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PubMed2001

A comparison of needs of patients with schizophrenia in five European countries: the EPSILON Study.

OBJECTIVE: To compare the occurrence of needs of patients with schizophrenia in Amsterdam, Copenhagen, London, Santander and Verona. METHOD: Patients with schizophrenia were interviewed with the Camberwell Assessment of Need. The mean numbers of total, met and unmet needs were compared across the sites. Ratings for individual domains were also examined. Means were adjusted, using multiple regression analysis, to control for patient differences between sites. RESULTS: The highest levels of unmet need were in Amsterdam and London. The number of met needs were similar. Adjusting for patient differences reduced the estimated number of unmet needs and total needs in Copenhagen, but made little difference elsewhere. There were many site differences for individual domains. CONCLUSION: Needs vary between different countries. Unmet needs are greater in large urban areas like London and Amsterdam. Differences in the pattern of individual needs may be partly explained in terms of service provision.

Adolescent↗
PubMed2002

Appropriateness of orthodontic referrals: self-perceived and normative treatment needs of patients referred for orthodontic consultation.

OBJECTIVES: The aims of this prospective study were to evaluate the self-perceived and normative orthodontic treatment needs of children referred for orthodontic consultation and to determine the proportion of children who were inappropriately referred. METHODS: The sample consisted of 257 children with a mean age of 12.0 years (SD = 2.4). An orthodontist assessed the children's normative treatment need using the dental health component (DHC) of the index of orthodontic treatment need (IOTN), and for patients in the mixed dentition the need for interceptive treatment was assessed. Questionnaires were answered by both the child and the parent to assess satisfaction with dental appearance and desire for treatment. RESULTS: The distribution of the IOTN grades showed that 73% of the children had definite need while 27% had borderline/no need for orthodontic treatment. Twenty-six per cent of children and 17% of parents did not express orthodontic concern, even though more than half of these children were in definite need of treatment as assessed by IOTN. The children's orthodontic concern was significantly related to the DHC scores. Out of the 103 children who were in the mixed dentition, only about 16% required interceptive treatment. CONCLUSIONS: The results indicated that a significant number of children were inappropriately referred for orthodontic treatment. Referring dentists need to assess the normative treatment needs of the children as well as the children's and parents' commitment and desire for orthodontic treatment before deciding on the need for referral.

Child↗
PubMed2003

Relationship of dental status, sociodemographic status, and oral symptoms to perceived need for dental care.

OBJECTIVE: Previous studies have noted a discrepancy between clinically determined oral health status (normative need), patients' perceptions, and perceived significance of dental signs and symptoms. Our objective was to quantify the relationships between normative need and self-reports to improve our understanding of the factors that contribute to perceived need for care. METHODS: Clinical examination and questionnaire data were derived from the Florida Dental Care Study, a study of oral health and dental care, in a representative sample of community-dwelling adults aged > or = 45 years. The questionnaire provided information about presence of signs and symptoms, self-ratings of oral health, perceived need for dental care, and sociodemographic status (SDS). Perceived need was measured on a 4-point nominal scale. RESULTS: Self-reported broken filling, broken denture, cavities, loose tooth, teeth that look bad, and toothache were strongly associated with self-reported perceived need for dental care. Satisfaction with dental health was also associated with perceived need, but self-rated oral health was not. Most measures of SDS were associated with perceived need. However, in a single multiple regression, with self-reported signs and symptoms accounted for, race, age group, sex, and educational attainment were not significantly associated with a currently perceived dental problem. CONCLUSIONS: Certain dental signs and symptoms were significantly associated with perceived need for dental care, as were certain aspects of SDS; even once differences in dental signs and symptoms had been taken into account. Disaggregating measurement of perceived need from a single dichotomous ('yes/no') scale to a 4-point nominal scale was elucidative.

Aged↗
PubMed1999

The needs assessment checklist: a clinical approach to measuring outcome.

