Validation of the Greek version of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+, version 3)

Abstract

Objectives: There is a growing need for evaluation of the results of mental health services and clinical treatment in older people, but evidence for effectiveness is limited in Greece. The Health of the Nations Outcome Scales for Elderly People (HoNOS65+) are promising instruments for the assessment of mental, physical and social health in older persons. They have been translated into the Greek language but have not been validated. The aim was to assess the inter-rater reliability, intraclass correlation, concurrent validity, internal consistency and sensitivity to change of HoNOS65+ in a Greek sample of older people with mental health problems.

Method: Two samples, one of inpatients in a psychiatric hospital and the other of older people living in the community were used. In order to test the extent to which the HoNOS65+ were sensitive to change the first sample was reassessed after two months and the second after three months. For each participant HoNOS65+ were completed by two independent raters, and the clinician rated blindly each participant on the Stockton Geriatric Rating Scale and a scale which measured behavioural, physical, cognitive and emotional status.

Results: In both groups (inpatients n = 50, community n = 65), the inter-rater reliability, intraclass correlation and concurrent validity were high while internal consistency of the scales taken together was low. At reassessment in 98 participants, HoNOS65+ showed changes comparable to clinician ratings.

Conclusion: The Greek version of HoNOS65+ can achieve high levels of reliability, validity and sensitivity to change for measuring outcomes in older people with mental health problems.

Keywords:

• HoNOS65+ Greek translation
• outcomes
• validation
• psychometrics

Acknowledgements

The authors would like to acknowledge Mrs Sofia Protopapa for helping in gathering data and for their entry into the database, Venetsanos Mavreas for translation of HoNOS65+ into Greek and Maria Fotiadou for back-translation into English.