Background
Methods
Translation and adaptation of the RAS-R to the Norwegian language and context
‘Plan? No... I have small plans throughout the day, but it's like overall plan you mean? I'm trying to understand what you mean … I'll answer unsure as to whether I have a plan, at least I don’t have a big plan.’
‘…. I'm not sure, not about the question, but it’s a bit “big” what they are asking about, almost as if they are asking about the meaning of life …’
‘I have an idea of what I want ... Don't I want to become myself, then? [] But if it is education ..., [or] is it as a person ..? I think it’s a bit of a vague question ...’
Study design and setting
Unit | Inclusion criteria | n (%) screened | n (%) included | Way of completing RAS-R |
---|---|---|---|---|
Mental health hospital with co-located CMHC for adults | Severe mental health condition and contact with mental health services > 6–12 months | 135 (42) | 112 (35) | Pencil and paper |
Two co-organised CMHCs for adults | 66 (21) | 52 (16) | ||
Mental health services in one municipality | Severe mental health condition | 36 (11) | 32 (10) | |
CMHC for adults | Used mental health services 2 years ago due to any mental health condition needing specialist care | 85 (26) | 35 (11) | Telephone interview |
SUM | 322 (100) | 231 (72) |
Participants
Ethics
Statistical analysis
Results
Respondents
Variable |
Mean (SD)
| Range | |
---|---|---|---|
Age (years) | 41 (14.2) | 18–77 | |
Visual Analogue Scale | In your experience, where in your process of recovery are you now, compared to where you were when things were at the worst (=1), and how you wish that your situation should ideally be (=10) | 6.1 (2.04) | 1–10 |
Number | Percent | ||
Gender | Man | 99 | 43 |
Woman | 128 | 56 | |
Highest completed level of education | Nine years compulsory school | 63 | 28 |
High school | 125 | 55 | |
University/college | 36 | 16 | |
Civil status | Married | 45 | 20 |
Co-habiting | 29 | 13 | |
Single | 116 | 51 | |
Divorced/separated | 23 | 10 | |
Widow (−er) | 3 | 1.3 | |
Other | 5 | 2.2 | |
Work statusa | Employed | 43 | 19 |
Self-employed | 4 | 1.8 | |
Supported employment | 3 | 1.3 | |
Domestic work | 2 | 0.9 | |
Disability pension | 98 | 43 | |
Student | 11 | 5 | |
Out of work | 7 | 3 | |
Retired | 4 | 1.8 | |
Sick leave | 44 | 19 | |
Other | 6 | 2.6 | |
Mental health service use | Out-patient, specialist services | 167 | 63 |
In-patient, specialist services | 24 | 11 | |
Community mental health services | 31 | 14 | |
ICD-10 primary diagnosis | F00-F09 Organic, including symptomatic, mental disorders | 1 | 0.4 |
F10-F19 Mental and behavioural disorders due to psychoactive substance use | 12 | 5 | |
F20-F29 Schizophrenia, schizotypal and delusional disorders | 37 | 16 | |
F30-F39 Mood disorders | 56 | 25 | |
F40-F48 Neurotic, stress-related and somatoform disorders | 67 | 29 | |
F50-F59 Behavioural syndromes associated with physiological disturbances and physical factors | 8 | 4 | |
