home residents with dementia: Validation of the German version of the ICECAP-O. PLoS ONE,9(3), e92016.PubMedPubMedCentral
17.
Makai, P., Koopmanschap, M. A., Brouwer, W. B., & Nieboer, A. A. (2013). A validation of the ICECAP-O in a population of post-hospitalized older people in the Netherlands. Health and Quality of Life Outcomes,11, 57.PubMedPubMedCentral
18.
Malley, J. N., Towers, A.-M., Netten, A. P., Brazier, J. E., Forder, J. E., & Flynn, T. (2012). An assessment of the construct validity of the ASCOT measure of social care-related quality of life with older people. Health and Quality of Life Outcomes,10(1), 21.PubMedPubMedCentral
19.
Sarabia-Cobo, C. M., Parás-Bravo, P., Amo-Setién, F. J., Alconero-Camarero, A. R., Sáenz-Jalón, M., Torres-Manrique, B., et al. (2017). Validation of the Spanish version of the ICECAP-O for nursing home residents with dementia. PLoS ONE,12(1), e0169354.PubMedPubMedCentral
20.
Goranitis, I., Coast, J., Day, E., Copello, A., Freemantle, N., Seddon, J., et al. (2016). Measuring health and broader well-being benefits in the context of opiate dependence: The psychometric performance of the ICECAP-A and the EQ-5D-5L. Value in Health,19(6), 820–828.PubMed
21.
Keeley, T., Coast, J., Nicholls, E., Foster, N. E., Jowett, S., & Al-Janabi, H. (2016). An analysis of the complementarity of ICECAP-A and EQ-5D-3L in an adult population of patients with knee pain. Health and Quality of Life Outcomes,14, 36.PubMedPubMedCentral
22.
Mitchell, P. M., Roberts, T. E., Barton, P. M., & Coast, J. (2015). Assessing sufficient capability: A new approach to economic evaluation. Social Science and Medicine,139, 71–79.PubMed
23.
Goranitis, I., Coast, J., Day, E., Copello, A., Freemantle, N., & Frew, E. (2017). Maximizing health or sufficient capability in economic evaluation? A methodological experiment of treatment for drug addiction. Medical Decision Making,37(5), 498–511.PubMed
24.
Coast, J. (2014). Strategies for the economic evaluation of end-of-life care: Making a case for the capability approach. Expert Review of Pharmacoeconomics & Outcomes Research,14(4), 473–482.
25.
26.
Steel, C., van der Gaag, M., Korrelboom, K., Simon, J., Phiri, P., Baksh, M. F., et al. (2015). A randomised controlled trial of positive memory training for the treatment of depression within schizophrenia. BMC Psychiatry,15(1), 85.PubMedPubMedCentral
27.
Kingslake, J., Dias, R., Dawson, G. R., Simon, J., Goodwin, G. M., Harmer, C. J., et al. (2017). The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: Study protocol for a randomised controlled trial. Trials,18(1), 558.PubMedPubMedCentral
28.
Burns, T., Rugkasa, J., Yeeles, K., & Catty, J. (2016). Coercion in mental health: A trial of the effectiveness of community treatment orders and an investigation of informal coercion in community mental health care. Programme Grants for Applied Research, 4(21).
29.
Simon, J., Łaszewska, A., Leutner, E., Spiel, G., Churchman, D., & Mayer, S. (2018). Cultural and linguistic transferability of the multi-dimensional OxCAP-MH capability instrument for outcome measurement in mental health: The German language version. BMC Psychiatry,18(1), 173.PubMedPubMedCentral
30.
Vergunst, F., Jenkinson, C., Burns, T., & Simon, J. (2014). Application of Sen’s capability approach to outcome measurement in mental health research: Psychometric validation of a novel multi-dimensional instrument (OxCAP-MH). Human Welfare, 3(1).
31.
32.
33.
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). DC: American Psychiatric Associaton Washington.
34.
Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of Life Research,13(2), 299–310.PubMed
35.
Meijer, R. R., de Vries, R. M., & van Bruggen, V. (2011). An evaluation of the Brief Symptom Inventory-18 using item response theory: Which items are most strongly related to psychological distress? Psychological Assessment,23(1), 193–202.PubMed
