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PubMed1982

The Kentucky elderly need assessment: concurrent validity of different measures of unmet need.

The purpose was to examine the concurrent criterion-based validity of different measures used in a statewide in-home need assessment survey of a representative sample of 570 older persons. Need was measured and defined in four different ways in six problem areas. The criterion measure was a life satisfaction scale. The set of four need measures yielded a significant multiple R, indicating that the set would generally be related to life satisfaction in older persons. Individually, three of the four need measures made significant contributions. The set of six problem areas also yielded a significant multiple R, with four (Mental Health, Health, Income, Nutrition) making significant individual contributions. Implications for need assessment measurement included: that problem-focused measures are strongly and generally related to need satisfaction, whereas service-focused measures have problems; that both evaluative and descriptive measures appear to be related to need satisfaction; and the clear value of a multineed conception for measurement and for application to program planning and resource allocation. Suggestions for improvement in measures were made and cross-validation called for.

Aged↗

PubMedDate not supplied

A comparison of client and mental health worker assessment of needs and unmet needs.

This study was set up to examine agreement on needs identified by mental health clients and their primary mental health workers. Mental health workers assessed a convenience sample of clients who completed an interview about the services they receive. Data were collected from 78 client and staff dyads regarding 11 need domains. Mental health workers and clients did not agree on the number of needs (ICC = 0.42). Kappa coefficients indicated significant agreement between staff and clients for only 1 of the 11 need domains (vocational need kappa = 0.67; others ranged from 0 to 0.58). The data further revealed that mental health workers and clients disagreed about unmet needs (kappa ranged from -0.07 to 0.46). These findings show that clients and staff have divergent opinions regarding needs. Integrating clients' perspectives into treatment plans may help address this issue.

Adult↗

PubMed1996

Orthodontic concern among 11-year-old children and their parents compared with orthodontic treatment need assessed by index of orthodontic treatment need.

The aims of the study were to compare the opinions of both the children and the parents with an orthodontist's assessment of treatment need, to investigate the children's self-esteem, and parents' opinion of treatment results. The study group of 359 children (51% girls, 49% boys, mean age 10.6 years) and their parents were asked about their opinions in separate questionnaires. The self-esteem of the children was measured by the global negative self-evaluation scale (GSE). An orthodontist assessed the children's dental casts with the index of Orthodontic Treatment Need (IOTN). Allocated to the dental health component (DHC) of IOTN, 53.2% children had very great to moderate need and 46.8% had little to no need. No sex difference was noted. The children's own assessments of the aesthetic component (AC) of IOTN were closer to the attractive end of the scale than the orthodontist's (p < 0.05). Desire for treatment was more frequent than dissatisfaction with children's occlusion (p < 0.001). The patients' orthodontic concern correlated significantly with both DHC and AC grades (p < 0.001). The children's GSE scores were not correlated to components of IOTN. For children with very great need, high self-esteem was related to orthodontic concern. The parents (90.8%) perceived dental esthetics to be equally important for girls and boys. Most parents (93.0%) thought the results of orthodontic treatment were good. The results indicate meaningful association between orthodontic concern and orthodontic treatment need assessed by IOTN. However, some patients with great need do not express orthodontic concern, whereas others with near ideal occlusion express concern.

Attitude to Health↗

PubMed1998

Assessing relatives' needs for psychosocial interventions in schizophrenia: a relatives' version of the Cardinal Needs Schedule (RCNS).

BACKGROUND: The methodology for measuring the needs of patients with severe mental illness is now well established through the MRC Needs for Care Assessment Schedule and its modification in the form of the Cardinal Needs Assessment. This paper reports the rationale and construction of a relatives' version of the Cardinal Needs Schedule and looks at preliminary data reporting on reliability and validity. METHODS: Potential problem areas for relatives were identified from the literature. The criteria determining Cardinal Needs for each problem included objective threshold, carer concern, and carer cooperation. The reliability of the Schedule was assessed in a study whereby 27 relatives of patients with established schizophrenic illness completed two Schedules administered by two independent raters within a short time period. RESULTS: The Schedule was acceptably reliable for most areas of need although there were some difficulties associated with the cooperation criteria. Concurrent measures of relatives and patients including EE, relative distress and patient psychopathology indicated that the Relatives' Cardinal Needs Schedule shows acceptable validity when used with a sample of 45 relatives. CONCLUSIONS: The paper suggests that the Schedule may prove to be a useful tool for both clinicians and researchers interested in establishing and evaluating family interventions.