F60-F69 Disorders of adult personality and behaviour | 18 | 8 | |
F70-F79 Mental retardation | 0 | 0 | |
F80-F89 Disorders of psychological development | 2 | 0.9 | |
F90-F98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence | 11 | 5 | |
Other | 11 | 5 |
Item |
Mean
|
SD
| Range | 95% CI |
---|---|---|---|---|
1. I have a desire to succeed | 4.6 | 0.62 | 1–5 | 4.56; 4.72 |
2. I have my own plan for how to stay or become well | 3.9 | 0.92 | 1–5 | 3.80; 4.05 |
3. I have goals in life that I want to reach | 4.2 | 0.90 | 1–5 | 4.08; 4.32 |
4. I believe that I can meet my current personal goals | 3.7 | 0.98 | 1–5 | 3.59; 3.85 |
5. I have a purpose in life | 3.8 | 0.94 | 1–5 | 3.72; 3.97 |
6. Even when I don’t care about myself, other people do | 4.1 | 0.83 | 1–5 | 4.0; 4.21 |
7. Fear doesn’t stop me from living the way I want to | 3.1 | 1.30 | 1–5 | 2.90; 3.25 |
8. I can handle what happens in my life | 3.3 | 1.02 | 1–5 | 3.20; 3.47 |
9. I like myself | 3.2 | 1.20 | 1–5 | 2.99; 3.31 |
10. If people really knew me, they would like me | 3.7 | 0.84 | 1–5 | 3.60; 3.82 |
11. I have an idea of who I want to become | 3.5 | 1.05 | 1–5 | 3.40; 3.67 |
12. Something good will eventually happen | 4.0 | 0.81 | 1–5 | 3.93; 4.14 |
13. I’m hopeful about my future | 3.9 | 0.99 | 1–5 | 3.72; 3.97 |
14. I continue to have new interests | 3.7 | 1.09 | 1–5 | 3.57; 3.86 |
15. Coping with my mental illness is no longer the main focus of my life | 3.1 | 1.23 | 1–5 | 2.98; 3.30 |
16. My symptoms interfere less and less with my life | 3.4 | 1.20 | 1–5 | 3,25; 3.54 |
17. My symptoms seem to be a problem for shorter periods of time each time they occur | 3.5 | 1.13 | 1–5 | 3.32; 3.61 |
18. I know when to ask for help | 3.9 | 1.06 | 1–5 | 3.78; 4.05 |
19. I am willing to ask for help | 4.1 | 0.92 | 1–5 | 4.01; 4.25 |
20. I ask for help when I need it | 3.8 | 1.08 | 1–5 | 3.68; 3.96 |
21. I can handle stress | 3.0 | 1.14 | 1–5 | 2.88; 3.18 |
22. I have people I can count on | 4.3 | 0.78 | 1–5 | 4.18; 4.38 |
23. Even when I don’t believe in myself, other people do | 4.0 | 0.87 | 1–5 | 3.88; 4.10 |
24. It is important to have a variety of friends | 3.5 | 1.40 | 1–5 | 3.31; 3.67 |
Summary scales | ||||
Personal confidence and hope (mean of items 7, 8, 9, 10, 11, 12, 13, 14 & 21) | 3.5 | 0.68 | 1.67–5 | 3.40; 3.58 |
Willingness to ask for help (mean of items 18, 19 & 20) | 4.0 | 0.89 | 1–5 | 3.84; 4.07 |
Goal and success orientation (mean of items 1, 2, 3, 4 & 5) | 4.1 | 0.63 | 1.4–5 | 3.99; 4.15 |
Reliance on others (mean of items 6, 22, 23 & 24) | 4.0 | 0.68 | 2–5 | 3.88; 4.06 |
Not dominated by symptoms (mean of items 15, 16 & 17) | 3.3 | 0.95 | 1–5 | 3.21; 3.45 |
Total scale (mean of items) | 3.7 | 0.56 | 1.92–5 | 3.66; 3.80 |
Total scale (sum of items) | 89.5 | 13.39 | 46–120 | 87.75; 91.24 |
Confirmatory factor analysis
Model | Fit-criterion | MLM-robust | ML |
---|---|---|---|
χ2 | 360.699 | 493.608 | |
p
| > .05 | .000 | .000 |
df
| 242 | 242 | |