36.
Franke, G. H., Jaeger, S., Glaesmer, H., Barkmann, C., Petrowski, K., & Braehler, E. (2017). Psychometric analysis of the brief symptom inventory 18 (BSI-18) in a representative German sample. BMC Medical Research Methodology,17, 14.PubMedPubMedCentral
37.
Moos, R. H., Nichol, A. C., & Moos, B. S. (2002). Global assessment of functioning ratings and the allocation and outcomes of mental health services. Psychiatric Services,53(6), 730–737.PubMed
38.
Hall, R. C. (1995). Global assessment of functioning: A modified scale. Psychosomatics,36(3), 267–275.PubMed
39.
Soderberg, P., Tungstrom, S., & Armelius, B. A. (2005). Reliability of global assessment of functioning ratings made by clinical psychiatric staff. Psychiatric Services,56(4), 434–438.PubMed
40.
Hilsenroth, M. J., Ackerman, S. J., Blagys, M. D., Baumann, B. D., Baity, M. R., Smith, S. R., et al. (2000). Reliability and validity of DSM-IV axis V. American Journal of Psychiatry,157(11), 1858–1863.PubMed
41.
Molodynski, A., Linden, M., Juckel, G., Yeeles, K., Anderson, C., Vazquez-Montes, M., et al. (2013). The reliability, validity, and applicability of an English language version of the Mini-ICF-APP. Social Psychiatry and Psychiatric Epidemiology,48(8), 1347–1354.PubMed
42.
Linden, M., & Baron, S. (2005). [The “Mini-ICF-Rating for Mental Disorders (Mini-ICF-P)”. A short instrument for the assessment of disabilities in mental disorders]. Rehabilitation,44(3), 144–151.PubMed
43.
EuroQol Group. (1990). EuroQol—A new facility for the measurement of health-related quality of life. Health Policy,16(3), 199–208.
44.
Buchholz, I., Thielker, K., Feng, Y. S., Kupatz, P., & Kohlmann, T. (2015). Measuring changes in health over time using the EQ-5D 3L and 5L: A head-to-head comparison of measurement properties and sensitivity to change in a German inpatient rehabilitation sample. Quality of Life Research,24(4), 829–835.PubMed
45.
46.
Ludwig, K., Graf von der Schulenburg, J. M., & Greiner, W. (2018). German value set for the EQ-5D-5L. Pharmacoeconomics,36(6), 663–674.PubMedPubMedCentral
47.
van Reenen, M., & Janssen, B. (2015). EQ-5D-5L user guide: Basic information on how to use the EQ-5D-5L instrument. Rotterdam: EuroQol Research Foundation.
48.
Rencz, F., Gulacsi, L., Drummond, M., Golicki, D., Prevolnik Rupel, V., Simon, J., et al. (2016). EQ-5D in Central and Eastern Europe: 2000-2015. Quality of Life Research,25(11), 2693–2710.PubMed
49.
50.
Terwee, C. B., Bot, S. D., de Boer, M. R., van der Windt, D. A., Knol, D. L., Dekker, J., et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology,60(1), 34–42.PubMed
51.
Streiner, D. L., Norman, G. R., & Cairney, J. (2015). Health measurement scales: A practical guide to their development and use. Oxford: Oxford University Press.
52.
Timmerman, M. E., Lorenzo-Seva, U., & Ceulemans, E. (2018). The number of factors problem. In P. Irwing, T. Booth, & D. J. Hughes (Eds.), The Wiley handbook of psychometric testing. New York: Wiley.
53.
Williams, B., Onsman, A., & Brown, T. (2010). Exploratory factor analysis: A five-step guide for novices. Australasian Journal of Paramedicine, 8(3).
54.
Timmerman, M. E., & Lorenzo-Seva, U. (2011). Dimensionality assessment of ordered polytomous items with parallel analysis. Psychological Methods,16(2), 209–220.PubMed
55.
Lorenzo-Seva, U. (2013). Why rotate my data using Promin? Technical Report. In U. R. I. V. Department of Psychology, Tarragona (Ed.).
56.
Lorenzo-Seva, U., & Ferrando, P. J. (2006). FACTOR: A computer program to fit the exploratory factor analysis model. Behavior Research Methods,38(1), 88–91.PubMed
57.
StataCorp. (2017). Stata statistical software: Release 15. College Station, TX: StataCorp LLC.
58.
Cohen, J. (1988). Set correlation and contingency tables. Applied Psychological Measurement,12(4), 425–434.
59.