OBJECTIVE: To evaluate the outcome of the Needs Assessment and Goal Planning Programme used in the rehabilitation of people with spinal cord injuries. The Needs Assessment Programme incorporates a behavioural indicator rating scale to detail the individual's progress and rehabilitation needs. This can also be used to evaluate the outcome of the rehabilitation programme in general. The Needs Assessment Checklist (NAC) forms part of the programme and is a tool which is used to evaluate rehabilitation outcome. SETTING: A purpose built, national spinal injuries centre in the United Kingdom. SUBJECTS: 82 patients who had completed the Needs Assessment Checklist, both at the beginning and towards the end of the rehabilitative process. RESULTS: Independence, as measured by the Checklist, was significantly greater in all domains at the time of the second Needs Assessment. CONCLUSIONS: The Needs Assessment and Goal Planning Programme is successful in establishing greater client independence, whether assessed at a verbal or physical level. Team members have used the Needs Assessment Checklist as a behavioural indicator of rehabilitation outcome based on available standards of rehabilitative care. Further development of the Needs Assessment Checklist now needs to focus on establishing concurrent validity and test/retest reliability. The measure developed proved to be a useful, clinically relevant and patient friendly assessment of rehabilitation outcome.

Activities of Daily Living↗
PubMed2004

Orthodontic treatment need in Asian adult males.

Orthodontic treatment in adults has gained social and professional acceptance in recent years. An assessment of orthodontic treatment need helps to identify individuals who will benefit from treatment and safeguard their interest. The purpose of this study was to assess the objective and subjective levels of orthodontic treatment need in a sample of orthodontically untreated adult Asian males. A sample of male army recruits (n = 339, age 17-22 years, Chinese = 258, Malay = 60, Indian = 21) with no history of orthodontic treatment or craniofacial anomalies participated in the study on a voluntary basis with informed consent. Impressions for study models were taken. Objective treatment need was assessed based on study model analysis using the Index of Orthodontic Treatment Need (IOTN). Questionnaires were used to assess subjective treatment need based on subjective esthetic component (EC) ratings. Fifty percentage of the sample had a definite need for orthodontic treatment (dental health component [DHC] grades 4 and 5), whereas 29.2% had a moderate need for treatment (DHC grades 3). The occlusal trait most commonly identified was dental crossbite. Malay males had the highest percentage with a definite need for treatment for both dental health and esthetic reasons in comparison with Chinese and Indian males. However, there was no difference in the level of treatment need among the ethnic groups (P > .05). No correlation between objective and subjective EC scores was found (P > .05). A high level of investigator-identified treatment need was not supported by a similar level of subject awareness among the adult sample.

Adolescent↗
PubMed2005

Orthodontic treatment need from eight to 12 years of age in an early treatment oriented public health care system: a prospective study.

The aim of this study was to investigate the effects of an early treatment oriented orthodontic program on treatment need at age 12 years in a public health care system. The subjects consisted of one whole age cohort in a municipality in Finland, 87 children in total. All children were examined at ages eight, 10, and 12 years. Treatment need was assessed on casts using a modified Dental Health Component of the Index of Orthodontic Treatment Need and a 10-Grade Scale based on the Treatment Priority Index. Early treatment was started on children having definite treatment need according to both indices. The agreement between indices was good at ages eight and 12 years and moderate at age 10 years. Treatment need changed significantly from eight to 12 years. Of the 29 children with definite treatment need at age eight years, only two had treatment need at age 12 years. Of the 38 children with no treatment need at age eight years, 28 remained in this category and only two children had definite need for treatment at age 12 years. The duration of treatment ranged from one to 61 months, although 59% of the treatments lasted two years or less. We conclude that systematically planned early orthodontic treatment may have contributed to the significant reduction in treatment need from eight to 12 years of age.

Age Factors↗
PubMed2001

The psychosocial needs of cancer patients: findings from an observational study.

The objectives of this study were to identify the prevalence of psychosocial need, and the contributory factors to need, among cancer patients, using a descriptive cross-sectional questionnaire survey of adult cancer patients. The participants were 1,000 patients from four hospitals in the north west of England with the following characteristics: tumour type (breast, colorectal, lymphoma, lung), being 1 month from a 'critical moment' in the cancer journey (i.e. (i) diagnosis, (ii) end of first treatment, (iii) recurrence, (iv) move from active treatment to palliative care), and aged over 18 years. The main outcome measure was a psychosocial needs inventory comprising seven needs categories (48 need items). A sample of 402 was achieved (40% response rate). Psychosocial needs relating to the need categories 'health professionals', 'information' and 'support networks' are commonly expressed and strongly felt by cancer patients. Needs relating to 'identity', 'emotional and spiritual' issues and 'practical' issues are less commonly expressed but are also strongly felt. Particular needs are related to tumour type, illness 'critical moment', age, gender, health status, socioeconomic and other social factors. This information should increase awareness among cancer care professionals about a range of psychosocial needs and may help them target particular patient groups for particular support interventions.