Normed χ2 | < 5.0 | 1.49 | 2.04 |
CFI | ≥ .90 | 0.924 | 0.876 |
TLI | ≥ .90 | 0.913 | 0.858 |
RMSEA | ≤ .06 | 0.046 | 0.068 |
RMSEA 90% CI | .06–.08 | .038–.055 | .059–0.076 |
SRMR | ≤ .08 | 0.063 | 0.063 |
Personal confidence and hope-factor | ||||
Item | β | Communality | B | SE |
RAS7 | 0.38 | 0.15 | 0.79 | 0.16 |
RAS8 | 0.64 | 0.41 | 1.04 | 0.14 |
RAS9 | 0.72 | 0.51 | 1.38 | 0.17 |
RAS10 | 0.59 | 0.35 | 0.78 | 0.11 |
RAS11 | 0.46 | 0.21 | 0.77 | 0.13 |
RAS12 | 0.61 | 0.37 | 0.78 | 0.11 |
RAS13 | 0.71 | 0.50 | 1.11 | 0.14 |
RAS14 | 0.64 | 0.41 | 1.11 | 0.15 |
RAS21 | 0.56 | 0.31 | 1.00 | |
Willingness to ask for help-factor | ||||
Item | β | Communality | B | SE |
RAS18 | 0.77 | 0.59 | 0.83 | 0.07 |
RAS19 | 0.76 | 0.68 | 0.72 | 0.06 |
RAS20 | 0.90 | 0.81 | 1.00 | |
Goal and success orientation-factor | ||||
Item | β | Communality | B | SE |
RAS1 | 0.35 | 0.13 | 0.33 | 0.07 |
RAS2 | 0.68 | 0.46 | 0.97 | 0.11 |
RAS3 | 0.69 | 0.48 | 0.96 | 0.11 |
RAS4 | 0.71 | 0.50 | 1.07 | 0.12 |
RAS5 | 0.69 | 0.48 | 1.00 | |
Reliance on others-factor | ||||
Item | β | Communality | B | SE |
RAS6 | 0.73 | 0.53 | 1.35 | 0.30 |
RAS22 | 0.68 | 0.46 | 1.16 | 0.27 |
RAS23 | 0.77 | 0.59 | 1.48 | 0.33 |
RAS24 | 0.33 | 0.11 | 1.00 | |
Not dominated by symptoms-factor | ||||
Item | β | Communality | B | SE |
RAS15 | 0.63 | 0.40 | 0.90 | 0.11 |
RAS16 | 0.80 | 0.64 | 1.06 | 0.10 |
RAS17 | 0.76 | 0.58 | 1.00 |
Convergent and discriminant validity
NDS | RO | GSO | WAH | PCH | RAS15 | RAS16 | RAS17 | RAS6 | RAS22 | RAS23 | RAS24 | RAS1 | RAS2 | RAS3 | RAS4 | RAS5 | RAS18 | RAS19 | RAS20 | RAS7 | RAS8 | RAS9 | RAS10 | RAS11 | RAS12 | RAS13 | RAS14 | RAS21 | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NDS | 1.00 | ||||||||||||||||||||||||||||
RO | 0.43 | 1.00 | |||||||||||||||||||||||||||
GSO | 0.46 | 0.49 | 1.00 | ||||||||||||||||||||||||||
WAH | 0.47 | 0.28 | 0.45 | 1.00 | |||||||||||||||||||||||||
PCH | a0.72 | 0.56 | a0.80 | 0.51 | 1.00 | ||||||||||||||||||||||||
RAS15 | 0.63 | 0.27 | 0.29 | 0.29 | 0.45 | 1.00 | |||||||||||||||||||||||
RAS16 | a0.80 | 0.35 | 0.37 | 0.37 | 0.58 | 0.50 | 1.00 | ||||||||||||||||||||||
RAS17 | a0.75 | 0.32 | 0.35 | 0.35 | 0.55 | 0.47 | 0.61 | 1.00 | |||||||||||||||||||||
RAS6 | 0.31 | a0.73 | 0.36 | 0.20 | 0.41 | 0.20 | 0.25 | 0.24 | 1.00 | ||||||||||||||||||||
RAS22 | 0.29 | 0.68 | 0.33 | 0.19 | 0.38 | 0.18 | 0.23 | 0.22 | 0.49 | 1.00 | |||||||||||||||||||
RAS23 | 0.33 | a0.77 | 0.38 | 0.21 | 0.43 | 0.21 | 0.27 | 0.25 | 0.56 | 0.52 | 1.00 | ||||||||||||||||||
RAS24 | 0.14 | 0.33 | 0.17 | 0.09 | 0.19 | 0.09 | 0.12 | 0.11 | 0.24 | 0.23 | 0.26 | 1.00 | |||||||||||||||||
RAS1 | 0.16 | 0.17 | 0.35 | 0.15 | 0.28 | 0.10 | 0.13 | 0.12 | 0.12 | 0.12 | 0.13 | 0.06 | 1.00 | ||||||||||||||||
RAS2 | 0.31 | 0.33 | 0.68 | 0.30 | 0.54 | 0.19 | 0.25 | 0.23 | 0.24 | 0.23 | 0.26 | 0.11 | 0.23 | 1.00 | |||||||||||||||
RAS3 | 0.32 | 0.34 | 0.69 | 0.31 | 0.55 | 0.20 | 0.25 | 0.24 | 0.25 | 0.23 | 0.26 | 0.11 | 0.24 | 0.47 | 1.00 | ||||||||||||||
