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PubMed2003

The value of the aesthetic component of the Index of Orthodontic Treatment Need in the assessment of subjective orthodontic treatment need.

Previous studies carried out using the Index of Orthodontic Treatment Need (IOTN) have reported that the Aesthetic Component (AC) has limited use in schoolchildren. The purpose of this study was to estimate whether dental concern expressed by the grade of the AC chosen by subjects is reliable and whether it may be predictive for potential co-operation. Such a correlation would indicate if the AC of the IOTN may help to identify individuals interested in orthodontic treatment who would co-operate well, and consequently who might derive the greatest benefits. The investigation was carried out in north-west Poland among 84 schoolchildren (42 girls and 42 boys) aged 12 years and was based on a questionnaire and clinical examination. The questionnaire contained items relating to the subjective assessment of dental appearance, demand for orthodontic treatment, the influence of the dentition on the general appearance, and any functional disorders (speech, mastication, muscular pain, etc.). Clinical examination was carried out at the schools each time by the same dentist. For statistical analysis chi-square (Yates corrected) and McNemar tests were used. A probability at the 5 per cent level or less (P < 0.05) was considered statistically significant. The outcome shows that the AC of the IOTN moderately reflects the subjective perception of dental aesthetics and demand for orthodontic treatment. The results indicate that using professional rating the AC scale does not seem to be more precise or reliable than self-evaluation. The correlation between dental concern and the AC would be higher if the 'no treatment need' category was split into two parts (e.g. 1-2 'no need', 3-4 'slight need') or the 'borderline need' category was moved two grades lower. The AC would then help to identify patients interested in treatment who would potentially be co-operative.

Attitude to Health↗

PubMed2006

Orthodontic treatment need in French schoolchildren: an epidemiological study using the Index of Orthodontic Treatment Need.

This survey was undertaken to assess the orthodontic treatment need in a sample of 9- to 12-year-old French children (mean age: 9.77 years; standard deviation: 0.84) attending 12 different schools in the same geographic area of Ile de France. Two examiners used the Index of Orthodontic Treatment Need (IOTN) in order to estimate treatment need. Five hundred and eleven children (268 males, 243 females) who had not previously received orthodontic treatment were examined. Two examiners, who had been previously trained in the use of occlusal indices, screened all the schoolchildren. No radiographs, study casts, or previously written records of the children were used; the IOTN was calculated from direct examination. Qualitative data were analysed using the chi-square test to determine differences in treatment need between subgroups of subjects, and kappa("kappa") statistics to analyse the findings. A correlation coefficient was used to compare professional assessments. Twenty-one per cent of the children presented an objective need for orthodontic treatment, 28 per cent had crowding, 28 per cent an increased overjet, and 15 per cent an increased overbite. The dental health component (DHC) of the IOTN was found to be reliable and simple to use. The malocclusion status of French schoolchildren was lower than that recorded in epidemiological studies of European children.

Chi-Square Distribution↗

PubMed2004

Cultural influences on health care use: differences in perceived unmet needs and expectations of providers by Latino and Euro-American parents of children with special health care needs.

This study compares service use, perceived unmet needs, and expectations of providers of Latino and Euro-American families of children with disabilities enrolled in a Title V Program. Eighty-four families and 20 providers participated in open-ended, semistructured, and structured interviews. Latino families underused Title V services (p <.001). The Latino families were more likely to cite unmet needs in the following areas: an unresolved health problem (p <.05), rehabilitation therapy programs (p <.001), or need for more information or a support group (p <.001). The Euro-American families cited unmet needs in the following areas: lack of day care (p <.001), respite services (p <.001), recreational programs (p <.001), and home health aides (p <.007). Textual analysis of open interviews revealed that the two groups of families had different expectations of providers. Latino cultural values play a role in these differences, creating barriers for effectively communicating with providers and for meeting children's needs.

Attitude to Health↗

PubMed2002

Learning needs assessment: assessing the need.

Learning needs assessment is a crucial stage in the educational process that leads to changes in practice, and has become part of government policy for continuing professional development. Learning needs assessment can be undertaken for many reasons, so its purpose should be defined and should determine the method used and the use made of findings. Exclusive reliance on formal needs assessment could render education an instrumental and narrow process rather than a creative, professional one. Different learning methods tend to suit different doctors and different identified learning needs. Doctors already use a wide range of formal and informal ways of identifying their own learning needs as part of their ordinary practice. These should be the starting point in designing formalised educational systems for professional improvement.

Education, Medical, Continuing↗

PubMed1991

Needs assessment needs assessment....

