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Learning needs assessment is a major concern of nursing staff development educators. This contact hour feature provides nursing staff development educators with information necessary to understand the needs assessment process.
The aim of the present study was to describe the realisation of the new-style needs assessment in the Netherlands and how it is evaluated. Furthermore, judgements about the new way of assessing (chronic) patients' needs with respect to home care are presented. Data were gathered by means of a postal survey of all assessment agencies, home-care organisations and health insurers. The new-style assessment, as regulated by the Needs Assessment Decree, implies that home-care needs should be objectively assessed independently of the availability of care supply and integrally with other types of (long-term) care. This study shows that all the organisational structures required to realise these goals are present. However, according to factual and evaluative data, many practical aspects of these structures appear to be deficient. The national assessment forms, an instrument for gaining objectivity, are judged impracticable by half of the assessment agencies. Mandating arrangements threaten independent as well as integral needs assessment. Whether the new-style assessment is evaluated positively or negatively depends upon the type of organisation under study. On the one hand, assessment agencies are positive about their achievements. On the other, home-care organisations are generally negative about the functioning and advantages of the new style of needs assessment. Health insurers' opinions are in between those of assessment agencies and home-care organisations.
This paper outlines the detail of the case study method used in a project commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the changing educational needs of community nurses with regard to needs assessment and quality of care in the context of the NHS and Community Care Act, 1990. It explains the methodological procedures and analytic processes which led to integration of data across the whole study, focusing on the role of a prior theoretical framework in case study design. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (N=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors. They were interviewed after the observation period (N=33 practitioners), to determine the extent of formality they attached to each assessment, and elicit information about aspects which may be embedded in everyday practice as well as those recorded for explicit requirements.The preliminary analysis resulted in the modification of a model for assessing service quality, and identified various points where a 'policy-practice gap' might arise between policies and practice in both the health service and education. The practicalities of operationalising a multiple case study design into research are highlighted, and the mechanism for 'generalising to theory' illustrated.
A review of the basic concepts in needs assessment and of the various ways in which needs assessment is performed with applications to clinical and health care programs is discussed in this article.
Continuing medical education (CME) program development and needs assessment have historically been practiced within the tradition of Ralph Tyler's education model. In light of transformational social, political, economic, and technical forces that demand greater account-ability and responsiveness from physicians, CME units are challenged to transform their cultures and structures from models that deliver education to models that support the facilitation of learning for enhanced competence and performance. This article describes key change forces for physicians and brings program development and needs assessment into focus for the discussion. The impact of change forces on program development and needs assessment are examined, and some techniques to move beyond the traditional approach of felt needs are presented as a way of enabling strategic administrative planning and change management.
OBJECTIVE: To determine the needs of surgical residents as teachers of clinical clerks. DESIGN: A needs assessment survey. SETTING: Department of Surgery, University of Toronto. PARTICIPANTS: Clinical clerks and surgical residents and staff surgeons. METHODS: Three stakeholder groups were defined: staff surgeons, surgical residents and clinical clerks. Focus-group sessions using the nominal group technique identified key issues from the perspectives of clerks and residents. Resulting information was used to develop needs assessment surveys, which were administered to 170 clinical clerks and 190 surgical residents. Faculty viewpoints were assessed with semi-structured interviews. Triangulation of these 3 data sources provided a balanced approach to identifying the needs of surgical residents as teachers. RESULTS: Response rates were 64% for clinical clerks and 66% for surgical residents. Five staff surgeons were interviewed. Consensus was noted among the stakeholder groups regarding the importance of staff surgeon role modelling and feedback, resident attitude, time management, knowledge of clerks' formal learning objectives, and appropriate times and locations for teaching. Discrepancies included a significant difference in opinion regarding the residents' capacity to address clerks' individual learning needs and to foster good team relationships. Residents indicated that they did not receive regular feedback regarding their teaching and that staff did not place an emphasis on their teaching role. CONCLUSIONS: This study has, from a multi-source perspective, assessed the needs of surgical residents as teachers. These needs include enhancing residents' education regarding how and what to teach medical students on a surgical rotation, and a need for staff surgeons to increase feedback to residents regarding their teaching.
