Authors
Stynke CasteleinMark van der GaagRichard BruggemanJ. T. van BusschbachDurk Wiersma
Topics
Schizophrenia research and treatmentMental Health and Patient InvolvementDiabetes Management and EducationObjective: This study compared three instruments that are used to measure empowerment of people with psychotic disorders. The study evaluated internal consistency, discriminant and convergent validity, sensitivity to symptom levels, and clinical usefulness. Methods: Fifty patients in the Netherlands were administered the Empowerment Scale (ES), the Personal Empowerment Scale (PES), and the Mental Health Confidence Scale (MHCS). Results: The MHCS had good internal consistency, whereas the levels for the ES and PES were just below what would be considered acceptable. The instruments demonstrated moderate correlations between total scores; correlations between subscale scores were weaker. Scores for all three instruments were comparably associated with symptom severity. Conclusions: All three instruments measure some aspect of empowerment among persons with severe mental illness. However, empowerment is too broadly defined to allow these instruments to have convergent validity. Among patients with psychotic disorders, the MHCS is recommended because it has good psychometric qualities and is clinically useful. (Psychiatric Services 59:1338-1342, 2008) E mpowerment is an outcome pur- sued by advocacy groups, consumer organizations, mental health professionals, and health care providers. It originates from the political arena, although a consensus has not yet been reached on its definition.The many definitions of empowerment suggest that the concept is still evolving (1) , and the number of empirical studies on empowerment is limited. Most definitions of empowerment include participation in society in terms of access to employment, education, and other valued resources (2, 3) . However, there is a distinction between definitions focusing on interpersonal characteristicscontrol over one's life and the recovery process or the efforts to achieve more control and self-efficacy (1)and those that also highlight influencing the organizational and societal structure in which one lives (4) .In instruments developed to measure empowerment, these differences can be seen. In this study, we assessed the impact of these differences and examined whether these instruments measure the same con-cept. Also, we aimed to gain some insight into how to choose the right instrument for measuring empowerment in a population of patients with psychotic disorders.The instruments studied are the Empowerment Scale (ES) (1), the Personal Empowerment Scale (PES) (2) , and the Mental Health Confidence Scale (MHCS) (5) . They are the most frequently cited instruments to measure empowerment in the literature, and their reliability and validity have already been established for people with severe mental illness (1, 2, 6) . Here we reappraised their internal consistency, convergent and discriminant validity, and applicability for patients with psychotic disorders (7, 8) . As for their convergent and discriminant validity, we hypothesized that the total scores of the instruments will have correlations of at least .70 and that between subscales with common content the correlations will be even stronger. Furthermore, we assessed the association between empowerment and the level of symptoms. standing of the Dutch language, and a clinical diagnosis of schizophrenia or a related psychotic disorder. Diagnoses were made according to DSM-IV criteria by experienced psychiatrists trained in the Schedules for Clinical Assessment in Neuropsychiatry (9) . There were no exclusion criteria. The study is in accordance with the Declaration of Helsinki, and all patients provided written informed consent.
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PublishedOct 29, 2008
TypeArticle
Citations50
References20