RAS4 | 0.32 | 0.35 | a0.71 | 0.32 | 0.56 | 0.20 | 0.26 | 0.25 | 0.26 | 0.24 | 0.27 | 0.12 | 0.24 | 0.48 | 0.49 | 1.00 | |||||||||||||
RAS5 | 0.32 | 0.34 | 0.69 | 0.31 | 0.55 | 0.20 | 0.25 | 0.24 | 0.25 | 0.23 | 0.26 | 0.11 | 0.24 | 0.47 | 0.47 | 0.49 | 1.00 | ||||||||||||
RAS18 | 0.36 | 0.21 | 0.34 | a0.77 | 0.39 | 0.22 | 0.29 | 0.27 | 0.16 | 0.14 | 0.16 | 0.07 | 0.12 | 0.23 | 0.24 | 0.24 | 0.24 | 1.00 | |||||||||||
RAS19 | 0.35 | 0.21 | 0.34 | a0.76 | 0.39 | 0.22 | 0.28 | 0.27 | 0.15 | 0.14 | 0.16 | 0.07 | 0.12 | 0.23 | 0.23 | 0.24 | 0.23 | 0.58 | 1.00 | ||||||||||
RAS20 | 0.42 | 0.25 | 0.40 | a0.90 | 0.46 | 0.26 | 0.34 | 0.32 | 0.18 | 0.17 | 0.19 | 0.08 | 0.14 | 0.27 | 0.28 | 0.29 | 0.28 | 0.69 | 0.68 | 1.00 | |||||||||
RAS7 | 0.28 | 0.22 | 0.31 | 0.20 | 0.38 | 0.17 | 0.22 | 0.21 | 0.16 | 0.15 | 0.17 | 0.07 | 0.11 | 0.21 | 0.21 | 0.22 | 0.21 | 0.15 | 0.15 | 0.18 | 1.00 | ||||||||
RAS8 | 0.47 | 0.36 | 0.51 | 0.33 | 0.64 | 0.29 | 0.37 | 0.35 | 0.26 | 0.24 | 0.28 | 0.12 | 0.18 | 0.35 | 0.35 | 0.36 | 0.35 | 0.25 | 0.25 | 0.30 | 0.25 | 1.00 | |||||||
RAS9 | 0.52 | 0.40 | 0.57 | 0.37 | a0.72 | 0.32 | 0.42 | 0.39 | 0.29 | 0.27 | 0.31 | 0.13 | 0.20 | 0.39 | 0.39 | 0.41 | 0.39 | 0.28 | 0.28 | 0.33 | 0.28 | 0.46 | 1.00 | ||||||
RAS10 | 0.42 | 0.33 | 0.47 | 0.30 | 0.59 | 0.27 | 0.34 | 0.32 | 0.24 | 0.22 | 0.25 | 0.11 | 0.16 | 0.32 | 0.32 | 0.33 | 0.32 | 0.23 | 0.23 | 0.27 | 0.23 | 0.38 | 0.42 | 1.00 | |||||
RAS11 | 0.33 | 0.26 | 0.37 | 0.24 | 0.46 | 0.21 | 0.27 | 0.25 | 0.19 | 0.17 | 0.20 | 0.09 | 0.13 | 0.25 | 0.25 | 0.26 | 0.25 | 0.18 | 0.18 | 0.21 | 0.18 | 0.30 | 0.33 | 0.27 | 1.00 | ||||
RAS12 | 0.44 | 0.34 | 0.49 | 0.31 | 0.61 | 0.28 | 0.35 | 0.33 | 0.25 | 0.23 | 0.26 | 0.11 | 0.17 | 0.33 | 0.34 | 0.35 | 0.34 | 0.24 | 0.24 | 0.28 | 0.23 | 0.39 | 0.44 | 0.36 | 0.28 | 1.00 | |||
RAS13 | 0.51 | 0.40 | 0.57 | 0.36 | a0.71 | 0.32 | 0.41 | 0.39 | 0.29 | 0.27 | 0.31 | 0.13 | 0.20 | 0.38 | 0.39 | 0.40 | 0.39 | 0.28 | 0.27 | 0.33 | 0.27 | 0.46 | 0.51 | 0.42 | 0.33 | 0.43 | 1.00 | ||
RAS14 | 0.46 | 0.36 | 0.51 | 0.33 | 0.64 | 0.29 | 0.37 | 0.35 | 0.26 | 0.24 | 0.28 | 0.12 | 0.18 | 0.35 | 0.35 | 0.36 | 0.35 | 0.25 | 0.25 | 0.29 | 0.25 | 0.41 | 0.46 | 0.38 | 0.30 | 0.39 | 0.46 | 1.00 | |
RAS21 | 0.40 | 0.31 | 0.44 | 0.28 | 0.56 | 0.25 | 0.32 | 0.30 | 0.23 | 0.21 | 0.24 | 0.10 | 0.15 | 0.3 | 0.31 | 0.31 | 0.31 | 0.22 | 0.22 | 0.26 | 0.21 | 0.36 | 0.40 | 0.33 | 0.26 | 0.34 | 0.40 | 0.36 | 1.00 |
CR | AVEa | Personal Confidence and Hope | Willingness to Ask for Help | Goal and Success Orientation | Reliance on Others | Not Dominated by Symptoms | |
---|---|---|---|---|---|---|---|
Personal confidence and hope | 0.830 | 0.359 |
0.599
| 0.429 | |||
Willingness to ask for help | 0.851 | 0.657 | 0.429 | 0.811 | |||
Goal and success orientation | 0.764 | 0.401 | 0.611 | 0.434 |
0.633
| ||
Reliance on others | 0.732 | 0.423 | 0.462 | 0.286 | 0.407 | 0.650 | |
Not dominated by symptoms | 0.774 | 0.536 | 0.620 | 0.423 | 0.354 | 0.362 | 0.732 |