Forensic Outcome Measures
Research type
Research Study
Full title
Development of a new outcome measure in forensic psychiatric services
IRAS ID
241740
Contact name
Howard Ryland
Contact email
Sponsor organisation
University of Oxford Clincal Trials and Research Governance
Duration of Study in the UK
2 years, 5 months, 31 days
Research summary
Research Summary
This project aims to find out what it means for patients in forensic psychiatric services to be making progress in their care from the perspective of patients and the professionals. The next step will be to develop a tool, most likely to be a type of questionnaire, to measure how people are doing. This would cover a range of areas, such as how the patients’ mental health is, the level of risk they pose to themselves or other people, how good their quality of life is and how well they are progressing towards rehabilitation back in to society.
Professionals working in forensic psychiatric services in the UK will be asked to fill in a survey about what they think are the most important things to measure. There will also be several face–to-face events, including focus groups of professionals, to further explore the themes that come up. Patients will also be interviewed in depth to gain their views about what is important.
A panel of both patients and professionals will be presented with information from the earlier stages and asked to rate the areas that they think are most important to measure. This will happen repeatedly, until there is agreement about the most important areas. The research team will then design questions that address these areas and ask the panel to decide which questions are the best. This will produce a new tool consisting of one set of questions for patients and another for professionals.
Patients and professionals will be asked to complete these questionnaires and feedback whether they make sense and if any improvements can be made to the language, order or presentation.
Summary of Results
Forensic mental health services provide care to people in secure psychiatric hospitals and specialised community teams. Measuring outcomes of care is important to safeguard patients and the public, monitor progress and develop treatment plans. Little is known about which outcomes are most important and existing outcome measures have limited patient input
Patients, carers and professionals from forensic mental health services were interviewed and took part in focus groups to identify which outcomes were important to them. Forty-two outcomes were identified in the six domains of ‘about me, my quality of life, my health, my safety and risk, my life skills and my pathway’.
Patients, carers and professionals were asked to rate the outcomes’ importance using a Delphi process. This involved asking people to rate the outcomes a first time, then showing them what the group thought, before asking them to rate the outcomes again. This is a way to gain a consensus between a group of people. Eight of the top fifteen outcomes were shared between patients/carers and professionals.
A new instrument for measuring outcomes in forensic mental health services was then developed, called the FORensic oUtcome Measure (FORUM), with complementary patient and clinician reported questionnaires. This focused on the outcomes that were most important and was tested with patients and clinicians to check that questions were easy to understand.
REC name
London - Surrey Research Ethics Committee
REC reference
18/LO/0929
Date of REC Opinion
19 Jul 2018
REC opinion
Further Information Favourable Opinion