Adult↗
PubMed1997

Patients' needs in hospital: nurses' and patients' views.

This study set out to identify the most important needs of hospital patients on surgical and medical wards and to assess the ability of nurses to identify these needs. The population consisted of 92 Finnish patients and 69 Finnish nurses. The study was carried out using a questionnaire designed on the basis of the need theory presented by Yura and Walsh. The results of the statistical analyses were presented in the form of frequencies, cross-tabulations and chi-square tests. The patients' most common needs were related to vital functions (44%), followed by those related to functional health status (38%) and environmental needs (36%). The last item on the list of expressed needs concerned reactions to functional health status (31%). Over 70% of the surgical patients suffered from problems related to sleep and rest. Less than 60% of them suffered from acute pain. Medical patients, in turn, had more frequent needs related to vital functions than did surgical patients. Three out of four medical patients suffered from acute pain. Sleep and rest disturbances, stress, bad mood and listlessness were also common problems. The nurses underestimated all patient needs, apart from environmental needs, which they regarded as the main concern of patients. There was a statistically significant difference between patients' and nurses' assessments for 38% of all needs. Moreover, there were differences in assessments between the surgical and medical wards included in the study.

Adolescent↗
PubMed1999

Chinese elderly patients' perceptions of their rehabilitation needs following a stroke.

Stroke is the third leading cause of death and disability among Chinese elderly patients in Hong Kong and yet the rehabilitation needs of these patients are rarely explored. The aim of this study was to identify the rehabilitation needs of Chinese elderly patients following a stroke. The study adopted an ethnographic approach, information being gathered by the researcher through interviews with 15 key informants selected by purposive sampling. The perceptions of patients as to their own needs were sought at three stages of recovery - in the acute and rehabilitation settings and at 1 month following discharge. Ethical approval was gained from the Chinese University Faculty of Medicine ethical committee and access agreed by the hospital authorities. Verbal approval was gained from the patients before each interview, following confirmation of the voluntary nature of participation and assurance of confidentiality and anonymity. The researcher's role was also clearly stated. Analysis of the interview data produced five categories of patient need at the three stages of recovery, namely informational, physical, psychological, social and spiritual. The most frequently stated, but largely unmet, need in all settings was the need for information, particularly information about the reasons for stroke and about the activities that promote recovery. In the acute and rehabilitation settings patients' responses indicated a need to be respected as individuals, to be addressed by name and to be provided with privacy. Although the Barthel Index administered during interviews charted recovery at different rates, nurses did not always make links between the level of functional ability and the help needed with physical tasks. They also failed to recognize the relationship between physical and psychological needs and the equal importance of both in recovery from stroke. As Chinese elderly patients tend to take a passive role in seeking help and information, nurses play a significant role in the identification of individual rehabilitation needs. Implications for nursing practice are discussed.

Activities of Daily Living↗
PubMed2003

Immediate needs of adult family members of adult intensive care patients in Hong Kong.

Having a family member admitted to Intensive Care Unit (ICU) is stressful for the whole family. Stress can hinder family members' coping and thus affect the support that is given to patient. In order to lessen the effect of stress, family members' immediate needs must be identified and met. The aim of this study was to explore the immediate needs of adult family members of adult intensive care patients in Hong Kong. The study adopted a descriptive cross-sectional design. The Chinese version of Critical Care Family Need Inventory (CCFNI) was used to investigate the immediate needs of a convenience sample of 40 adult family members of patients in an adult ICU. Data were collected through personal interviews within 24-72 hours of patients' admission. Findings revealed that 25 out of 45 need items on the CCFNI that were rated as important or very important. The need "to know the expected outcome" was ranked as the most important. All the needs related to reassurance were ranked within the top 10 important needs. The top 10 important needs were met by doctors and nurses. There were significant differences in needs between family members with different gender, experience of visiting ICUs, religious background and characteristics of patients. The findings suggest that family members perceived reassurance and information support as important. Although this study was limited by using a small convenience sample, the findings could still provide insight for nurses working in ICUs.

Adolescent↗
PubMed2001

Prosthetic treatment need in a representative German sample.

