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The Oxcap MH measure of health

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The OxCAP-MH (Oxford CAPabilities questionnaire-Mental Health) is a self-reported capability wellbeing instrument designed for outcome measurement in mental health research[1]. It captures dimensions of wellbeing within the conceptual framework of the capability approach. The OxCAP-MH has 16 items that are all rated on a 1–5 scale and include: limitation in daily activities, social networks, losing sleep over worry, enjoying social and recreational activities, having suitable accommodation, feeling safe, likelihood of assault, likelihood of discrimination, influencing local decisions, freedom of expression, appreciating nature, respecting and valuing people, enjoying friendship and support, self-determination, imagination and creativity, access to interesting activities or employment.

The original English version of the questionnaire was developed by Judit Simon and colleagues[1] alongside the Oxford Community Treatment Order Evaluation Trial (OCTET) randomised controlled trial[2] in the UK between 2008 and 2014. The OxCAP-MH’s first psychometric validation, which was examined on a sample of patients with a primary diagnosis of revolving door psychotic illness, confirmed good feasibility, reliability and validity of the questionnaire with great potential for implementation in mental health practice for clinical and health economic evaluations[3][4]. Since then the OxCAP-MH has been used and tested in different populations, settings and countries, including patients with mental health problems such as psychosis[5], depression[6], bipolar disorder[7], receiving integration assistance[8], or mixed mental health service use[9]; other specific population groups such as refugees[10], or people living with HIV/AIDS[11]; and the general population[12] including the COVID-19 pandemic[13][14]. The OxCAP-MH has also been implemented as outcome measure in multiple mental health economic evaluations[15][16][17][18][19] and has preliminary preference weights developed[20].

Distribution of the OxCAP-MH is managed by the Department of Health Economics (DHE) at the Medical University of Vienna. A dedicated website provides detailed instructions for the registration of use and up-to-date information about the latest developments including available language versions (e.g. English, German[21], Hungarian[22], Chinese, Luganda[23], Juba Arabic[24], Korean (South Korea), Macedonian, Moldovan, Russian (Ukraine), and Ukrainian) and key references. The OxCAP-MH can be used free of charge for non-commercial education, research and clinical patient care purposes following prior registration.

Development

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The OxCAP-MH’s theoretical background is rooted in Amartya Sen’s capability theory[25]. The development of this instrument was based on the earlier work of Paul Anand, who created a list of capability indicators based on Martha Nussbaum’s list of 10 central human capabilities[26] and the data from British Household Panel Survey[27][28]. The list of central human capabilities regarded by Nussbaum as “constitutional guarantees in all nations”, include life expectancy, bodily health, bodily integrity, senses, imagination and thought, emotions, practical reason, affiliation, other species, play and control over one’s environment[26]. This work was later developed into the OCAP-18 questionnaire designed to measure outcomes of public health interventions led by the University of Glasgow[29]. As a subsequent step, the OCAP-18 was developed and tested into the OxCAP-MH capability wellbeing measure for use in mental health research[1] as part of the Oxford Community Treatment Order Evaluation Trial (OCTET) study[2] led by the University of Oxford. The OxCAP-MH underwent full psychometric validation[4] and a standardised scoring system, complete concept elaboration and user guide were developed in collaboration between the University of Oxford and the Department of Health Economics (DHE) at the Medical University of Vienna by 2017.

