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PubMed1996

Measuring the need for psychiatric treatment in the general population: the community version of the MRC Needs for Care Assessment.

The community version of the MRC Needs for Care Assessment Schedule (NFCAS-C) is a new instrument designed for the psychiatric conditions seen in general populations. Its principles are based on the original Needs for Care Assessment, although that was developed for the very different population of those with long-standing mental illness (Brewin et al. 1987). The NFCAS-C is designed to reproduce, in an itemized and systematic manner, the functioning of well-organized primary care and psychiatric services. It is primarily intended for research purposes, in particular, the comparison of treatment needs and services in different populations. In this paper we describe the problems of assessing the need for psychiatric care in general populations and the rationale and development of the instrument, while in its companion we present the results of a reliability study (Lesage et al. 1995).

Adult↗

PubMed1996

An exploration of parental perception of the nature and level of support needed to care for their child with special needs.

This paper is part of a study attempting to identify parental perception of support necessary to care for their child with special needs. The existing literature has been analysed, revealing a paucity of studies relating to the parents' perception. The study gathered data from questionnaires administered to 25 randomly selected parents who have children with special needs, exploring multi-disciplinary support. The other method used was conducting three semi structured interviews, with parents known to the paediatric team in the locality being studied. The health professionals input, respite care and overall level of support have been studied from the questionnaires. The interviews highlighted many areas where the paediatric community nurse could fulfil some of the parents' support needs. The response rate was 19 questionnaires returned, covering 21 children, as two families had two children with special needs. The results indicate that half the parents were satisfied with the support they received, with the main groups giving support being education and relatives, followed by health and social services.

Adolescent↗

PubMed2001

[The standardized assessment of the need for treatment and support in severe mental illness: the development and testing of the German version of the Camberwell assessment of Need-EU].

OBJECTIVE: The development and the psychometric testing of the German version of the Camberwell Assessment of Need-EU will be presented. METHOD: The internal consistency of the subscales total needs, met needs and unmet needs was tested by the application of the CAN-EU on a representative sample of 307 patients with schizophrenia according to ICD-10 F20.0. Test-retest-reliability and inter-rater-reliability was tested with a sub-sample of 41 patients. RESULTS: The internal consistency and the test-retest-reliability of the German version of the CAN-EU is satisfying and slightly higher in comparison with the other European versions. The inter-rater-reliability is also satisfying but smaller in comparison with the other European versions. CONCLUSIONS: In general, the psychometric properties of the German version of the CAN-EU are satisfying but the lower inter-rater-reliability in comparison with the other European versions suggests that more precise coding rules for the German version of the CAN-EU must be formulated to improve the inter-rater agreement of the instrument.

Adult↗

PubMed2003

Infection control practitioners' perceptions and educational needs regarding bioterrorism: results from a national needs assessment survey.

BACKGROUND: The perceived threat that biological weapons will be used in an act of terror against the United States has escalated sharply since the discovery of anthrax-tainted letters after the terrorist attacks of September 11, 2001. These events underscore the critical nature of health care and public health preparedness and the need to augment infection control practitioner education and training. METHODS: Between October 2000 and August 2001 a national needs assessment was conducted by use of a 35-question survey. The survey measured infection control practitioners' (ICPs') perception of the risk for bioterrorism in the United States and in their community, the proportion of ICPs with prior training in bioterrorism preparedness, and preferences for delivery media of future bioterrorism education. RESULTS: The assessment of the perceived threat of bioterrorism in the United States during the next 5 years (P =.022) and in the ICPs' work community (P <.001) revealed significant regional differences. Only half (56%) of the respondents reported prior training in bioterrorism preparedness. Respondents reported that the 2 most common barriers to receiving training were lack of training opportunities (70.2%) or no dedicated work time for training (19.4%). CONCLUSIONS: The results of this study indicate an urgent need for more resources and opportunities for clinical education in bioterrorism preparedness that will provide continuing education credit. Successful bioterrorism education will require a variety of instructional designs and media delivery methods to address ICPs' preferences and needs.

Bioterrorism↗

PubMed2005

The information needs and behaviour of clinical researchers: a user-needs analysis.