Needs assessment is now a high priority, but it is conceptually muddled and technically difficult. In the past a variety of academic disciplines addressing different aspects of health care have produced a range of definitions on 'need' applicable to their own setting. In the context of the National Health Service Review, 'need' may best be defined as the ability to benefit from 'health care', which depends both on morbidity and on the effectiveness of care. An analysis of its relationship with 'demand', which is the health care that people ask for, and 'supply', which is provided, exposes the limitations of current information sources, and confirms that the formal assessment of needs will inevitably be a lengthy task. Despite these difficulties there is much that can and should be done incrementally to influence contracts between providers and purchasers towards meeting health care needs.

Data Collection↗

PubMed1991

[Initial validation of a new scale for needs: the inventory of family needs].

This article presents the initial validation study results of a new scale to measure family needs: l'Inventaire des besoins des familles (IBF) (Chartier & Coutu-Wakulczyk, 1988). The scale is available in both French and English. Based on the perceptual theory, the IBF is a self-report scale composed of 33 items. It also offers three (3) different sub-scores of the importance of needs: the Global Score of Needs (GSN), the Intensity Need Index (INN) and the Total Number of Needs (TNN). The IBF was first validated on a sample of 207 subjects drawn from the adult population of immediate family members visiting a patient in a surgical intensive care unit in the CHUS in Sherbrooke. The reliability yielded a 0.91 Cronback Alpha coefficient and the homogeneity coefficient for Spearman-Brown and Guttman procedures were 0.89 and 0.86 respectively. The principal component factor analysis and factorial matrices lead to examine the conceptual structure of five independent factors.

Adolescent↗

PubMedDate not supplied

An assessment of national needs for community physician manpower in Nigeria: staff training needs and programmes.

This second part of a national survey was designed to identify the training needs and programmes considered most appropriate by the most senior health management staff of the state governments for the field practice of community medicine in Nigeria. The operation of the current primary health care programme and the field practice of community medicine although constitutionally a local government responsibility, effectively rests on the state governments at present because of economic and political constraints at the LG level. The main needs identified in the study are for a certifiable and appropriate generalist community physician training programme as well as the relative levels of emphasis needed in the different sub-specialty areas. While holders of the current fellowship diploma in public health of the National Postgraduate Medical College of Nigeria are welcome to practice in the field if they are available, many state governments and officials consider the programme ill-suited to the needs of field practice community physicians. Thirteen (68.4% of the) respondents, consider it suitable only for jobs at state employment levels and higher up. Twelve of the 17 physician respondents considered clinical practice essential for all community physicians. Eighteen of the 21 state governments would be ready to sponsor their physician candidates to local training programmes in public health as identified in this study, if different from the current postgraduate fellowship. Maternal and child health was the area of sub-specialty training considered most needed in the states. This was followed by epidemiology, environmental health, health education, health and biostatistics, health management, and occupational health in that order.(ABSTRACT TRUNCATED AT 250 WORDS)

Community Medicine↗

PubMed1998

Measuring the information needs of husbands of women with breast cancer: validity and reliability of the Family Inventory of Needs--husbands.

PURPOSE/OBJECTIVES: A two-phase study was undertaken to test the Family Inventory of Needs--Husbands (FIN-H), a tool designed to measure the information needs of husbands of women with breast cancer and the extent to which these needs are met. DESIGN: Methodologic survey. SAMPLES: Phase I: a panel of 6 husbands; phase II: 84 husbands of women with breast cancer. METHODS: Panel of expert ratings followed by pilot test of the two-part survey. FINDINGS: In phase I, husbands assessed the FIN-H for clarity, internal consistency, and content validity. All preset criteria were met. In phase II, internal consistency, test-retest reliability, and internal validity were assessed. Internal consistency estimates as measured by Cronbach's standardized alpha coefficients were 0.91 and 0.93. Test-retest correlations were 0.82 and 0.76 (p = 0.0001). Exploratory factor analysis suggested that the FIN-H consists of five factors. CONCLUSIONS: Initial results suggest that the FIN-H is reliable and valid. Further testing is needed to confirm these results. IMPLICATIONS FOR NURSING PRACTICE: Before nurses can address the information needs of husbands of women with breast cancer, use of a reliable and valid assessment tool is recommended.

Adult↗

PubMed2000

Inhaled short acting beta2-agonist use in asthma: regular vs as needed treatment.