References

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  1. ^ a b c Simon, Judit; Anand, Paul; Gray, Alastair; Rugkåsa, Jorun; Yeeles, Ksenija; Burns, Tom (2013). "Operationalising the capability approach for outcome measurement in mental health research". Social Science & Medicine. 98: 187–196. doi:10.1016/j.socscimed.2013.09.019. PMID 24331898.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  2. ^ a b Burns, Tom; Rugkåsa, Jorun; Molodynski, Andrew; Dawson, John; Yeeles, Ksenija; Vazquez-Montes, Maria; Voysey, Merryn; Sinclair, Julia; Priebe, Stefan (2013). "Community treatment orders for patients with psychosis (OCTET): a randomised controlled trial". Lancet. 381 (9878): 1627–1633. doi:10.1016/S0140-6736(13)60107-5. ISSN 1474-547X. PMID 23537605.
  3. ^ Vergunst, F., Jenkinson, C., Burns, T. & Simon, J (2014). "Application of Sen's Capability Approach to Outcome Measurement in Mental Health Research: Psychometric Validation of a Novel Multi-dimensional Instrument (OxCAP-MH)" (PDF). Human Welfare. 3 (1): 1–4.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  4. ^ a b Vergunst, Francis; Jenkinson, Crispin; Burns, Tom; Anand, Paul; Gray, Alastair; Rugkåsa, Jorun; Simon, Judit (2017). "Psychometric validation of a multi-dimensional capability instrument for outcome measurement in mental health research (OxCAP-MH)". Health and Quality of Life Outcomes. 15 (1): 250. doi:10.1186/s12955-017-0825-3. ISSN 1477-7525. PMC 5745777. PMID 29282075.
  5. ^ Helter, Timea Mariann; Coast, Joanna; Łaszewska, Agata; Stamm, Tanja; Simon, Judit (2022). "Comparison of capability and health-related quality of life instruments in capturing aspects of mental well-being in people with schizophrenia and depression". BJPsych Open. 8 (4): e117. doi:10.1192/bjo.2022.514. ISSN 2056-4724. PMC 9301777. PMID 35758648.
  6. ^ Browning, Michael; Bilderbeck, Amy C.; Dias, Rebecca; Dourish, Colin T.; Kingslake, Jonathan; Deckert, Jürgen; Goodwin, Guy M.; Gorwood, Philip; Guo, Boliang; Harmer, Catherine J.; Morriss, Richard; Reif, Andreas; Ruhe, Henricus G.; van Schaik, Anneke; Simon, Judit (2021). "The clinical effectiveness of using a predictive algorithm to guide antidepressant treatment in primary care (PReDicT): an open-label, randomised controlled trial". Neuropsychopharmacology. 46 (7): 1307–1314. doi:10.1038/s41386-021-00981-z. ISSN 1740-634X.
  7. ^ Steel, Craig; Wright, Kim; Goodwin, Guy M.; Simon, Judit; Morant, Nicola; Taylor, Rod S.; Brown, Michael; Jennings, Susie; Hales, Susie A.; Regan, Jemma; Sibsey, Michaela; Thomas, Zoe; Meredith, Lynette; Holmes, Emily A. (2023). "The IBER study: a feasibility randomised controlled trial of imagery based emotion regulation for the treatment of anxiety in bipolar disorder". International Journal of Bipolar Disorders. 11 (1): 27. doi:10.1186/s40345-023-00305-8. ISSN 2194-7511.
  8. ^ Baumgardt, Johanna; Daum, Marcel; von dem Knesebeck, Olaf; Speck, Andreas; Röh, Dieter (2018). "[Assess Capabilities Among Chronically Mentally Ill People: First Test Results on a Draft German Version of the OxCAP-MH as Part of the BAESCAP Study]". Psychiatrische Praxis. 45 (3): 140–147. doi:10.1055/s-0043-101903. ISSN 1439-0876. PMID 28371948.
  9. ^ Łaszewska, Agata; Schwab, Markus; Leutner, Eva; Oberrauter, Marold; Spiel, Georg; Simon, Judit (2018). "Measuring broader wellbeing in mental health services: validity of the German language OxCAP-MH capability instrument". Quality of Life Research. 28 (8): 2311–2323. doi:10.1007/s11136-019-02187-9. ISSN 1573-2649. PMC 6620251. PMID 31030365.
