Chapter 2 40 it. The dropout percentage would give an indication of the number of completers of the intervention that could be expected in the main study. We also wanted to explore client characteristics related to dropout. Outcome measures for the main study Illness management and illness outcomes The primary outcome measure of the main study is the client version of the IMRS (10, 24). One of the secondary outcome measures is the clinician-rated IMRS (1012, 24). The items of these two IMR scales mainly concern aspects of illness management and illness outcomes. Each of the two scales includes 15 items scored on a 5-point scale (11, 12). Research on the IMR Scales indicates that internal consistency is moderate, that two-week test-retest reliability is high, and that the scales have convergent validity (24-28). This supports the use of the IMR Scales in assessing illness management and recovery in people with severe mental illness. Additional illness-management scales Given the limited number of items in the IMR scales, the main study will also assess illness management using other validated and more comprehensive scales as secondary outcome variables, assessing coping, social support, treatment compliance, insight into illness, and problems with alcohol and drugs. To measure these topics, we will use the respective instruments: the Coping Self-Efficacy Scale (CSES) (29), the Multidimensional Scale of Perceived Social Support (MSPSS) (30), the Service Engagement Scale (SES)(31), the Insight Scale (IS)(32), and one item (item 24) of the Addiction Severity Index (ASI) (33, 34). Illness outcomes: symptoms and relapses The secondary outcomes on illness-management outcomes are symptoms, health complaints and functional limitations, and relapses. These topics will be measured with the Brief Symptom Inventory (BSI) (35-37) and the EQ-5D (38), with the number of relapses being operationalized as the number and duration of hospital admissions and the number of emergency-department visits. Recovery In Mueser’s conceptual framework (1), the concept of recovery is differentiated into subjective recovery and objective recovery. We will assess subjective recovery as secondary outcome variable using a generic personal recovery scale, and by using four measures to assess internal stigma, self-esteem and life-goals: The Mental Health Recovery Measure (MHRM) (39, 40) (authorized Dutch translation (41, 42)); the Internal Stigma of Mental Illness (Ismi) (43); one item of the Quality of Life
RkJQdWJsaXNoZXIy MjY0ODMw