Activities of Daily Living↗

PubMed2000

Assessment of hospitalised cancer patients' needs by the Needs Evaluation Questionnaire.

BACKGROUND: Cancer disease modifies the order and the nature of needs connected with the state of health. The aim of this study was to evaluate the informative, psychological, social and practical needs of hospitalised cancer patients by means of the Needs Evaluation Questionnaire (NEQ), an instrument designed concisely for the convenience of patients and medical staff. PATIENTS AND METHODS: Different samples of consecutive hospitalised cancer patients were involved in the various phases of designing the instrument: 30 patients for items identification, 101 patients for completeness and acceptability evaluation, 423 patients for construct validity and prevalence of needs; content and reliability analysis were performed on 2 subsamples of, respectively, 60 and 88 of the patients from the last sample. RESULTS: The validation analysis showed rather good reliability, structure validity and internal consistency of the questionnaire. The prevalence analysis showed that the most common needs were: 'more information about my future conditions' (74%); 'more information about my diagnosis' (56%); 'more information about the exams I am undergoing' (52%); 'more explanations on treatments' (51%); 'to have a better dialogue with clinicians' (57%); 'better services from the hospital' (bathrooms, meals, cleaning) (56%). CONCLUSIONS: The NEQ, self-completed by patients, has proven to be a useful clinical tool for obtaining a systematic and undistorted overview of the principal needs with respect to the state of health of patients. This instrument, which can also be administered by persons not belonging to the health care system such as volunteers, and inserted into the patients' hospital charts, could be used by the medical staff to identify the real needs of patients at an early stage.

Female↗

PubMed2001

Information and support needs of women with primary relatives with breast cancer: development of the Information and Support Needs Questionnaire.

AIMS OF THE STUDY: The aim was to develop and pilot test a newly developed measure, The Information and Support Needs Questionnaire (ISNQ), for use with women with primary relatives with breast cancer. BACKGROUND/RATIONALE: Breast cancer is a major risk to the health of women in the United Kingdom (UK). Increasingly, research is documenting women's needs for information and support, particularly at the time of diagnosis. However, to date there is little understanding of the information and support needs of women who have a family history of breast cancer. Contributing to the dearth of understanding of female relatives' needs is the lack of valid and reliable instruments for use in descriptive and intervention research with this population. DESIGN/METHODS: The ISNQ and survey items documenting family history, sources of information and support for breast cancer risk, breast self-care practices, and other variables were pilot tested for the acceptability of the measures, appropriateness of the data collection methods, initial psychometric properties of the ISNQ, and time and financial costs of administration. Data were collected from 39 women living in the North-west of England who had primary relatives with breast cancer using mailed questionnaires and follow-up telephone interviews. FINDINGS: The items on the ISNQ were reported to be clear, acceptable to women and to yield relevant data. The psychometric properties of the new measure were satisfactory with a high reliability coefficient alpha. Descriptive findings indicate that women had moderate to high needs for information and support, but reported that these needs were not well met. CONCLUSIONS: The results of this pilot are guiding the development of a larger study in which the information and support needs of women with a family history of breast cancer are explored.

Adult↗

PubMed2004

Dental treatment need among 20 to 25-year-old Swedes: discrepancy between subjective and objective need.

Our aim was to analyze variables from a questionnaire sent to 20 to 25-year-old Swedes to determine how they perceive their oral treatment need, and to determine which variables affect this perception. The questionnaire was sent to 650 individuals randomly selected from the database of the National Social Insurance Board of Sweden. The response rate was 78%. Another questionnaire was sent to the dentists of these young adults in order to collect clinical information. The response rate was 66%. The respondent's answer to the question 'How do you rate your dental treatment need today?' was dichotomized and used as a dependent variable in a multivariate logistic regression model. Each increase in number of decayed-filled teeth led to a 13% increased treatment need, bad oral hygiene a 2.24-fold increase, and no periodontal disease an 80% reduction in treatment need. A higher education beyond comprehensive school increased the perceived treatment need 7.16 times; a poorer dental health than one's contemporaries led to a 14.47-fold increase. When dentist and patient assessments were combined, variables related to the patients' self-assessments were the only significant contributors to the statistical model. A lack of concordance between patients' and dentists' assessments of treatment need was found which highlighted the differences between patients' and dentists' views on treatment need. This study shows the importance of communication between dentist and patient.