BACKGROUND: Inhaled beta2-adrenergic agonists delivered by inhalation are very widely used in asthma. There has been much controversy of the use and possible consequences of the use of these agents for regular, as opposed as-needed use in asthma. OBJECTIVES: This review to assessed the clinical trial evidence to test whether using regular use of short-acting beta2-agonists reduced asthma control and pulmonary function; worsened symptoms, airway reactivity and quality of life; and increased the rate of exacerbations. SEARCH STRATEGY: A search was carried out of the Cochrane Airways Group "Asthma and Wheez* RCT" register using the terms: regular AND [beta agonist OR bronchodilator OR salbutamol OR albuterol Or terbutaline OR isoproterenol OR reproterol OR fenoterol]. Bibliographies of existing trials were searched and primary trial authors and pharmaceutical companies were approached for additional trials. SELECTION CRITERIA: Randomised controlled trials in which the short-acting beta2-agonist was given regularly in the experimental group, together with an inhaled bronchodilator for relief of symptoms ('rescue use'). The control group consisted of matching placebo inhaled regularly, with an inhaled bronchodilator for as-needed 'rescue use'. DATA COLLECTION AND ANALYSIS: Data were extracted and quality assessments were made by both reviewers. Parallel group and cross-over trials were analysed separately. Where possible data were pooled using a fixed effects model. MAIN RESULTS: Over 800 abstracts were identified, following a review, 60 papers were requested for full assessment by both reviewers. 34 trials from 30 papers met the entry criteria. Data from 31 outcomes were analyzable. There was little difference between the treatments for nearly all outcomes. In cross-over studies, evening peak flow was better with regular treatment, weighted mean difference (WMD) 13.1 l/min (95% confidence interval 24.3, 1.9). In contrast, the FEV1 was better with as-needed treatment (WMD 157 ml (95% CI: 123, 192). Bronchial hyper reactivity was slightly better in the as-needed group, standardised mean difference 0.23, 95% CI: 0.52, 1.12. REVIEWER'S CONCLUSIONS: These results support current guidelines. There is little advantage in using short-acting beta2-agonists regularly, and potentially some small clinical disadvantage.

Adrenergic beta-Agonists↗

PubMed2003

Evaluation of an instrument to assess the needs of men diagnosed with prostate carcinoma: an assessment of the validity and reliability of a self-administered questionnaire developed to measure the needs experienced by men diagnosed with prostate carcinoma.

BACKGROUND: This study was conducted to evaluate a self-administered questionnaire developed to measure the needs experienced by men diagnosed with prostate carcinoma (the Prostate Cancer Needs Questionnaire [PCNQv1.1]). The PCNQv1.1 was constructed in two parts. Part 1 measures the needs at diagnosis and initial treatment and Part 2 measures current needs. METHODS: A random sample of 650 men diagnosed with prostate carcinoma who were being treated by a urologist of the Hunter Urology Group in Newcastle, New South Wales, Australia, were invited to participate in the study. They were sent by post the self-administered PCNQv1.1. Completed questionnaires were received from 385 men. Information provided on 100 additional men was considered ineligible. RESULTS: The principal components method of factor analysis with varimax orthogonal rotation identified eight factors with eigenvalues greater than 1, which accounted for 61.7% of the variance in Part 1 of the PCNQv1.1. Likewise, six factors were identified in Part 2, which accounted for 63.5% of the variance. Internal reliability coefficients (Cronbach alpha) were adequate for identified factors with values ranging from 0.70 to 0.88 for Part 1 and from 0.71 to 0.87 for Part 2. Test-retest reliability was acceptable with intraclass correlation coefficients ranging from 0.61 to 0.78 for Part 1 and from 0.60 to 0.82 for Part 2. CONCLUSIONS: These results suggest that the PCNQv1.1 is a valid and reliable instrument to assess the needs experienced by men diagnosed with prostate carcinoma.

Adult↗

PubMed1975

TAT need achievement and need affiliation in minimally brain-injured and normal children an their parents.

The families of 16 minimally brain-injured children were compared in need for achievement and need for affiliation with 16 families of normal children. The families were matched on age, sex, and birth order of the children, and on education of the fathers. Needs were measured by means of TAT type cards for both parents and children. The data indicated that the minimally brain-injured children and their mothers were lower in achievement motivation than the normal children and their mothers (rho less than .05). Results on the fathers were in the same direction, but were not significant. In addition, parents of minimally brain-injured children seemed to have a different pattern of influence on their offspring than parents of normal children. The achievement needs of the mothers in the former group were positively related to their children's behavior (rho less than .05), and the achievement needs of the fathers in the latter group were negatively related to their children's behavior (rho less than .05). Finally, there were no differences or relationships found for affiliation motivation.

Achievement↗

PubMed1975

Need associations of male prisoners: a multi-dimensional assessment of Murray needs.

Previous studies have revealed quantitative differences between delinquents and nondelinquents in the strength of Murray needs. To provide clarification and elaboration of such past findings, need associations derived from the Picture identification Test were analyzed by t test and discriminant analysis for a group of 112 male prisoners and 112 male nonincracerated normals matched with the prisoners for age and education. Greater than chance (.05 level) numbers of association score differences were obtained between the two groups. Differences in need association scores were interpreted in light of past findings. Need association differences were revealed for the Achievement, Affiliation, Sex, and Order needs among others.

Journal Article↗

PubMed1991

[The needs of psychiatric patients for contact with social counselors and the needs of relatives for contact with the patient's psychiatrists].

