The construction and validation of the Assessment of Mental Health Related Quality of Life (PsyQoL) instrument

心理健康是国家卫生优先领域之一，也是造成疾病负担的最大因素之一。世卫组织的预测表明，到2020年，抑郁症的负担将仅次于心血管疾病。正在开发新的精神疾病治疗方法，必须对其进行评估。目前的研究方法不允许这些疗法的成本效益与其他医疗服务的成本效益进行准确的比较，因为这需要衡量“效用”或“生活质量”。迄今为止开发的少数“通用”“生活质量工具”在对不同疾病的“敏感性”方面差异很大，即检测变化的能力，而且没有一个对心理健康状态的变化非常敏感。目前的项目就是要克服这一缺陷。这将通过改进和扩大澳大利亚开发的一种工具-生活质量评估工具来实现。这是迄今为止唯一的工具，它是使用正确的心理测量仪器建设的原则，并描述了健康状况的影响，对病人的能力，在社会环境中发挥作用。被称为PsyQoL的新工具将通过在现有工具中加入心理健康“模块”和修改现有项目来提高工具的灵敏度。所使用的方法将包括在描述健康状况和推导效用分数方面的若干方法创新。该项目将包括一个大规模的“验证”研究，其中将包括人口“规范”的建设，也是PsyQoL和其他工具得分之间的“汇率”的创建。该项目的意义在于，PsyQoL将允许有效和可靠地测量健康状况，在心理和其他健康相关干预措施之间创造一个“公平竞争环境”。

Mental Health is one of the national health priority areas as well as one of the largest contributors to burden of disease. WHO projections suggest that by 2020 the burden of depression alone will be second only to cardiovascular disease. New treatments for mental disorders are being developed which must be evaluated. Current research methods do not allow an accurate comparison of the cost effectiveness of these therapies with the cost effectiveness of other medical services as this requires the measurement of 'utility' or 'quality of life'. The small number of 'generic' 'quality of life instruments' developed to date vary significantly in their 'sensitivity' to different illnesses-their ability to detect change-and none is very sensitive to changes in mental health states. The present project is to overcome this deficit. This will be achieved by refining and expanding an instrument developed in Australia, the Assessment of Quality of Life (AQoL) instrument. This is the only instrument to date which was both constructed using correct psychometric principles of instrument construction and which describes health states in terms of the effect upon a patient's ability to function in a social environment. The new instrument called the PsyQoL will increase instrument sensitivity by including a mental health 'module' to the existing instrument and revising existing items. The methods used will include several methodological innovations in the description of health states and the derivation of utility scores. The project will include a large scale 'validation' study which will include the construction of population 'norms' and also the creation of 'exchange rates' between the PsyQoL and other instrument scores. The significance of the project is that the PsyQoL will allow valid and reliable measurement of health states in a way that creates a 'level playing field' between mental and other health related interventions.