Psychometric Evaluation and Therapeutic Application of Quality-of-Life Outcome Measures in Psychiatric Inpatient Care

Literature Review
QoL outcome measures have become increasingly valuable in inpatient psychiatric settings. Outcome measures can enhance patient outcomes over time, and these measures should be relevant to the population they serve. To understand if the outcome measure is an appropriate and helpful measurement properties are assessed. Measurement properties encompass the various strands of scientific inquiry that establish whether a measure accurately assesses what it claims to measure and whether it maintains consistency over time.
A review of 38 studies identified 23 different QoL outcome measures that had been tested in at least a partial inpatient population. The outcome of the review suggests that no single outcome measure encompasses all measurement properties suitable for use in this setting. Several outcome measures showed promising evidence and could be adapted for this setting. Overall, it was clear that more patient and clinician involvement and feedback were needed on the content of the identified scales to make the scale relevant and valuable for adult psychiatric inpatient populations.
Empirical Study
DIALOG is a QoL and patient experience measure that has been tested in community settings. A patient may highlight areas they would like to work on when completing DIALOG, and DIALOG+ provides a method for structuring conversations and setting goals to work towards gradual change in those selected areas. DIALOG+ has been successfully tested in community settings; however, to our knowledge, it has not been tested in an inpatient setting. Therefore, the study aimed to determine if it is achievable in this setting.
The study's outcome revealed numerous challenges in applying DIALOG and DIALOG+ in this setting, including inadequate recruitment and engagement. Staff highlighted barriers such as the need for additional training and coaching, greater team input, improved systems and leadership, as well as the unique aspects of rehabilitation settings.