Using a person-generated mental health outcome measure in large clinical trials in Kenya and Pakistan: Self-perceived problem responses in diverse communities

Abstract

Health care should be informed by the physical, socioeconomic, mental, and emotional well-being of the person, and account for social circumstances and culture. Patient-generated outcome measures can contribute positively to mental health research in culturally diverse populations. In this study, we analysed qualitative responses to the Psychological Outcome Profiles (PSYCHLOPS) Questionnaire—a patient-generated outcome measure based on open-ended questions, and compared the qualitative responses gathered to conventional, nomothetic measures used alongside the PSYCHLOPS in two studies. Data were collected as part of outcome research on a psychological intervention in Pakistan ( N = 346) and Kenya ( N = 521). Two researchers coded the qualitative responses to the PSYCHLOPS and identified overarching themes. We compared the overarching themes identified to the items in the conventional, nomothetic outcome measures to investigate conceptual equivalence. Using the PSYCHLOPS, the most frequently reported problems in Kenya were financial constraints, poor health, and unemployment. In Pakistan, the most frequent problems were poor health and emotional problems. Most of the person-generated problem concepts were covered also in nomothetic measures that were part of the same study. However, there was no item equivalence in the nomothetic measures for the most frequent PSYCHLOPS problem cited in both countries. Response bias and measurement bias may not be excluded. More research on the use of PSYCHLOPS alongside conventional outcome measures is needed to further explore the extent to which it may bring added value. Use of a PSYCHLOPS semistructured interview schedule and efforts to minimise response biases should be considered.

Problems after flight: understanding and comparing Syrians’ perspectives in the Middle East and Europe

“…Overall, the results show the prevalence of psychological problems and the importance of social network and local displacement-related factors on psychological wellbeing, and illustrate psychological problems as the common consequence of a range of stressors. Psychological 27 [44] 15 [33] 23 [40] 65 [40] Interpersonal 15 [25] 14 [30] 15 [26] 44 [27] Physical/psychosomatic health 13 [21] 13 [28] 10 [18] 36 [22] Separation from family members 11 [18] 8 [17] 13 [23] 32 [20] Related to war/home country 7 [11] 6 [14] 7 [12] 20 [12] Related to family duties 10 [16] 5 [13] 2 [4] 17 [10] Personal development/unmet personal needs 0 [0] 3 [7] 7 [12] 10 [6] Note: N J number of participants in Jordan, N T number of participants in Turkey, N S number of participants in Switzerland, n/a not applicable Finances 11 [18] 17 [37] 6 [11] 34 [21] Camp related issues 26 [43] n/a n/a 26 [16] Government regulations 3 [5] 4 [9] 12 [21] 19 [12] Housing 2 [3] 5 [11] 11 [19] 18 [11] Medical treatment 6 [10] 6 [13] 3…”

“…Stressors and mental health of SRAs have been predominantly assessed through nomothetic measurements -often developed and validated in western contexts [20]. Studies have shown that standard instruments often fail to encompass all aspects of distress in cross-cultural settings, and that it is a fallacy to assume that symptoms in different cultural contexts carry the same significance across cultures [21][22][23]. Client-generated outcome measurements are person-centred by definition and unlike standardized measures, they seek to encompass the individuals' phenomenological experiences as well as their priorities, local values, perspectives and expectations [22,24,25].…”

Personalising Outcome Measurement in Substance Misuse Treatment: the Feasibility and Psychometrics of Two Individualised Outcome Measures

“…This was a low number in comparison with previous studies, where more than 90% of patients' responses to PSYCHLOPS allowed total score calculation (Ashworth et al 2004(Ashworth et al , 2005(Ashworth et al , 2009. In other studies, PSYCHLOPS has been administered as an interview measure, to ensure no missing data in populations with literacy issues (Harper Shehadeh et al 2019).…”

Problems After Flight: Understanding and Comparing Syrians’ Perspectives in the Middle East and Europe

“…Table 2 Overview Categories of self-reported problems of the three study populations. [44] 15 [33] 23 [40] 65 [40] Interpersonal 15 [25] 14 [30] 15 [26] 44 [27] Physical/psychosomatic health 13 [21] 13 [28] 10 [18] 36 [22] Separation from family members 11 [18] 8 [17] 13 [23] 32 [20] Related to war/home country 7 [11] 6 [14] 7 [12] 20 [12] Related to family duties…”

“…Stressors and mental health of SRAs have been predominantly assessed through nomothetic measurements -often developed and validated in western contexts (Kirmayer & Pedersen, 2014). Studies have shown that standard instruments often fail to encompass all aspects of distress in cross-cultural settings, and that it is a fallacy to assume that symptoms in different cultural contexts carry the same signi cance across cultures (Hassan, Ventevogel, Jefee-Bahloul, Barkil-Oteo, & Kirmayer, 2016;Shehadeh et al, 2019;Wells, Wells, & Lawsin, 2015). Client-generated outcome measurements are person-centred by de nition and unlike standardized measures, they seek to encompass the individuals' phenomenological experiences as well as their priorities, local values, perspectives and expectations (Ashworth et al, 2007;Hassan et al, 2016;Sales, Neves, Alves, & Ashworth, 2018).…”