Adult↗

PubMed1997

Need and unmet need for mental health care among elderly public housing residents.

Epidemiologic survey data from elderly residents of six public housing developments were used to determine the prevalence of need and unmet need for mental health care. Thirty-seven percent of this predominantly African American sample needed mental health services, and 58% of those who needed care had unmet needs. Logistic regression analyses showed that males, older residents, those with no Medicare insurance, and those with more Activities of Daily Living (ADL) impairments were at greater risk of both needing mental health care and receiving no mental health care services. Findings suggest the need for targeted interventions that would increase service utilization and potentially reduce the likelihood of eviction or placement in more restrictive settings.

Black or African American↗

PubMed1993

How many physicians will be needed to provide medical care for older persons? Physician manpower needs for the twenty-first century.

To estimate the number of full-time-equivalent (FTE) physicians and geriatricians needed to provide medical care in the years 2000 to 2030, we developed utilization-based models of need for non-surgical physicians and need for geriatricians. Based on projected utilization, the number of FTE physicians required to care for the elderly will increase two- or threefold over the next 40 years. Alternate economic scenarios have very little effect on estimates of FTE physicians needed but exert large effects on the projected number of FTE geriatricians needed. We conclude that during the years 2000 to 2030, population growth will be the major factor determining the number of physicians needed to provide medicare care; economic forces will have a greater influence on the number of geriatricians needed.

Activities of Daily Living↗

PubMed1994

The influence of the setting of 'cut-off' points for orthodontic treatment need upon the reliability of the Index of Orthodontic Treatment Need.

This investigation evaluated the effect of setting cut-off points for treatment allocation upon the reliability of the Index of Orthodontic Treatment Need (IOTN). Cut-off points were placed between the grades signifying 'need' and 'moderate need' and between 'need' and 'no need' for treatment. The reliability of each of these dichotomous decisions was evaluated with (i) the Kappa statistic and (ii) the false positive and false negative rates. We found that the reliability was decreased and the false positive rate was increased when the cut-off point was placed between the 'need' and 'moderate need' for treatment levels. The effect of this variation in reliability is discussed.

Esthetics, Dental↗

PubMed1995

The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness.

BACKGROUND: People with severe mental illness often have a complex mixture of clinical and social needs. The Camberwell Assessment of Need (CAN) is a new instrument which has been designed to provide a comprehensive assessment of these needs. There are two versions of the instrument: the clinical version has been designed to be used by staff to plan patients' care; whereas the research version is primarily a mental health service evaluation tool. The CAN has been designed to assist local authorities to fulfil their statutory obligations under the National Health Service and Community Care Act 1990 to assess needs for community services. METHOD: A draft version of the instrument was designed by the authors. Modifications were made following comments from mental health experts and a patient survey. Patients (n = 49) and staff (n = 60) were then interviewed, using the amended version, to assess the inter-rater and test-retest reliability of the instrument. RESULTS: The mean number of needs identified per patient ranged from 7.55 to 8.64. Correlations of the inter-rater and test-retest reliability of the total number of needs identified by staff were 0.99 and 0.78 respectively. The percentage of complete agreement on individual items ranged from 100-81.6% (inter-rater) and 100-58.1% (test-retest). CONCLUSIONS: The study suggests that the CAN is a valid and reliable instrument for assessing the needs of people with severe mental illness. It is easily learnt by staff from a range of professional backgrounds, and a complete assessment took, on average, around 25 minutes.

Adult↗

PubMed1994

Linking resource use to consumer level of need: field test of the level of need-care assessment (LONCA) method.