  10. ^ van der Boor, C. F.; Taban, D.; Ismail, K.; Simon, J.; Roberts, B.; Fuhr, D.; Tol, W. A.; Greco, G. (2024). "Measuring refugees' capabilities: translation, adaptation, and valuation of the OxCAP-MH into Juba Arabic for use among South Sudanese male refugees in Uganda". Journal of Patient-Reported Outcomes. 8 (1): 40. doi:10.1186/s41687-024-00720-0. ISSN 2509-8020. PMC 10987405. PMID 38564035.
  11. ^ Katumba, Kenneth R.; Laurence, Yoko V.; Tenywa, Patrick; Ssebunnya, Joshua; Laszewska, Agata; Simon, Judit; Vassall, Anna; Kinyanda, Eugene; Greco, Giulia (2021). "Cultural and linguistic adaptation of the multi-dimensional OXCAP-MH for outcome measurement of mental health among people living with HIV/AIDS in Uganda: the Luganda version". Journal of Patient-Reported Outcomes. 5 (1): 32. doi:10.1186/s41687-021-00306-0. ISSN 2509-8020. PMC 8026780. PMID 33826007.
  12. ^ Balázs, Péter György; Łaszewska, Agata; Simon, Judit; Brodszky, Valentin (2014). "Population normative data for OxCAP-MH capability scores". The European Journal of Health Economics. doi:10.1007/s10198-024-01696-w. ISSN 1618-7601. PMID 38789619.
  13. ^ Simon, Judit; Helter, Timea M.; White, Ross G.; van der Boor, Catharina; Łaszewska, Agata (2021). "Impacts of the Covid-19 lockdown and relevant vulnerabilities on capability well-being, mental health and social support: an Austrian survey study". BMC Public Health. 21 (1): 314. doi:10.1186/s12889-021-10351-5. ISSN 1471-2458. PMC 7868863. PMID 33557816.
  14. ^ White, Ross G.; Christiansen, Paul; van der Boor, Catharina (2023). "A longitudinal study of capability-based quality of life and mental health in the first 5-months of lockdown restrictions in the UK". BMC Public Health. 23 (1): 451. doi:10.1186/s12889-023-15285-8. ISSN 1471-2458. PMC 9993355. PMID 36890497.
  15. ^ Simon, Judit; Mayer, Susanne; Łaszewska, Agata; Rugkåsa, Jorun; Yeeles, Ksenija; Burns, Tom; Gray, Alastair (2021). "Cost and quality-of-life impacts of community treatment orders (CTOs) for patients with psychosis: economic evaluation of the OCTET trial". Social Psychiatry and Psychiatric Epidemiology. 56 (1): 85–95. doi:10.1007/s00127-020-01919-4. ISSN 1433-9285. PMC 7847440. PMID 32719905.
  16. ^ Simon, Judit; Kiss, Noemi; Korrelboom, Kees; Kingdon, David; Wykes, Til; Phiri, Peter; van der Gaag, Mark; Baksh, M. Fazil; Steel, Craig (2022). "Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia". International Journal of Environmental Research and Public Health. 19 (19): 11985. doi:10.3390/ijerph191911985. ISSN 1660-4601. PMID 36231292.
  17. ^ Kingslake, Jonathan; Dias, Rebecca; Dawson, Gerard R.; Simon, Judit; Goodwin, Guy M.; Harmer, Catherine J.; Morriss, Richard; Brown, Susan; Guo, Boliang; Dourish, Colin T.; Ruhé, Henricus G.; Lever, Anne G.; Veltman, Dick J.; van Schaik, Anneke; Deckert, Jürgen (2017). "The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial". Trials. 18 (1): 558. doi:10.1186/s13063-017-2247-2. ISSN 1745-6215. PMC 5701462. PMID 29169399.
  18. ^ Azim, Lumbini; Hindmarch, Paul; Browne, Georgiana; Chadwick, Thomas; Clare, Emily; Courtney, Paul; Dixon, Lyndsey; Duffelen, Nichola; Fouweather, Tony; Geddes, John R.; Goudie, Nicola; Harvey, Sandy; Helter, Timea; Holstein, Eva-Maria; Martin, Garry (2021). "Study protocol for a randomised placebo-controlled trial of pramipexole in addition to mood stabilisers for patients with treatment resistant bipolar depression (the PAX-BD study)". BMC Psychiatry. 21 (1): 334. doi:10.1186/s12888-021-03322-y. ISSN 1471-244X. PMC 8256234. PMID 34225686.
