Needs Assessment Research: Unmet Needs

A pilot study of needs assessment in acute psychiatric inpatients.

Stansfeld S, Orrell M, Mason R, Nicholls D, D’Ath P.
Department of Psychiatry and Behavioural Sciences, University College London Medical School, UK. Soc Psychiatry Psychiatr Epidemiol 1998 Mar;33(3):136-9

The needs of acute psychiatric patients have been less studied than those of long-term patients. A pilot study of needs assessment using the MRC Needs for Care Assessment Schedule is reported in 35 consecutive acute inpatients who had been in hospital for 1 month or more. Unmet clinical needs included treatment of drug side effects and dangerous and socially embarrassing behaviour. Unmet social needs were widespread and included household shopping, cooking meals, occupation and money management. Although the MRC Needs for Care Assessment was found unsuitable for assessing needs in very acutely ill patients whose mental status was rapidly changing, we did find it a useful instrument in more stable acute patients, both on an individual basis and for identifying service underprovision.

A questionnaire assessment of unmet needs for rehabilitation services and resources for people with multiple sclerosis: results of a pilot survey in five European countries. Needs Task group of MARCH (Multiple Sclerosis and Rehabilitation, Care and Health Services Research in Europe).

Kersten P, McLellan DL, Gross-Paju K, Grigoriadis N, Bencivenga R, Beneton C, Charlier M, Ketelaer P, Thompson AJ.
Health Research Unit, School of Health Professions and Rehabilitation Sciences, University of Southampton, UK. Clin Rehabil 2000 Feb;14(1):42-9

Objective: To develop an international services and needs assessment instrument (SUN) for people with multiple sclerosis and their carers and to pilot this in different countries of the European Community.

Design: Interview study of people with multiple sclerosis, their carers and nominated key professionals examining the unmet needs of patients and carers.

Setting: Belgium, Estonia, Greece, Italy and the United Kingdom.

Main Outcome Measures: Needs assessment questionnaire.

Results: The study comprised 137 people with multiple sclerosis, 125 carers and 111 professionals. Patients reported on average 2.9 unmet needs for themselves; their carers and professionals reported on average 2.4. Needs were categorized into seven broad categories. Due to difficulties experienced by the local researchers in distinguishing between needs and objectives a large proportion of needs had to be assigned to the ‘other’ category.

Conclusions: The SUN is a valuable and practicable tool for the identification of unmet needs for people with multiple sclerosis and their carers. Formal validation and reliability testing of the different language versions is recommended.

Improving primary health care for people with learning disabilities.

Bollard M.
Learning Disability Service, Coventry Healthcare NHS Trust. Br J Nurs 1999 Oct 14-27;8(18):1216-21

‘Signposts for Success’ (Department of Health (DoH), 1998a) states that specialist learning disability services (SpLDS) must promote liaisons with, and offer specialist advice to, primary healthcare teams (PHCTs). With the advent primary care groups (DoH, 1998b), genuine collaboration and partnership-forging is necessary and timely to prevent people with learning disabilities being excluded from healthcare services. The project described in the article had three broad aims: first, to establish a practice register of people with learning disabilities in all practices involved in the project; second, to enable practice nurses (PNs), with support, to carry out a systematic health check within the practice of people with learning disabilities; and third, to enable the project nurse to act as a crucial link between SpLDS and the PHCT. The health checks highlighted unmet health and social needs, which were then met through appropriate referral and intervention, mainly to specialist services. Follow ups were conducted to measure any health gain as a result of the applied Interventions. Evidence of health gain was revealed, pointing to the clinical effectiveness of performing such checks within the PHCTs.

Lifetime care needs of individuals with multiple sclerosis.

Stolp-Smith KA.
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA. J Spinal Cord Med 1998 Apr;21(2):121-3

Reliability and validity of the CANDID–a needs assessment instrument for adults with learning disabilities and mental health problems.

Xenitidis K, Thornicroft G, Leese M, Slade M, Fotiadou M, Philp H, Sayer J, Harris E, McGee D, Murphy DG.
Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London. Br J Psychiatry 2000 May;176:473-8

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.

Methods: 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.
p. 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.
p. Conclusion: The CANDID is a brief, valid and reliable needs assessment instrument for adults with learning disabilities and mental health problems.