The assessment of nursing home needs is becoming an important research endeavor because of the rapid social changes in the past 20 to 30 years in Taiwan. The purpose of this article is to present the methodology, as well as the results of a nursing home community needs assessment. A cross-sectional descriptive study using a mailed questionnaire was conducted. The results indicated low awareness level, low personal experience, high service needs, and high potential for use of nursing home services among the individuals living in 10 surveyed towns (N = 319).
BACKGROUND: People with learning disabilities and mental health problems have complex needs. Care should be provided according to need. AIM: To develop a standardised needs-assessment instrument for adults with learning disabilities and mental health problems. METHOD: The Camberwell Assessment of Need for Adults with Developmental and Intellectual Disabilities (CANDID) was developed by modifying the Camberwell Assessment of Need (CAN). Concurrent validity was tested using the Global Assessment of Functioning (GAF) and the Disability Assessment Schedule (DAS). Test-retest and interrater reliability were investigated using 40 adults with learning disabilities and mental health problems. RESULTS: CANDID scores were significantly correlated with both DAS (P < 0.05) and GAF scores (P < 0.01). Correlation coefficients for interrater reliability were 0.93 (user), 0.90 (career), and 0.97 (staff ratings); for test-retest reliability they were 0.71, 0.69 and 0.86 respectively. Mean interview duration was less than 30 minutes. CONCLUSIONS: The CANDID is a brief, valid and reliable needs assessment instrument for adults with learning disabilities and mental health problems.
In the light of the growing awareness of professionals in the community of the need to undertake health needs assessments of the population, this literature review sets out to explore, delineate and critically analyse the various approaches to community needs assessment, to facilitate a greater understanding of their strengths and weaknesses. The review commences by highlighting its complex nature, and attempting to define what is meant by 'needs assessment' from the differing perspectives of three dominant approaches, namely sociology, epidemiology and health economics. It continues by putting forward an argument for the use of the community health profile, being a multi-focal approach to needs assessment, combining quantitative with qualitative data, and proceeds with a discussion of strengths and weaknesses related to its compilation, in particular factors relating to reliability and validity of data sources. The consumer perspective is also reviewed, as are issues surrounding the ethics of data collection and problems concerning aggregation of the numerous data sources into meaningful policy. Throughout the review, issues are discussed with reference to the current political context in the United Kingdom. Equally important is the community nurse perspective, which is integrated into the arguments where appropriate.
INTRODUCTION: Local health departments are among the first agencies to respond to disasters or other mass emergencies. However, they often lack the ability to handle large-scale events. Plans including locally developed and deployed tools may enhance local response. Simplified cluster sampling methods can be useful in assessing community needs after a sudden-onset, short duration event. METHODS: Using an adaptation of the methodology used by the World Health Organization Expanded Programme on Immunization (EPI), a Microsoft Access-based application for two-stage cluster sampling of residential addresses in Louisville/Jefferson County Metro, Kentucky was developed. The sampling frame was derived from geographically referenced data on residential addresses and political districts available through the Louisville/Jefferson County Information Consortium (LOJIC). The program randomly selected 30 clusters, defined as election precincts, from within the area of interest, and then, randomly selected 10 residential addresses from each cluster. The program, called the Rapid Assessment Tools Package (RATP), was tested in terms of accuracy and precision using data on a dichotomous characteristic of residential addresses available from the local tax assessor database. A series of 30 samples were produced and analyzed with respect to their precision and accuracy in estimating the prevalence of the study attribute. Point estimates with 95% confidence intervals were calculated by determining the proportion of the study attribute values in each of the samples and compared with the population proportion. To estimate the design effect, corresponding simple random samples of 300 addresses were taken after each of the 30 cluster samples. RESULTS: The sample proportion fell within +/-10 absolute percentage points of the true proportion in 80% of the samples. In 93.3% of the samples, the point estimate fell within +/-12.5%, and 96.7% fell within +/-15%. All of the point estimates fell within +/-20% of the true proportion. Estimates of the design effect ranged from 0.926 to 1.436 (mean = 1.157, median = 1.170) for the 30 samples. CONCLUSIONS: Although prospective evaluation of its performance in field trials or a real emergency is required to confirm its utility, this study suggests that the RATP, a locally designed and deployed tool, may provide population-based estimates of community needs or the extent of event-related consequences that are precise enough to serve as the basis for the initial post-event decisions regarding relief efforts.