Regarding declining resources epidemiological data on needs for oral rehabilitation are required. Within the framework of an oral health survey a non-stratified two-stage random sample was taken to represent the over 14-year-old population of Saxony/Germany. The participation rate was 55%. Normative need was determined by dental assessment and guidelines developed in a consensus process, subjective prosthetic treatment need by self-complete questionnaire. About 97% of the realized sample could be planned within the guidelines. About 81% had normative prosthetic treatment need. Compared with the rate of normative need the rate of subjective need (13%) was considerably lower (chi(2) P < 0;01). Different predictive parameters of subjective need were identified by logistic regression. Besides other factors subjective need was associated with giving dentist's recommendation as significant reason for prosthetic restorations [odds ratio (OR)=5;43], not believing that the own teeth were all right (OR=0;17), and the existence of prosthetic restorations (OR=3;87 for fixed restorations; OR=4;05 for removable dentures). The guidelines proved their suitability to assess normative prosthetic treatment need in oral health surveys. Further research is necessary to find adequate options for including patients' preferences in an adequate need definition.

Adult↗
PubMed2002

Needs assessment and discharge: a Scottish perspective.

Discharge from hospital remains a difficult area for health services and it is unclear how much impact policy directives have had on discharge outcomes. The recent National Service Framework for mental health has highlighted discharge as a key area with Standard Five indicating minimum requirements at discharge from hospital. In order to aid this process this paper discusses the findings of a needs assessment of patients following discharge from psychiatric inpatient care in Scotland. The needs and unmet needs as assessed by both patients and mental health community staff on the Camberwell Assessment of Need (CAN) are presented. The CAN seeks to identify needs in a range of domains addressing basic, health, social, functioning and service issues. The sample comprised 173 patients recently discharged from acute psychiatric units in eight health board areas of Scotland and 98 community staff identified as providing key support to 98 of the patient sample. The findings indicate that the needs of patients discharged from hospital are complex and that the targeting of mental health services according to diagnostic criteria may not be the best way of ensuring support reaches those in most need. The range of needs identified suggests that fully integrated multidisciplinary care is essential to meet needs at discharge. The period initially after hospital discharge is one of vulnerability and incorporating a needs assessment into the discharge planning could aid the care planning process required by the Framework.

Adolescent↗
PubMed1999

The patient's perceived caring needs: measuring the unmeasurable.

The aim of this study is to elucidate the phenomenon of the caring need in the life-world of the patient and, on the basis of this, to compare patients' perceived caring needs with the six areas of need contained in a new instrument for patient classification, the Oulu Patient Classification (OPC). A total of 75 patients were interviewed and the data were analysed by means of a phenomenological-hermeneutical method. Seventeen perceived caring needs emerged from the process of interpretation. The patients experienced themselves as an indivisible unit that contained existential/spiritual needs and desires. The patients' caring needs are constituted from their problems, needs and desires, where human desire for life, love and meaningfulness may, express itself as bodily, psychical and existential/spiritual needs. A comparison between the patients' perceived caring needs and the OPC shows that patients' existential/spiritual needs do not emerge clearly enough and that the instrument should be supplemented by a caring perspective.

Activities of Daily Living↗
PubMedDate not supplied

Caregiver responses and needs. An ambulatory bone marrow transplant model.

PURPOSE: This longitudinal, descriptive outcomes study was conducted to compare the emotional responses and needs of the caregivers of patients who undergo bone marrow transplantation (BMT) for hematologic malignancies, as observed in an inpatient/outpatient (IPOP) setting with those in an inpatient setting. DESCRIPTION OF STUDY: A convenience sample of 43 caregivers for patients undergoing either autologous or allogeneic BMT was selected from both the inpatient unit (n = 26) and the IPOP ambulatory setting (n = 17). Emotional responses were measured by the Profile of Mood States. The importance and satisfaction of informational, patient-care, and psychological needs were assessed with the Caregiver Needs Survey, a modified version of the Home Cancer Caregiver Needs Survey. Data were collected at six points across the BMT trajectory, from before the procedure to 12 months after. Descriptive statistics were used to report sample characteristics, emotional responses, and needs. Nonparametric statistics were used to compare the IPOP and inpatient caregiver groups, and to identify relationships between emotional responses and needs within groups. RESULTS: IPOP caregivers were found to have significantly less mood disturbance at points before discharge. Both groups showed a decrease in mood disturbance 6 and 12 months after BMT. IPOP caregivers had higher levels of satisfaction of their informational and psychological needs at day 21. Significant correlations between total mood disturbance and satisfaction of informational, psychological, and patient-care needs were found for inpatient caregivers across treatment time points. CLINICAL IMPLICATIONS: These findings support the IPOP model of care as being less emotionally distressing for and better meeting the needs of family caregivers. Specific implications for practice include the importance of caregiver education in the area of patient-care information and of assessment and intervention to meet caregiver psychological needs. Continued evaluation of the impact of changes in care delivery on family caregivers is essential for the provision of comprehensive cancer care.