A team of service system planners in King County, Washington, field-tested the feasibility of the LONCA (level of need-care assessment) method as a strategy to match resources to consumer level of need. LONCA links resources to need by first measuring the incidence and intensity of consumer needs in specific functioning domains. It then preliminarily specifies the type and intensity of services required to minimally but appropriately address specific consumer needs, calculates service costs, and identifies clusters of consumers with similar need and cost profiles. The field test supported the feasibility of performing LONCA tasks. The resulting scheme for clustering consumers appeared to have face validity and was modestly associated with at least 3 independent indicators of resource need: program status, residential status, and hospitalizations. Despite its limitations, the article supports further development of LONCA for use as a resource allocation tool for local service systems.

Community Mental Health Services↗

PubMed1998

The impact of psychosocial need and needs resolution on quality of life in patients with brain tumors.

The diagnosis of cancer of the central nervous system (CNS) is often the diagnosis of an incurable, progressive disease with devastating effects on the physical, psychosocial, and cognitive functioning of patients. Because many of the treatment options are noncurative in nature, issues related to quality and quantity of life become paramount. The purpose of the authors' research was to explore the prevalence of psychosocial needs in this cancer population and to determine whether these needs and their resolution impact on quality of life (QOL). Telephone interviews were conducted with 75 patients in whom primary CNS cancer was diagnosed and who were able to pass the Mini-Mental Health Status Examination. Analysis of results indicated that the majority of patients (97.3%) had at least one concern; concerns over treatment side effects, controlling uncertainty, having a meaningful existence, self and body image, and family concerns were among the five most frequently cited need domains. Most patients (91.8%) received help. However, 75.3% reported needing additional help. The number of needs reported and the severity of fatigue most significantly impacted QOL. The study identified the needs and experiences of the patient with CNS cancer. Quality of life and needs assessment information can be used to screen patients for distress and to measure the outcome of medical and psychosocial care and ultimately to ease the burden of illness.

Journal Article↗

PubMedDate not supplied

Needs assessment surveys in gerontological nursing: are we really assessing continuing education needs and priorities?

The growing elderly population with diverse and complex health care needs requires increased attention to educational preparation for nurses who provide their care. This article describes a needs assessment effort that reinforces the importance of using a variety of strategies to collect data to facilitate planning relevant educational offerings. Results of the study indicated a wide variety of learning needs and diverse opinions regarding priorities. In addition, all participants in the study indicated perceptions of greater educational need for other RNs in gerontological practice than for themselves. The extent of the perception of need for educational offerings in gerontology and the lack of consensus about priorities indicate a need for further research. Several issues surrounding survey methods for collecting needs assessment data are discussed.

Education, Nursing, Continuing↗

PubMed2005

Determining older people's needs for care by Registered Nurses: the Nursing Needs Assessment Tool.

AIMS: This paper reports a study to determine an appropriate framework for assessing older people's needs for nursing within the policy of 'free nursing', and to attempt to identify valid, reliable and usable assessment tool for determining this eligibility. BACKGROUND: In 2001, the United Kingdom government introduced 'free nursing care' legislation, eligibility for which was subject to a nursing needs assessment. This paper outlines the search for and subsequent development of an appropriate tool for assessing older people's eligibility for free nursing care in Northern Ireland. METHODS: Following a systematic search of the literature, existing tools used in ascertaining older people's nursing needs were identified. Each tool was systematically assessed in accordance with criteria of validity, reliability, usability, comprehensiveness of assessment and ability to quantify nursing care needs. From the findings, an assessment instrument, Nursing Needs Assessment Tool was subsequently developed and tested. Paired assessments of older people were undertaken independently by assessor dyads and evaluated statistically. Assessors' opinions on the usability of the instrument were sought through a focus group. RESULTS: One hundred and ten paired assessments were returned (63%). Overall there was 65% agreement between assessors. Kappa scores indicated good levels of inter-rater reliability. Correlation co-efficient measures reinforced these results. Findings from the focus group confirmed the validity, usability and comprehensiveness of the tool. CONCLUSIONS: The Nursing Needs Assessment Tool is a reliable, valid and usable instrument. This has major implications for the standardization of assessment for older people.

Aged↗

PubMed2007

Assessing unmet supportive care needs in partners of cancer survivors: the development and evaluation of the Cancer Survivors' Partners Unmet Needs measure (CaSPUN).

BACKGROUND: Partners of cancer patients typically provide the majority of patients' emotional and physical care. Partners may be profoundly affected by the cancer and may experience ongoing supportive care needs across the survivorship continuum. Research has been restricted by a lack of psychometrically evaluated measures and in this study, a self-report measure of partners' needs was developed and empirically evaluated. METHODS: Questionnaire items generated from a qualitative study were constructed into a 47- item unmet need measure (Cancer Survivors' Partners Unmet Needs measure, CaSPUN). The psychometric properties of the CaSPUN were evaluated in 212 partners of patients who had been diagnosed with cancer 1-11 years earlier and were currently disease-free. RESULTS: The CaSPUN was modified to include 35 unmet need items, 6 positive change items and an open ended item. The CaSPUN demonstrates a high level of acceptability, internal consistency and construct validity, although test-retest reliability was moderate. Factor analysis identified five discrete factors: (1) Relationships, (2) Information, (3) Partner Issues, (4) Comprehensive Care and (5) Emotional Support. CONCLUSIONS: The CaSPUN permits the identification of long-term supportive care needs in generic populations of cancer survivors' partners and will assist with the formulation of recommendations regarding required supportive care services.

Adult↗

PubMed2002

Validity of the Index of Complexity, Outcome, and Need (ICON) in determining orthodontic treatment need.

Occlusal indices are used to determine eligibility for orthodontic treatment in several publicly funded programs. The Index of Complexity, Outcome, and Need (ICON), based on the perception of 97 orthodontists from 9 countries, has been proposed as a multipurpose occlusal index. The aim of this study was to investigate the validity of the ICON as an index of orthodontic treatment need compared with the perception of need as determined by a panel of US orthodontists. One hundred seventy study casts, representing a full spectrum of malocclusion types and severity, were scored for orthodontic treatment need by an examiner calibrated in the ICON. The results were compared with the decisions of an expert panel of 15 orthodontic specialists from the central Ohio area. The simple kappa statistic (0.81) indicated very high agreement of the index with the decisions of the expert panel. The sensitivity (94%), specificity (85%), positive predictive value (92%), negative predictive value (90%), and overall accuracy of the ICON (91%) also confirmed good agreement with the orthodontic specialists. The panel found that 64% of the casts required orthodontic treatment; the ICON scores indicated that 65% of the cases needed treatment. There was agreement between the expert panel and the index in 155 of the 170 cases. These results support the use of the ICON as a validated index of orthodontic treatment need.

Dental Health Surveys↗

PubMed2005

The Need of Support and Service Questionnaire (NSSQ): a brief scale to assess needs in clients with long-term mental disabilities.

We present the Need of Support and Service Questionnaire (NSSQ), a new instrument developed to provide professionals in psychiatric care and community social services with a tool to assess needs of support and service in mentally disabled clients. The final version of the instrument was designed after comments from professionals in psychiatric care, community social services, and the clients and their relatives. A reliability study (test-retest, n=77), inter-rater (n=69) and a validity study (n=529) were performed. In the validity study, comparisons were done with the Camberwell Assessment of Need (CAN) scale, the Global Assessment of Functioning (GAF) scale and the Social and Occupational Functioning Assessment Scale (SOFAS). The test-retest and inter-rater reliability were 0.86 and 0.76, respectively. The percentage of agreement on the individual items ranged from 83.1% to 100.0% (test-retest) and 76.8% to 100.0% (inter-rater reliability). The corresponding kappa coefficients ranged from 0.63 to 1.00 (test-retest) and 0.33 to 1.00 (inter-rater reliability). The comparison between NSSQ and CAN items demonstrated high sensitivity and specificity as well as satisfactory likelihood ratios (LRs). The correlations between GAF and SOFAS scores and the number of needs of support, number of needs of service and the total number of needs of support and service were -0.49, -0.32 and -0.47, and -0.48, -0.26 and -0.45, respectively. All correlations were statistically significant (P<0.01). The results demonstrated that the psychometric characteristics of the NSSQ were satisfactory. Moreover, professionals without any formal training easily used it.

Disability Evaluation↗