Revicki, D., Hays, R. D., Cella, D., & Sloan, J. (2008). Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. Journal of Clinical Epidemiology,61(2), 102–109.PubMed
60.
Payakachat, N., Ali, M. M., & Tilford, J. M. (2015). Can the EQ-5D detect meaningful change? A systematic review. Pharmacoeconomics,33(11), 1137–1154.PubMedPubMedCentral
61.
WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychological Medicine,28(3), 551–558.
62.
Beckerman, H., Roebroeck, M., Lankhorst, G., Becher, J., Bezemer, P. D., & Verbeek, A. (2001). Smallest real difference, a link between reproducibility and responsiveness. Quality of Life Research,10(7), 571–578.PubMed
63.
Koo, T. K., & Li, M. Y. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine,15(2), 155–163.PubMedPubMedCentral
64.
Streiner, D. L., & Norman, G. R. (1995). Health measurement scales: A practical guide to their development and use. Oxford: Oxford University Press.
65.
Davis, J. C., Liu-Ambrose, T., Richardson, C. G., & Bryan, S. (2013). A comparison of the ICECAP-O with EQ-5D in a falls prevention clinical setting: Are they complements or substitutes? Quality of Life Research,22(5), 969–977.PubMed
66.
Goranitis, I., Coast, J., Al-Janabi, H., Latthe, P., & Roberts, T. E. (2016). The validity and responsiveness of the ICECAP-A capability-well-being measure in women with irritative lower urinary tract symptoms. Quality of Life Research,25, 2063–2075.PubMedPubMedCentral
67.
Keeley, T., Al-Janabi, H., Nicholls, E., Foster, N. E., Jowett, S., & Coast, J. (2015). A longitudinal assessment of the responsiveness of the ICECAP-A in a randomised controlled trial of a knee pain intervention. Quality of Life Research,24(10), 2319–2331.PubMedPubMedCentral
68.
Mitchell, P. M., Al-Janabi, H., Byford, S., Kuyken, W., Richardson, J., Iezzi, A., et al. (2017). Assessing the validity of the ICECAP-A capability measure for adults with depression. BMC Psychiatry,17(1), 46.PubMedPubMedCentral
69.
Rand, S., Malley, J., Towers, A.-M., Netten, A., & Forder, J. (2017). Validity and test-retest reliability of the self-completion adult social care outcomes toolkit (ASCOT-SCT4) with adults with long-term physical, sensory and mental health conditions in England. Health and Quality of Life Outcomes,15(1), 163.PubMedPubMedCentral
70.
Baumgardt, J., Daum, M., von dem Knesebeck, O., Speck, A., & Röh, D. (2018). Assess capabilities among chronically mentally ill people: First test results on a draft German version of the OxCAP-MH as part of the BAESCAP study. Psychiatrische Praxis,45(3), 140–147.PubMed
71.
Al-Janabi, H., Flynn, T. N., Peters, T. J., Bryan, S., & Coast, J. (2015). Test-retest reliability of capability measurement in the UK general population. Health Economics,24(5), 625–630.PubMed
Metadata
Title
Measuring broader wellbeing in mental health services: validity of the German language OxCAP-MH capability instrument
Authors
Agata Łaszewska
Markus Schwab
Eva Leutner
Marold Oberrauter
Georg Spiel
Judit Simon
Publication date
01-08-2019
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 8/2019
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-019-02187-9

Other articles of this Issue 8/2019

Quality of Life Research 8/2019 Go to the issue

OriginalPaper

The role of religious coping and social support on medication adherence and quality of life among the elderly with type 2 diabetes

Review

The influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents: a systematic review and meta-analysis

OriginalPaper

Comparison of generic and condition-specific oral health-related quality of life instruments in patients with oral submucous fibrosis

OriginalPaper

Health-related quality of life and perceived health status of Turkish population

Correction

Correction to: Eculizumab improves fatigue in refractory generalized myasthenia gravis

OriginalPaper

Factors associated with low health-related quality of life among younger and older Thai patients with non-valvular atrial fibrillation