Psychometric study of the Required Care Levels for People with Severe Mental Disorder Assessment Scale (ENAR-TMG)

David Lascorz, Victoria López, Carmen Pinedo, Joan Trujols, Joan Vegué, Víctor Pérez

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    Introduction: People with severe mental disorder have significant difficulties in everyday life that involve the need for continued support. These needs are not easily measurable with the currently available tools. Therefore, a multidimensional scale that assesses the different levels of need for care is proposed, including a study of its psychometric properties. Method: One-hundred and thirty-nine patients (58% men) with a severe mental disorder were assessed using the Required Care Levels for People with Severe Mental Disorder Assessment Scale (ENAR-TMG), the Camberwell Assessment of Need scale, and the Health of the Nation Outcome Scales. ENAR-TMG's psychometric features were examined by: a) evaluating 2 sources of validity evidence (evidence based on internal structure and evidence based on relations to other variables), and b) estimating the internal consistency, temporal stability, inter-rater reliability, and sensitivity to change of scores of the ENAR-TMG's subscales. Results: Exploratory factor analyses revealed a one-factor structure for each of the theoretical dimensions of the scale, in which all but one showed a significant and positive correlation with the Camberwell Assessment of Need (range of r: 0.143-0.557) and Health of the Nation Outcome Scales (range of r: 0.241-0.474) scales. ENAR-TMG subscale scores showed acceptable internal consistency (range of ordinal α coefficients: 0.682-0.804), excellent test-retest (range of intraclass correlation coefficients: 0.889-0.999) and inter-rater reliabilities (range of intraclass correlation coefficients: 0.926-0.972), and satisfactory sensitivity to treatment-related changes (range of η2: 0.003-0.103). Conclusions: The satisfactory psychometric behaviour of the ENAR-TMG makes the scale a promising tool to assess global functioning in people with a severe mental disorder.
    Original languageEnglish
    Pages (from-to)156-168
    JournalRevista de Psiquiatria y Salud Mental
    Issue number3
    Publication statusPublished - 1 Jul 2018


    • Assessment scale
    • Escala de evaluación
    • Estudio psicométrico
    • Funcionamiento psicosocial
    • Psychometric study
    • Psychosocial functioning
    • Severe mental disorder
    • Trastorno mental grave


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