Validation of the Danish version of the Questionnaire about the Process of Recovery (QPR): psychometric properties, sensitivity to change, and meaningful difference.
TL;DR
The Danish QPR-7 is a valid and reliable brief measure for patient-centered recovery assessment in mental health care and its invariance properties, interpretability thresholds, and low respondent burden support its usefulness in routine monitoring of individual recovery gains alongside clinical outcomes.
Abstract
Background
Validated patient-reported outcome measures are needed to assess personal recovery alongside symptom-based outcomes in mental health care. The Questionnaire about the Process of Recovery (QPR) assesses subjective recovery aligned with CHIME processes, but no version of the QPR has previously been validated in Danish, including the widely used QPR-15 and the more recently developed QPR-7. This study assessed psychometric properties, sensitivity to change, and meaningful difference thresholds for the Danish QPR in community mental health samples.
Methods
Pooled analyses were conducted using baseline (n = 353) and follow-up (n = 234) data from adults with mental illness in Danish community mental health services. Confirmatory factor analysis, measurement invariance testing across subgroups, content validity, internal consistency, convergent/discriminant validity, responsiveness analyses were applied, as well as anchor-based methods (CGI-S, MANSA) to establish meaningful difference thresholds.
Results
QPR-15 showed poor unidimensional fit. QPR-7 demonstrated satisfactory fit (CFI = 0.96, TLI = 0.95, SRMR = 0.039, RMSEA = 0.061), internal consistency, invariance across sex, age, education, mental disorder type, and over time. The data were normally distributed without floor/ceiling effects, and correlations supported convergent/discriminant validity. QPR-7 change was strongly associated with changes in quality of life. Meaningful difference values: 2.5 (small)/3.5 (moderate) points within-person; 1.5(small)/2.5 (moderate) points between-group.
Conclusion
The Danish QPR-7 is a valid and reliable brief measure for patient-centered recovery assessment in mental health care. Its invariance properties, interpretability thresholds, and low respondent burden support its usefulness in routine monitoring of individual recovery gains alongside clinical outcomes.