  19. ^ Au-Yeung, Sheena Kristine; Griffiths, James; Roberts, Sophie; Edwards, Chloe; Yu, Ly-Mee; Bogacz, Rafal; Rendell, Jennifer; Attenburrow, Mary-Jane; Watson, Stuart; Chan, Fiona; Cipriani, Andrea; Cleare, Anthony; Harmer, Catherine J.; Kessler, David; Evans, Jonathan (2022). "PAX-D: study protocol for a randomised placebo-controlled trial evaluating the efficacy and mechanism of pramipexole as add-on treatment for people with treatment resistant depression". BMJ Ment Health. 25 (2): 77–83. doi:10.1136/ebmental-2021-300282. ISSN 1362-0347. PMC 9046747. PMID 34810175.
  20. ^ Helter, Timea Mariann; Kaltenboeck, Alexander; Baumgartner, Josef; Mayrhofer, Franz; Heinze, Georg; Sönnichsen, Andreas; Wancata, Johannes; Simon, Judit (2022). "Does the relative importance of the OxCAP-MH's capability items differ according to mental ill-health experience?". Health and Quality of Life Outcomes. 20 (1): 99. doi:10.1186/s12955-022-02009-6. ISSN 1477-7525. PMC 9233329. PMID 35751092.
  21. ^ Łaszewska, Agata; Schwab, Markus; Leutner, Eva; Oberrauter, Marold; Spiel, Georg; Simon, Judit (2019). "Measuring broader wellbeing in mental health services: validity of the German language OxCAP-MH capability instrument". Quality of Life Research. 28 (8): 2311–2323. doi:10.1007/s11136-019-02187-9. ISSN 1573-2649. PMC 6620251. PMID 31030365.
  22. ^ Helter, Timea Mariann; Kovacs, Ildiko; Kanka, Andor; Varga, Orsolya; Kalman, Janos; Simon, Judit (2021). "Internal and external aspects of freedom of choice in mental health: cultural and linguistic adaptation of the Hungarian version of the Oxford CAPabilities questionnaire-Mental Health (OxCAP-MH)". BMC Psychology. 9 (1): 161. doi:10.1186/s40359-021-00660-0. ISSN 2050-7283. PMC 8524921. PMID 34663472.
  23. ^ Katumba, Kenneth R.; Laurence, Yoko V.; Tenywa, Patrick; Ssebunnya, Joshua; Laszewska, Agata; Simon, Judit; Vassall, Anna; Kinyanda, Eugene; Greco, Giulia (2021). "Cultural and linguistic adaptation of the multi-dimensional OXCAP-MH for outcome measurement of mental health among people living with HIV/AIDS in Uganda: the Luganda version". Journal of Patient-Reported Outcomes. 5 (1): 32. doi:10.1186/s41687-021-00306-0. ISSN 2509-8020. PMC 8026780. PMID 33826007.
  24. ^ van der Boor, C.F.; Taban, D.; Ismail, K.; Simon, J.; Roberts, B.; Fuhr, D.; Tol, W.A.; Greco, G. (2024). "Measuring refugees' capabilities: translation, adaptation, and valuation of the OxCAP-MH into Juba Arabic for use among South Sudanese male refugees in Uganda". Journal of Patient-Reported Outcomes. 8 (1): 40. doi:10.1186/s41687-024-00720-0. ISSN 2509-8020. PMC 10987405. PMID 38564035.
  25. ^ Sen, Amartya (1999). Choice, welfare, and measurement (Harvard University press paperback edition, 1997 ed.). Cambridge, Mass: Harvard University Press. ISBN 978-0-674-12778-4.
  26. ^ a b Nussbaum, Martha C. (2000). Women and human development: the capabilities approach. The John Robert Seeley lectures. Cambridge ; New York: Cambridge University Press. ISBN 978-0-521-66086-0.
  27. ^ Anand, Paul; Hunter, Graham; Smith, Ron (2005). "Capabilities and Well-Being: Evidence Based on the Sen–Nussbaum Approach to Welfare". Social Indicators Research. 74 (1): 9–55. doi:10.1007/s11205-005-6518-z. ISSN 1573-0921.
  28. ^ Anand, Paul; Hunter, Graham; Carter, Ian; Dowding, Keith; Guala, Francesco; Van Hees, Martin (2009). "The Development of Capability Indicators". Journal of Human Development and Capabilities. 10 (1): 125–152. doi:10.1080/14649880802675366. ISSN 1945-2829.
  29. ^ Lorgelly, Paula K.; Lorimer, Karen; Fenwick, Elisabeth A. L.; Briggs, Andrew H.; Anand, Paul (2015). "Operationalising the capability approach as an outcome measure in public health: The development of the OCAP-18". Social Science & Medicine. 142: 68–81. doi:10.1016/j.socscimed.2015.08.002. ISSN 1873-5347. PMID 26291444.
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