Psychiatric patients admitted for the first time and aged 18-45 years were investigated concerning their need for contact with a social worker and their relatives' need for contact with the psychiatrist concerned. 54% had already had contact with a social worker but 21% had an unfulfilled need for contact with a social worker. Patients from social class V, in particular, required contact with social workers. 62% of the relatives had no contact with the psychiatrist concerned and 61% of these were dissatisfied with this. 43% of the relatives who had contact with the patient's were not satisfied with that contact. It is emphasized that consideration of the patients' needs for contact with a social worker and the needs of there relatives for more frequent and better contact with the psychiatrist concerned are necessary and desirable to a greater extent than is the case at present.

Adolescent↗

PubMed1994

Meeting the needs of special-needs patients.

In today's society, the trend is toward massive de-institutionalization of individuals with special needs. With the growth of community-based facilities and healthcare, dentists need to embrace the challenge of meeting the oral health needs of special-needs patients. To do so, and establish a trust relationship with these patients, they will require training, education and, above all, compassion. Through accessibility, the provision of care and positive attitudes, the dental profession can profoundly assist in improving the quality of life of special-needs patients.

Dental Care for Persons with Disabilities↗

PubMed1994

[Information needs and problems of patients with myocardial infarct and coronary bypass. A study of information needs and problems from the viewpoint of Orem's theory].

Problems and information needs of patients six months after myocardial infarction or after coronary artery bypass surgery were assessed in this study. The theoretical framework was provided by the theory of Orem (1991). Data on problems experienced and need for more or other information were collected by semi-structured interviews. Results show that almost all (81) of the 82 patiënts did experience problems the first six months after discharge. Most (60) of the 82 patients stated they had needed more or other information concerning one or more topics. Most information was needed concerning: knowledge of the disease, convalescence, tiredness, risk factors, medication, emotional reactions en deleterious effects of treatment. The relationship between problems, information needs, health condition and character of the topic (affective or cognitive) was also examined.

Adaptation, Psychological↗

PubMed2005

The Needs Assessment for Advanced Cancer Patients (NA-ACP): a measure of the perceived needs of patients with advanced, incurable cancer. a study of validity, reliability and acceptability.

AIMS: To describe the psychometric evaluation of a measure designed to assess the perceived needs of patients with advanced, incurable cancer. METHOD: A questionnaire known as the Needs Assessment for Advanced Cancer Patients (NA-ACP) was developed based on a review of available literature and professional opinion. A sample of 246 patients (consent rate = 59%) completed the NA-ACP, 28 patients completed the acceptability questions, while 41 completed a retest copy of the NA-ACP. The construct validity of the questionnaire was examined via principal components analysis, while reliability was evaluated in terms of the internal consistency of domains and test-retest scores. RESULTS: The principal components analysis revealed seven domains assessing patients' psychological/emotional, medical information/communication, social, symptom, daily living, spiritual and financial needs. The test-retest reliability estimates were within accepted levels, as were all but one of the internal consistency scores. The NA-ACP was highly acceptable for this patient group. CONCLUSION: The NA-ACP is one of the first multi-dimensional instruments specifically designed to assess the needs of patients with advanced, incurable cancer. The present study provides evidence of the NA-ACP's validity, reliability, and acceptability. The NA-ACP has potential applications both as a research tool and within clinical settings.

Adolescent↗

PubMed1991

Measurement of oral status and treatment need among subjects with dental prostheses: are the measures less reliable than the prostheses? Part II: Treatment need in removable prosthodontics.

Evaluation of treatment need in removable prosthodontics has been an important component of many epidemiologic and clinical oral health surveys. Accurate measurement of need for care enhances health care program planning, quality of care evaluation, and good clinical and health services research. Unfortunately, similar to the measures of oral and prosthesis status discussed in Part I of this review, measures of treatment need in removable prosthodontics have generally been neither reliable nor valid, and have lacked scientific credibility. Part II describes existing measures for treatment need in removable prosthodontics.

Dental Care↗

PubMed1995

The need for nursing and midwifery programmes of education to address the health care needs of minority ethnic groups.

The article reviews some of the more influential literature of the past decade on the health needs of ethnic groups, in an effort to identify what is being done by nursing and midwifery education to address the health care needs of these groups and to prepare practitioners who are able to respond to these needs. The article suggests that despite the relative lack of progress in this field of health care and education, there still exists much confusion, disagreement and lack of clarity around many issues, such as the identification of relevant content, the integration of this content into the curriculum and more importantly the delivery of this content. The literature seems to point to a lack of cultural knowledge, particularly for certain ethnic groups, which needs to be rectified. But even when knowledge is available, the evidence clearly indicates that both educators and practitioners are failing to translate this into effective and culturally sensitive care. The article suggests that nursing and midwifery education could and should play an important role in the development and dissemination of culturally sensitive care.

Curriculum↗