Chapter 2 42 The fidelity of implementation of IMR per group was measured on the IMR Fidelity Scale (49). The IMR Fidelity Scale is a scale to assess the degree of implementation of the IMR model. It consists of 13 items, each of which is rated on a five-point scale and each of which is behaviorally anchored; a score of five indicates full implementation. The other scale points represent an increasing degree of implementation (51). The total score is the mean of all item-scores. Per group, fidelity measurement took almost a day, and was carried out by the principal researcher on the day of one of the last sessions. It consisted of semi-structured interviews with participants and the two trainers, plus observation of one session, and checking forms. The effectiveness of IMR with regard to illness management and illnessmanagement outcomes was measured with the Illness Management and Recovery Scale patient self-score version; and with the lllness Management and Recovery Scale clinician-rated version. Similarly, the effectiveness of IMR with regard to Recovery was measured with the Recovery Markers Questionnaire (RMQ)(52), a free-standing 24-item self-report subscale of the Recovery Enhancing Environment Measure (REE), which has a 5-point agreement-response scale ranging from “strongly agree” to “strongly disagree”. The scale has high internal and face validity (53, 54). Measuring improvement on recovery is a secondary outcome measure of the main study. Sample Size For the pilot study we could include most people who intended to participate in the six IMR groups (N=81). We did baseline measurements and gathered sociodemographic data on these participants. Feasibility criteria Our primary feasibility criterion was whether the institute was able to recruit a sufficient number of participants for the six IMR groups planned for the pilot study. According to the IMR Fidelity Scale, the maximum number of participants in a group is eight (49). We therefore needed 48 participants. Making allowance for some dropout, we thus aimed to recruit about ten people per group: 60 in total. We wanted to establish how many clients had to be asked to participate in IMR for this number to be reached. Our second primary feasibility criterion was the satisfaction of most participants and clinicians with IMR. The third was to achieve significant results on our effectiveness-related outcome measures. Our first secondary feasibility criterion was that the institute could achieve total scores on the IMR Fidelity Scale of ≥ 4.0, which is considered to reflect good fidelity
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