AIMS: As part of the strategy to set up a new information service, including a physical Resource Centre, the analysis of information needs of clinical research professionals involved with clinical research and development in the UK and Europe was required. It also aimed to identify differences in requirements between the various roles of professionals and establish what information resources are currently used. METHODS: A user-needs survey online of the members of The Institute. Group discussions with specialist subcommittees of members. RESULTS: Two hundred and ninety members responded to the online survey of 20 questions. This makes it a response rate of 7.9%. Members expressed a lack of information in their particular professional area, and lack the skills to retrieve and appraise information. DISCUSSION: The results of the survey are discussed in more detail, giving indications of what the information service should collect, what types of materials should be provided to members and what services should be on offer. RECOMMENDATION: These were developed from the results of the needs analysis and submitted to management for approval. Issues of concern, such as financial constraint and staff constraints are also discussed. CONCLUSIONS: There is an opportunity to build a unique collection of clinical research material, which will promote The Institute not only to members, but also to the wider health sector. Members stated that the most physical medical libraries don't provide what they need, but the main finding through the survey and discussions is that it's pointless to set up 'yet another medical library'.

Academies and Institutes↗

PubMed2000

The Southampton Needs Assessment Questionnaire (SNAQ): a valid tool for assessing the rehabilitation needs of disabled people.

OBJECTIVE: To validate the Southampton Needs Assessment Questionnaire (SNAQ) for use with disabled people during face-to-face interviews. DESIGN: The SNAQ was designed to be used in a cross-sectional survey of disabled people with a physical disability with a follow-up study one year later. Content and criterion validity was examined using 32 disabled people who took part in the pilot study. Construct validity and internal reliability was examined using data from 93 disabled people who took part in the main survey. Responsiveness of the questionnaire was evaluated using the data gathered during a follow-up study of 77 people had taken part in the original study. OUTCOME MEASURES: The OPCS Disability Severity Scales (OPCS) and the Functional Independence Measure (FIM) were used to measure level of disability of participants, the Nottingham Health Profile (NHP) and the UK version of the SF-36 to examine perceived health status. PARTICIPANTS: People with a primary physical disability, aged 16-65, randomly selected from two disability registers in southern England. MAIN RESULTS: Content and criterion validity were established. Construct validity and internal reliability of the SNAQ was good. Inter-rater reliability was not tested since only one researcher conducted the interviews. Test-retest reliability was not formally tested because of the probability that participants would learn from the first needs assessment questionnaire and that different results on a retest occasion could arise from this. The SNAQ was sensitive in picking up changes over time. CONCLUSION: The SNAQ has shown good validity (content, coverage and construct), internal reliability, sensitivity and responsiveness. Further studies are needed to define the consequences of meeting or not meeting the rehabilitation needs of disabled people. Inter-rater reliability remains to be established.

Adolescent↗

PubMed1980

Public Health Service--health systems agencies and state health planning and development agencies; certificate of need reviews. Notice regarding certificate of need programs.

This Notice sets forth advance information regarding amendments to the regulations governing certificate of need reviews by health systems agencies and State health planning and development agencies. This Notice is intended to provide early guidance to States prior to publication of interim final regulations implementing the amendments to certificate of need provisions of the Public Health Service Act made by the Health Planning and Resources Development Amendments of 1979 (Pub. L 96-79). This early guidance will assist the States in beginning to revise their certificate of need laws. Under the amended provisions of the Public Health Service Act, the planning agencies are required to review and determine the need for proposed capital expenditures, institutional health services and major medical equipment. The Secretary intends to publish these interim final regulations within a few weeks. Following consideration of comments which will be solicited with regard to the interim regulations, the Secretary will publish an analysis of the comments and will revise those regulations as appropriate.

Certificate of Need↗

PubMed1980

Adequate function of the cell: interactions between the needs of the cell and the needs of the organism.

The continuous maintenance of cell adequate function (cellular stress) is considered to be the main feature which characterizes the activity of a live cell. In accordance with the concept of cellular stress, the transition of the cell to the state of adequate functioning represents a dual commitment. The cell must function adequately to respond to the demands of the organism and to provide for its own needs. Thus, it is proposed that two systems exist for the regulation of the adequate function of the cell: one enabling the cell to respond to the demands of the organism, and the other providing for the needs of the cell itself. The hormonal system of the organism represents the first of these mechanisms, and I believe that another system exists for regulation of intracellular needs. Adequate function of the cell is determined by the regulative, controlling and defense mechanisms. The balance between the needs of the cell and of the organism should be a concern of physician, since it provides for the optimal function and health of the organism as a whole.

Adaptation, Physiological↗

PubMed1997

EMS for children: recommendations for coordinating care for children with special health care needs. Emergency Medical Services for Children, National Task Force on Children With Special Health Care Needs.