Activities of Daily Living↗
PubMed2006

[Needs for care of former long-stay-patients living outside of the psychiatric hospital].

OBJECTIVE: The aim of this study was to assess the needs for care of 116 former long-stay patients during the first 42.9 months after discharge. METHOD: Patients and mental health professionals rated needs using the "Berliner Bedürfnisinventar" (Berlin Needs for Care Inventory). RESULTS: Out of a total of 16 needs areas, patients reported a mean number of 7.6 needs, therapists reported 10 needs. Patients with lower global functioning scores showed a significantly lower number of needs, while patients living in psychiatric nursing homes and patients with learning disabilities had a significantly higher number of needs. In most areas, agreement between patients' and therapists' assessment was good to moderate. In most areas the rate of unmet versus total needs was above 90 %. Patients received help almost exclusively from institutions or mental health services. CONCLUSION: The care needs of discharged patients were generally met and placement in institutions was considered appropriate.

Activities of Daily Living↗
PubMed2000

Met and unmet needs reported by severely disabled people in southern England.

PURPOSE: To examine the met and unmet needs for rehabilitation of disabled people living in the community in Southern England. METHOD: A cross sectional interview study of people with a primary physical disability, aged 1665. Disabled people were randomly selected from two existing disability registers, which comprised disabled people who had been identified by community rehabilitation services as being in need of regular surveillance by formal assessment of their care needs. A new semi-structured needs assessment questionnaire was developed and validated for the study (the Southampton Needs Assessment Questionnaire, SNAQ). Level of disability was examined with the OPCS Disability and Severity Scales. RESULTS: Ninety three disabled people participated. Their median (IQR) OPCS score was 8 (6-10). Participants reported a median (IQR) of three unmet needs (2-7). The most prevalent unmet needs were for adaptations, equipment, physiotherapy and wheelchairs, rather than unmet needs for intellectual and social fulfilment. CONCLUSIONS: Disabled people who were already in touch with community rehabilitation services continued to express unmet needs for further services. Meeting the more basic needs relating to people's housing, equipment, physiotherapy and wheelchairs may enable them to be more independent and fulfilled in other areas of their lives.

Activities of Daily Living↗
PubMed2004

Orthodontic treatment need and demand in 12-14-year-old north Jordanian school children.

This study was undertaken to assess the need and demand for orthodontic treatment among 12-14-year-old north Jordanian school children. In total, 1002 students randomly selected to represent five geographical areas of Irbid were examined. The examinations were carried out twice, first on the pupils in the school premises and then using study models taken from each student. The dental health (DHC) and aesthetic (AC) components of the Index of Orthodontic Treatment Need (IOTN) were used as an assessment measure of the need for orthodontic treatment. The demand for orthodontic treatment was measured by asking the students 'if it was necessary, would they like to have their teeth straightened by an orthodontist'. The results showed that approximately one-third (34 per cent) of the children examined had a definite need for orthodontic treatment. Within this group, 73.5 per cent were in need of orthodontic treatment according to the DHC, 23.5 per cent had both DHC and AC great need scores, and 3 per cent were in need according to the AC only. Severe contact point displacement of more than 4 mm was the most common occlusal feature in the definite treatment need group, followed by impeded eruption of teeth, hypoplasia of a single tooth and increased overjet of more than 6 mm but less than or equal to 9 mm. The demand for orthodontic treatment among the students was 49 per cent. Approximately half of them (54 per cent) had a definite need for orthodontic treatment. This study provides baseline data on the need and demand for orthodontic treatment among a Jordanian population, which is important for planning public orthodontic and dental services.

Adolescent↗
PubMed1994

Measuring unmet needs to assess the quality of home health care.

Until now home care research has been primarily focused on functional limitations. The instrument presented in this article also takes into account needs for psychosocial care, extra information, nursing care, and extra arrangements such as adaptations of the house. Elderly people with a chronic disease (n = 311) were interviewed using structured questions concerning the presence of unmet needs. The six need scales represented two dimensions: needs referring to physical functioning and needs referring to psychosocial well-being. However, considerable differences were found in the amount of formal and informal care and in the presence of unmet needs between the need scales constituting one dimension. