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SUPPLEMENT |
Clinical and Social Psychiatry Research Unit, University of Cantabria, Santander, Spain
Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
Hvidovre Hospital, Department of Psychiatry, Copenhagen, Denmark
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, King's College, London, UK
Department of Medicine and Public Health, Section & Psychiatry, University of Verona, Italy
Correspondence: Professor José Luis Vázquez-Barquero, Professor of Psychiatry, Unidad de Investigación en Psiquiatria Clinica y Social, Hospital Universitario ‘Marqués de Valdecilla’, Universidad de Cantabria, Avda. Valdecilla s/n, 39008 Santander, Spain. Tel: +34 942 203 446 or 202 545; fax: +34 942 202 655 or 203 447
Declaration of interest No conflict of interest. Funding detailed in Acknowledgements.
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ABSTRACT |
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 TOP ABSTRACT INTRODUCTIONEPSILON STUDYMATERIAL AND METHODRESULTSDISCUSSIONCONCLUSIONSACKNOWLEDGMENTSREFERENCES |
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Method The LQoLP-EU was administered to a total sample of 404 patients to check its internal consistency, and a sub-sample of 294 patients was interviewed a second time within 7-15 days to verify its test-retest reliability.
Results Internal consistency of the total domains, perceived QoL
scale (Life Satisfaction Scale, LSS) was good at 0.87. Of the nine subjective
QoL domains Work and Leisure showed the lowest internal consistency (0.30 and
0.56 respectively), the values of the remaining sub-scales ranging between
0.62 and 0.88. The pooled ICC score for LSS was 0.82, and for the nine
subjective QoL domain subscales it ranged from 0.61 (Safety) to 0.75 (Living
Situation). There were significant differences between the sites in 
and ICCs for sub-scales, but not for the LSS.
Conclusion The LQoLP-EU has good internal consistency and reliability in the five European centres.
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INTRODUCTION |
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TOPABSTRACTINTRODUCTIONEPSILON STUDYMATERIAL AND METHODRESULTSDISCUSSIONCONCLUSIONSACKNOWLEDGMENTSREFERENCES |
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Taking these issues into consideration, the Lancashire Quality of Life Profile (LQoLP) (Oliver et al, 1996) was developed from Lehman's Quality of Life Interview (Lehman et al, 1982; Lehman, 1983 a b), combining objective and subjective measures in several life ‘domains’. Oliver has assessed the initial psychometric properties of the LQoLP in chronic psychiatric patients. Construct, content and criterion validity were found acceptable and the evaluation of the internal consistency of the sub-scales was considered good (Oliver et al, 1996a, 1997). However, test-retest reliability assessment was not performed. A subsequent reliability study conducted by Hansson et al in 1998 reported satisfactory results regarding the instruments' reliability and internal consistency. Nevertheless, the significance of their findings might be questioned, given the limited number of cases (29) included in the study. Thus a thorough and comprehensive verification of the cross-cultural applicability and psychometric properties of the instruments was needed. This verification process has been carried out as a component of the European Psychiatric Services: Inputs Linked to Outcome Domains and Needs (EPSILON) Study, a multi-centre study conducted in five European countries, whose aims are described below.
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EPSILON STUDY |
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TOPABSTRACTINTRODUCTIONEPSILON STUDYMATERIAL AND METHODRESULTSDISCUSSIONCONCLUSIONSACKNOWLEDGMENTSREFERENCES |
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The specific aim of the present paper is to describe the development of a European Version of the LQoLP, the LQoLP-EU, at the same time verifying its reliability and internal consistency in representative samples of people with schizophrenia in the five European centres participating in the EPSILON Study. The paper should be read in close conjunction with other related papers in this series, which give more detailed accounts of key related aspects of the study (Becker et al, 1999, 2000; Knudsen et al, 2000; Schene et al, 2000).
Outcome scales included in the reliability study
The reliability study included the conversion of five scales from their
original language into the other four study languages. The scales are:
Camberwell Assessment of Need - European Version (CAN-EU), Client
Socio-Demographic Service Receipt Inventory - European Version (CSSRI-EU),
Involvement Evaluation Questionnaire - European Version (IEQ-EU), Lancashire
Quality of Life Profile - European Version (LQoLP-EU), and the Verona Service
Satisfaction Scale - European Version (VSSS-EU).
Lancashire Quality of Life Profile - European Version
(LQoLP-EU)
The LQoLP was originally developed by Oliver et al
(1996) from Lehman's Quality
of Life Interview (Lehman, 1983
a,
b;
Lehman et al, 1982). It is a structured self-report interview (to be administered by trained
interviewers) comprising 105 items. It includes the following nine domains:
work and education (7 items); leisure and participation (8 items); religion
(4 items); finances (7 items); living situation (12 items); legal status
and safety (5 items); family relations (7 items); social relations (6 items)
; and health (10 items). The subjective components of these ‘domains’ are
evaluated on a seven-point Life Satisfaction Scale (LSS). In addition, the
interview allows the assessment of the following additional areas: (a)
positive and negative affect (10 items) with the Bradburn
(1969) Affect-Balance Scale;
(b) Self-Esteem Scale (10 items)
(Rosenberg, 1965); (c)
measures of Global Well-Being, including two items: Cantril's Ladder
(Cantril, 1965) and a Happiness
Scale (Gurin et al,
1960); (d) the Quality of Life Uniscale, which gives an
opportunity of evaluating the quality of life of the patient
(Spitzer & Dobson, 1981)
independently of the patient's own opinion; (e) the perceived Quality of Life
Score, an average of the sum of the subjective items of the first nine
domains.
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MATERIAL AND METHOD |
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TOPABSTRACTINTRODUCTIONEPSILON STUDYMATERIAL AND METHODRESULTSDISCUSSIONCONCLUSIONSACKNOWLEDGMENTSREFERENCES |
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Translation and cultural adaptation of the LQoLP-EU
Before the reliability analyses were undertaken, the original English
version of the LQoLP was converted into its European versions (Dutch, Danish,
Spanish and Italian). The procedure followed was translation,
back-translation, focus groups and target checking. Focus groups took place in
Amsterdam, Copenhagen, Santander and Verona. The aim of the focus groups was
to identify conflicting areas in the wording and cultural applicability of the
instrument. As a consequence, a number of changes were made to the local
translations of the instruments (for additional details see
Knudsen et al, 2000,
this supplement). Specifically, as regards the LQoLP-EU, as a result of the
experience obtained in the focus group and pilot testing of the instrument, a
detailed manual was produced to clarify aspects related to its administration
and scoring.
Case identification
Cases included in the study were adults aged 18-65, selected as
representative of all people suffering from schizophrenia who were in contact
with services in each of the five study sites. Study samples were identified
either from psychiatric case registers (in Copenhagen and Verona) or
case-loads of local specialist mental health services (in-patient, out-patient
and community). Patients included had been in contact with mental health
services during the 3-month period before the start of the study (September
1997). Patients with an ICD-10 clinical diagnosis of F20-F25 were considered
as candidates for the study. The diagnosis was confirmed using the item group
checklist (IGC), which is part of the Schedule for Clinical Assessment in
Neuropsychiatry (SCAN) (World Health
Organization, 1992; Vázquez-Barquero,
1993). Finally, only patients with an ICD-10 F20 research
diagnosis were included in the study. In addition, the following exclusion
criteria were applied: current residence in prison, secure residential
services or hostels for long-term patients; co-existing mental retardation,
primary dementia or other severe organic disorder; and periods of in-patient
treatment lasting longer than one year.
Study procedure
The numbers of patients finally included in the study varied from 52 to 107
in the five different sites, with a total of 404 participants in the study as
a whole. From those patients, a sub-sample of 294 was selected to participate
in the test-retest study, and these patients were interviewed twice with the
LQoLP-EU. The time interval between the two interviews ranged from 1 to 2
weeks, and the same interviewer performed both interviews with each patient.
Patients were given oral information about the purpose and procedures of the
study by the interviewer and asked for their consent to participate.
Interviewers were previously trained in the use of the LQoLP-EU; in addition,
all interviewers received training in the use of the SCAN and all other
EPSILON Study instruments. SCAN training was carried out at the Institute of
Psychiatry, London, and at the Clinical and Social Psychiatry Research Unit,
Santander. There were regular follow-up meetings to ensure the standardised
use of instruments, and a series of study coordinating meetings. The
coordinating centre (in London) prepared the SPSS templates used at all the
participating sites to store the information gathered during the interviews,
thus ensuring data consistency and homogeneity.
Reliability testing
Reliability testing in the EPSILON Study is conducted on several levels,
depending on the nature of the instruments involved and the way they are
administered (interviews v. questionnaires). Two kinds of reliability tests
were used: the Cronbach's statistic to check the internal consistency
of scales and sub-scales consisting of more than one item, and intraclass
correlation coefficient (ICC), to check the test-retest reliability of scales
and sub-scales. These statistics are discussed in Streiner & Norman
(1995). Each step in the
analysis was described in an analysis protocol, which was followed by all
sites.
First, differences in sample variances were explored using the Levene test.
Cronbach's was computed for each site and for the pooled sample, and a
test for differences in values between sites was performed as well
(Feldt et al, 1987).
Intra-class correlation coefficients were computed by maximum likelihood
estimation of a variance components model with patients entered as random
effects, and (in the case of pooled estimates) site entered as a fixed
effect.
The ratio of the between-patient to total variance was used for the ICC, and the variance-covariance matrix for the components was used to obtain standard errors based on the delta technique (Dunn, 1989). Fisher's Z transformation was applied to all ICCs to enable approximate comparisons to be made between sites (Donner & Bull, 1983), and differences between sites were tested for significance by the method of weighting (Armitage & Berry, 1994) before transforming back to the ICC scale. The standard error of measurement was obtained from the ‘error’ component of variance. Finally, a paired t-test on test-retest data was carried out in order to assess any systematic changes from time 1 to time 2.
Because there were missing items, mean substitution (means over all valid
cases) was used before estimating . This procedure is likely to provide
conservative estimates of the true values (i.e. underestimates), but
may magnify the apparent significance of inter-site differences, because it
underestimates the standard errors of . In most cases the number of
missing values was small, and they can reasonably be assumed to be random. One
exception is the Work sub-scale, where there were many items ‘not applicable’
(such as work satisfaction, for those unemployed). The items from the Work
sub-scale were omitted from the estimation of for the total (ISS)
scale.
For reasons of comparability, all sites used the same procedure and the
same software for all instruments: SPSS for Windows 7.5 or higher
(Norusis, 1993), the Amsterdam
-testing program ALPHA. EXE (based on
Feldt et al, 1987),
and MicrosoftTM Excel for tests of the homogeneity of ICCs.
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RESULTS |
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TOPABSTRACTINTRODUCTIONEPSILON STUDYMATERIAL AND METHODRESULTSDISCUSSIONCONCLUSIONSACKNOWLEDGMENTSREFERENCES |
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Internal consistency
Internal consistency evaluates the interrelatedness of the items in the
LQoLP-EU. It was assessed by the Cronbach's coefficient with a single
administration of the instrument. Three items were excluded from this
analysis, since they are administered to certain patients only: those
married, retired, or previously admitted to psychiatric hospitals.
The coefficients were high for LSS average score, as shown in
Table 2, with a pooled estimate
of 0.87 (95% CI 0.85-0.88). In the remaining nine subjective sub-scales,
Cronbach's ranged from 0.30 (Work) to 0.88 (Finances). The domains
with the lowest values were Work (0.30, 0.14-0.42), Leisure Activities (0.56,
0.48-0.52), Religion (0.62, 0.53-0.58) and Social Relations (0.66, 0.58-0.72),
and for these four sub-scales the reliabilities were very low for some
individual sites (see Table
2).
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In the Self-Esteem scale the results showed the following coefficients: 0.77 (0.73-0.80) for positive self-esteem and 0.67 (0.62-0.72) for negative self-esteem. For the Affect Balance scale, the results were 0.74 (0.70-0.78) for positive affects and 0.68 (0.62-0.72) for negative affects.
Test-retest reliability
Table 3 shows the intraclass
correlation between the test and retest interviews for the patients in the
reliability sub-sample (only 294 patients took part in the retesting). The
pooled ICC score for global satisfaction (LSS) was 0.82. The nine life domain
sub-scale ICCs ranged between 0.61 (Safety) to 0.75 (Living Situation). ICC
estimations for the Affect balance scale were 0.72 for positive affect and
0.71 for negative affect. In the Self-Esteem scale the results were 0.71 for
positive self-esteem and 0.63 for negative self-esteem. Test-retest
reliabilities were 0.65 for Cantril's Ladder, 0.78 for Global Well-Being and
0.81 for QoL Uniscale.
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Test-retest ICCs were good for the LSS (pooled estimate 0.82, 95% CI 0.78-0.85) and also for the individual sub-scales, which ranged from 0.61 to 0.75. The coefficients appear to be higher for the LSS than for the individual sub-scales, perhaps due to the greater stability of the LSS, being the total of many items. There is evidence for differences between sites for the individual sub-scales but not for the LSS. The only centre with relatively low ICCs for sub-scales is Verona, but paired t-tests on the time 2 and time 1 results show this is not due to an overall tendency to higher or lower values at retest in Verona, but can be explained by random variation. There are relatively high values of the standard error of measurement (s.e.)m associated with the low ICCs at Verona, and the higher (s.e.)m in Verona is the explanation for the overall higher standard deviation (0.84 in Table 1).
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DISCUSSION |
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TOPABSTRACTINTRODUCTIONEPSILON STUDYMATERIAL AND METHODRESULTSDISCUSSIONCONCLUSIONSACKNOWLEDGMENTSREFERENCES |
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value ranging between 0.75 and 0.86 for the
LSS scale; and other authors (Kaiser
et al, 1997) reported results ranging from 0.53 to 0.79.
Our own results corroborate the adequate internal consistency of the total
scale (LSS) of the LQoLP-EU, since Cronbach's value was 0.87. Additionally, the internal consistency of nine subjective life domains was adequate for most sub-scales, although there were a few that were less satisfactory. The most conflicting domains were: Work (0.30), Leisure Activities (0.56) and Religion (0.62). In the case of Work, values differed widely between centres, the highest being in London (0.76), and the lowest in Amsterdam (0.12) and Santander (0.18). The Pearson correlation between items in this domain was not significantly different from zero in the two latter centres (Amsterdam 0.107, Santander 0.135). It has to be recognised that assessment of the internal consistency of this sub-domain is very difficult, because of items which are missing or ‘not applicable’. It may be that a much larger sample is needed, specifically directed at this particular item, or possibly even reconstruction of the sub-scale from other items. In the domain of Religion, the centre showing the most conflicting results was Amsterdam (0.33), and this may be because religion is a very sensitive topic for people with schizophrenia, as indeed for the general population.
Other authors (Oliver et al, 1997) had originally found variations between centres in certain domains. In particular, they found most conflict in the results in the areas of Safety, Religion, Living Situation, Leisure and Work. In the five studies quoted, coefficients for the Work domain ranged from 0.53 to 0.80; for Leisure they ranged from 0.59 to 0.8, and for Religion from 0.45 to 0.85. A possible explanation for this (in previous studies as well as in the current study) is that items included in these domains represent discrete concepts that do not compose a single dimension. Thus an individual may achieve a high score on some and a low one on others. For example, a patient could be very satisfied with his/her job, but not with the amount of money he/she earns; or outdoor leisure activities do not require the same abilities as indoor leisure activities.
In our study, the Cronbach's values for the Affect Balance and
Self-Esteem scales were all satisfactory, although was lower for
negative self-esteem (0.67) than for positive self-esteem for (0.77). The
values are similar to those detected by previous authors
(Hansson et al,
1998).
The test-retest ICCs for the total subjective satisfaction score were good, and they were adequate for each of the nine life domains. Although there was some evidence for differences between the sites in the reliabilities of the sub-domains, they were all above 0.61. The total score showed no evidence of differences, and a pooled estimate is 0.82 (95% CI 0.79-0.86). Unfortunately, in previous studies with this instrument a similar analysis was not carried out, and thus comparison with other data is not possible.
Finally, the paired t-tests analysis between interviews at time 1 and time 2 show that there is no overall tendency to higher or lower values at the retest, thus indicating that the values between test and retest are reasonably stable. Therefore it seems that the time between the test and the retest is not long enough to influence the results. Furthermore, there seems to be no tendency for patients to modify their appraisal of quality of life in the second interview (i.e. because answering the questions make them reassess their quality of life).
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CONCLUSIONS |
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TOPABSTRACTINTRODUCTIONEPSILON STUDYMATERIAL AND METHODRESULTSDISCUSSIONCONCLUSIONSACKNOWLEDGMENTSREFERENCES |
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ACKNOWLEDGMENTS |
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TOPABSTRACTINTRODUCTIONEPSILON STUDYMATERIAL AND METHODRESULTSDISCUSSIONCONCLUSIONSACKNOWLEDGMENTSREFERENCES |
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This study was supported by the European Commission BIOMED-2 Programme (Contract BMH4-CT95-1151). Thanks are due to Dr J. Oliver for his permission to include the LQoLP in the EPSILON Study and for his helpful comments and assistance in its administration and scoring. We would also like to acknowledge the sustained and valuable assistance of the users, carers and the clinical staff of the services in the five study sites. In Amsterdam, the EPSILON Study was partly supported by a grant from the Nationaal Fonds Geestelijke Volksgezondheid and a grant from the Netherland Organization for Scientific Research (940-32-007). In Santander the EPSILON Study was partially supported by the Spanish Institute of Health (FIS) (FIS Exp. No. 97/1240). In Verona additional funding for studying patterns of care and costs of a cohort of patients with schizophrenia were provided by the Regione del Veneto, Giunta Regionale, Ricerca Sanitaria Finalizzata, Venezia, Italia (Grant No. 723/01/96 to Professor M. Tansella).
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REFERENCES |
|---|
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Bachrach, L. L. (ed.) (1970) Deinstitutionalization: An Analytic Review and Sociological Perspective. Rockville, MD: National Institute of Mental Health.
Becker, T., Knapp, M., Knudsen, H. C., et al
(1999) The EPSILON study of schizophrenia in five European
countries: design and methodology for standardising outcome measures and
comparing patterns of care and service costs. British Journal of
Psychiatry, 175, 514
-521.
Becker, T., Knapp, M., Knudsen, H. C., et al
(2000) Aims, outcome measures, study sites and patient
sample. EPSILON Study I. British Journal of
Psychiatry, 177 (suppl. 39), s1
-s7.
Bradburn, N. (1969) The Structure of Psychological Well-Being. Chicago: Aldine.
Cantril, H. (ed.) (1965) The Pattern of Human Concerns. New Brunswick, NJ: Rutgers University Press.
Corten, P., Mercier, C. & Pelc, I. (1994) Subjective quality of life: clinical model for assessment of rehabilitation treatment in schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 29, 178 -183.[Medline]
Donner, A. & Bull, S. (1983) Inferences concerning a common intraclass correlation coefficient. Biometrics, 39, 771 -775.[CrossRef][Medline]
Dowrick, C., Casey, P., Dalgard, O., et al
(1998) Outcomes of Depression International Network (ODIN).
Background, methods and field trials. British Journal of
Psychiatry, 172, 359
-363.
Dunn, G. (1989) Design and analysis of reliability studies. In Health Measurement Scales: A Practical Guide to their Development and Use (eds D. Streiner & G. Norman). Oxford: Oxford University Press.
Feldt, L. S., Woodruff, D. & Salih, F. (1987) Statistical inference for coefficient alpha. Applied Psychological Measurement, 11, 93-103.
Gurin, G., Veroff, J. & Feld, S. (1960) Americans View their Mental Health. New York: Basic Books.
Hansson, L., Svensson, B. & Björkman, T. (1998) Quality of life of the mentally ill. Reliability of the Swedish version of the Lancashire Quality of Life Profile. European Psychiatry, 13, 231 -234.[CrossRef]
Kaiser, W., Priebe, S., Barr, W., et al., (1997) Profiles of subjective quality of life in schizophrenic in- and outpatient samples. Psychiatry Research, 66, 153 -166.[CrossRef][Medline]
Knudsen, H. C.,
Vázquez-Barquero, J. L., Welcher, B., et
al (2000) Translation and cross-cultural adaptation of
outcome measurements for schizophrenia. EPSILON Study 2. British
Journal of Psychiatry, 177 (suppl.
39), s8-s14.
Lamb, R. H. (1979) The new asylums in the community. Archives of General Psychiatry, 36, 129 -134.[Abstract]
Lehman, A. F. (1983a) The well-being of chronic mental patients: assessing their quality of life. Archives of General Psychiatry, 40, 369 -373.[Abstract]
Lehman, A. F. (1983b) The effects of psychiatric symptoms on quality of life assessments among the chronic mentally ill. Evaluation and Program Planning, 6, 143-151.[CrossRef][Medline]
Lehman, A., Ward, N. & Linn, L. (1982)
Chronic mental patients: the quality of life issue. American
Journal of Psychiatry, 139, 1271
-1276.
McCrone, P., Leese, M., Thornicroft, G., et al
(2000) Reliability of the Camberwell Assessment of Need -
European Version. EPSILON Study 6. British Journal of
Psychiatry, 177 (suppl. 39), s34
-s40.
Norusis, M. (1993) SPSS for Windows. Chicago: SPSS Inc.
Oliver, J., Huxley, P. & Bridges, K. (eds) (1996) Quality of Life and Mental Health Services. London: Routledge.
Oliver, J., Huxley, P. Priebe, S., et al. (1997) Measuring the quality of life of severely ill people using the Lancashire Quality of Life Profile. Social Psychiatry and Psychiatric Epidemiology, 32, 76 -83.[CrossRef][Medline]
Rosenberg, M. (ed.) (1965) Society and the Adolescent Self-image. Princeton University Press.
Ruggeri, M., Lasalvia, A., Dall'Agnola, R., et al
(2000) Development, internal consistency and reliability of
the Verona Service Satisfaction Scale - European version. EPSILON Study 7.
British Journal of Psychiatry,
177 (suppl. 39), s41
-s48.
Schene, A. H., Koeter, M., van Wijngaarden, B., et al
(2000) Methodology of a multi-site reliability study. EPSILON
Study 3. British Journal of Psychiatry,
177 (suppl. 39), s15
-s20.
Spitzer, W. O. & Dobson, A. J. (1981) Measuring the quality of life of cancer patients. Journal of Chronic Disorders, 34, 585 -597.
Streiner, D. & Norman, G. (1995) Health Measurement Scales: A Practical Guide to their Development and Use. Oxford: Oxford University Press.
Sullivan, G., Wells, K. & Leake, B. (1991)
Quality of life of seriously mentally ill persons in Mississippi.
Hospital and Community Psychiatry,
42, 752
-754.
van Wijngaarden, B., Schene, A. H., Koeter, M., et al
(2000) Care-giving in schizophrenia: development, internal
consistency and reliability of the Involvement Evaluation Questionnaire -
European Version. EPSILON Study 4. British Journal of
Psychiatry, 177 (suppl. 39), s21
-s27.
Vázquez-Barquero, J. L. (1993) SCAN, Cuestionarios para la Evaluación Clinica en Neuropsiquiatria. Madrid: Meditor.
World Health Organization (1992) Schedules for Clinical Assessment in Neuropsychiatry (ed.-in-chief J. K. Wing). Geneva: WHO.
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