STUDY OBJECTIVE: To address the need for coordinated care for children and their families during the acute care phase of their hospitalization. METHODS: A multidiscipline task force developed this concept paper through a consensus process. The process was coordinated by the Emergency Medical Services for Children Program (a program of the Health Resources and Services Administration and the National Highway Traffic Safety Administration). The task force included representatives from prehospital care, acute care, rehabilitation, primary care, and education, as well as consumers. This representation provided a broad perspective on the needs of children and their families in the transition from hospital care to home. CONCLUSION: One designated individual is essential during the acute care phase who can assist the family with gaining information and resources to ensure a successful transition to community services and resources. This article provides a framework for acute care facilities and providers to use in planning services and working with acutely ill and injured children. Several recommendations highlight the need for care coordination to be initiated early in the child's hospitalization. An overview of services and resources (both health and educational) that a child and family may need is also provided. Such services and resources include identifying a care coordinator, working with the family to identify a primary care provider before hospital discharge, and building bridges with community-based health and education services.

Child↗

PubMed1999

Family support, financial needs, and health care needs of rural elderly in China: a field study.

This study examined family support, financial needs, and health care needs of 100 elderly persons in a rural county in China. Data revealed that immediate family members helped elderly persons with activities of daily living and instrumental activities of daily living, and that adult children also provided financial assistance to most of the elderly. However, only eight percent of the elderly persons reported that they had adequate financial resources. In the four villages surveyed, collective health care systems had collapsed in the early 1980's. Due to high costs of health care and the absence of government support, almost two thirds of the elderly persons had unmet needs for health care. In addition, elderly persons who reported poor health were more likely to have unmet financial and health care needs.

Journal Article↗

PubMed2005

Triptans for migraine therapy: a comparison based on number needed to treat and doses needed to treat.

OBJECTIVE: Managed care and other decision makers need sound comparative information to support the formulary selection process and reimbursement decisions for the treatment of migraine. The objective of this study was to compare currently marketed triptan therapies using number-needed-to-treat (NNT) and doses-needed-to-treat (DNT) measures. DNT was further used to derive triptan treatment cost to achieve 100 successfully treated patients such that the cost-effectiveness of each treatment regime could be compared from the payer perspective. METHODS: Using published meta-analysis data to categorize patients as treatment success or failure, an NNT and a DNT were derived for each triptan. Treatment success was defined as achieving a 2-hour pain response, sustained through 24 hours postdose. Costs were derived by multiplying DNT by the average wholesale price (AWP) minus 15% for each triptan. RESULTS: Eletriptan 40 mg had the lowest NNT, with 361 patients needing to be treated in order to have 100 patients achieve clinical benefit; rizatriptan 5 mg had the highest NNT (597 patients). Eletriptan 40 mg required 388 doses to successfully treat 100 patients.the lowest number of doses of the triptans considered; rizatriptan 5 mg required the highest number (662 doses). Eletriptan 40 mg had the lowest total triptan cost of USD 5,630 to successfully treat 100 patients. The highest total triptan cost of treatment was USD 11,136 for naratriptan 2.5 mg. CONCLUSIONS: Eletriptan 40 mg provides the best value in terms of the lowest DNT, assuming an approximately equal AWP discount for each triptan. Eletriptan 40 mg also was found to have the lowest total triptan cost to successfully treat 100 patients. Future research should further explore the utility of DNT in managed care decision making.

Algorithms↗

PubMed2002

Geographies of need and the new NHS: methodological issues in the definition and measurement of the health needs of local populations.

For a variety of purposes it is increasingly necessary to establish the health needs of local populations. Following a critique of existing proxies of need, this paper presents and evaluates an alternative which draws upon epidemiological evidence concerning the age, sex and social class distribution of morbidity in order to estimate the prevalence of specific conditions in designated populations. By way of demonstrating the insights to be gained through the use of these indicative prevalence rates, the paper considers the treatment of ischaemic heart disease in a sample of 539 practices and presents evidence regarding the significance of deprivation and rurality in determining health service use relative to needs.

Epidemiologic Methods↗

PubMed1999

[Health care needs and their assessment. Part 2. The need for health and health care].

Health needs assessment is primarily concerned with the benefits that can be expected from the provision of different kinds of health services. These are closely related to the levels of health risks and illness in the population and the expected effectiveness of the service in reducing health risks and the consequences of illness as indicated by results of evaluative research or by clinical consensus. Levels of disease and health risks in a population are commonly referred to as needs for health, and the levels of expected benefit are referred to as the needs for services or care.

Czech Republic↗

PubMedDate not supplied

Understanding communities today: using matching needs and services to assess community needs and design community-based services.

Matching Needs and Services (MNS) is a practice tool intended to help people who work with vulnerable children use rigorously assembled information on needs as a guide to design, implement, and evaluate more-effective services. To do this, MNS focuses on needs but links them to outcomes and thresholds before dealing with the services to achieve those outcomes.

Child↗

PubMed1998

A community needs assessment: the care needs assessment pack for dementia (CarenapD)--its development, reliability and validity.

OBJECTIVE: To develop and evaluate a multidisciplinary needs assessment tool for people with dementia living in the community and their carers. DESIGN: The measure was developed through applying a theory of need, generating content, consultation with potential users and refinement and evaluation. Validity was established incrementally through the development process. SETTING: The development and evaluation was conducted in a variety of settings, including multidisciplinary dementia community care teams, social work departments, day hospitals, and inpatient and residential care. PATIENTS: The evaluation included community patients with a formal diagnosis of dementia (N = 34) and consultation with a multidisciplinary group of potential users (N = 23). The development process included inpatients with a formal diagnosis of dementia (N = 157) and consultation with potential users (N = 170) from a range of professions including both health and social care. MEASURES: Interrater reliability was assessed using the kappa statistic. Social validity was estimated using a measure developed for this purpose as part of the development process. RESULTS: The evaluation of interrater reliability demonstrated that three-quarters of assessors agreed on at least 85% of items in the CarenapD. The kappa statistic demonstrated that agreement for 76.2% of items in the CarenapD was 'good' or better (ie kappa >0.75), for 12.4% of items it was 'fair' or 'moderate' (ie kappa 0.35-0.60) and for the remaining 12 (11.4%) items for which kappa could not be calculated there was low intra-item variance and high agreement (>90%). There was good evidence for social validity. CONCLUSIONS: The CarenapD is a reliable and valid multidisciplinary assessment of need for people with dementia living in the community and their carers.

Aged↗

PubMed1989

The health needs of the majority versus the health needs of the individual: the reorganization of medical education in Colombia.

The challenge of excellence in community health services has been taken up by medical educators in Colombia. Confronted with a nation where the primary indicators of disease mortality and morbidity (cardiovascular disease and infant mortality) were characteristic of First and Third World patterns, respectively, the Ministry of Health and La Asociacion Colombiana de Facultades de Medicina (ASCOFAME), representatives of institutions of medical education, have collaborated to conduct a needs assessment of the country's health needs and devised an implementation plan designed to better address the needs of the majority of that nation's people. As a model, the Colombian reorganization of medical education is an example which could be emulated by the U.S. where policy makers are struggling with troublesome questions of cost, equity and quality.

Colombia↗

PubMed1992

Needs assessment for persons with severe mental illness: what services are needed for successful community living?

The development and implementation of effective community support systems are goals of many public mental health authorities who are attempting to shift the focus and dollars for mental health services from inpatient to community care. This article presents the results of a survey which asked 90 community mental health agency case managers to assess the community support and residential needs of over 1400 of their clients. Medication monitoring and therapy were rated high priority needs. Psychosocial treatment, day and vocational activities also ranked high. Survey responses regarding residential services indicated a need for more supported and supervised options.

Adolescent↗

PubMed2005

What fathers need: a countywide assessment of the needs of fathers of young children.

OBJECTIVE: Realizing the paucity of data available concerning fatherhood, the Fatherhood Collaborative of San Mateo County, a public-private community partnership with leadership from the local Maternal, Child and Adolescent Health (MCAH) program, conducted a countywide needs assessment to ask fathers of young children about their personal and service-related needs in order to assist local stakeholders in expanding and improving services for families. METHODS: Both quantitative and qualitative data were collected. A total of 204 fathers of children aged 0 to 5 years completed a 35-question survey. In addition, 80 fathers and community representatives participated in nine focus groups. RESULTS: A complex set of needed services for fathers in the county emerged from the assessment, including: father-child activities; parks and recreational activities; better schools; parenting classes; support groups; high quality, affordable childcare; and general legal assistance. Only one-half felt the county was doing a good or excellent job in supporting fathers. CONCLUSIONS: This assessment is one county's effort to collect data about fathers, from fathers, in order to shape MCAH programming to better serve families. This assessment may serve as a model for other MCAH programs interested in improving services for fathers and families.

Adult↗