This article describes the process of developing a learning needs assessment. The process includes developing a tool, collecting data, and analyzing results. Understanding the needs assessment process and the pitfalls to avoid may assist educators in implementing their own learning needs assessments.
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.
Preparatory to establishing a computer services program for residents, Presbyterian Homes, a multi-campus continuing care retirement community, conducted an assessment of residents' computer needs, ownership, and usage. Based on the results of the needs assessment, computer resource rooms were established at each facility, with computer hardware and software adapted for the use of seniors. We also deliver adapted computer education for residents, including small-group training in basic software skills; classes on software for computer accessibility; and workshops on themes motivating computer use. Ongoing evaluation shows that half of residents make use of computer resources, and that their computer skills have opened the door to other educational opportunities.
A marketing needs assessment was undertaken as a community health project for baccalaureate nursing students. The objective of the project were: (1) to conduct a needs assessment utilizing the concepts of marketing in health planning, and (2) to identify health needs of a community based on active participation by members of the community. Through a collaborative effort with a community health agency, students were able to integrate the principles of marketing and participative decision-making into a learning experience. The results of the needs assessment provided the agency with valuable information for strategic planning.
Public policy practitioners are often confronted with the problem of "needs assessment." But needs can be defined and measured in many ways, and often in pursuit of fundamentally different ends. This paper provides a brief paradigmatic comparison of two alternative approaches to the problem of needs assessment in the area of substance misuse, and it concludes with a case study describing the implementation of a model developed by the New York State Division of Substance Abuse Services.
The National Service Framework for older people (Department of Health (DOH), 2001a) identifies health promotion as one of the eight standards for improving the health and well-being of older people. Population health needs assessment is the first stage in any public health promotion cycle. This article critiques health needs assessment methodology, investigates the origins of health needs assessment and discusses the application of health needs assessment theory in a community hospital setting.
This paper describes the needs assessment phase of a mental health promotion programme for rural communities in Ireland. As part of a larger study encompassing four rural communities, a cross-sectional study of the mental health beliefs and perceptions of 1014 people was carried out. Employing a combination of interviewer-administered questionnaire and the vignette method, the needs assessment explores the levels of awareness, current practices, attitudes and stigma concerning depression and suicide among a randomly selected quota sample of community members. Lower levels of awareness, less confidence in dealing with mental health issues, negative attitudes to help-seeking and social stigma emerge as particular issues for men and the under 40 age group. Women were found to have more positive attitudes generally, were more likely to use informal social support networks and were more open about discussing mental health matters. The predominant interpretation of the depression vignette was to view it as a mental health problem with good prospects for recovery given appropriate help. Social relationships, negative thinking patterns and social stresses were perceived as being particularly important in explaining the origins of depression. The implications of the findings for planning the intervention phase of the project are considered.
BACKGROUND: The Service Need Assessment Profile (SNAP) measures individual functional needs in areas of daily living. It produces a support profile, detailing the time allocations for staff support to assist in each area of need. The Supports Intensity Scale (SIS) is a support needs assessment scale designed to provide an objective measure of a person's need for support in medical, behavioural, and life activities. SIS can be used for individualised support planning, clinical judgements regarding support needs, resource allocation and financial planning. The Inventory for Client and Agency Planning (ICAP) assesses adaptive and maladaptive behaviours and gathers additional information to determine type and amount of special assistance that people with disabilities need. METHOD: This study evaluated the construct and criterion validities of SNAP in relation to the SIS and ICAP, using assessment data from 114 individuals with a range of disabilities and levels of severity. RESULTS: Construct and criterion validities were supported for the SNAP by high correlations with SIS, ICAP, and staff estimates of support needs and by its capacity to discriminate between sub-groups in expected ways. CONCLUSIONS: The results provide support for the use of SNAP as a support needs instrument.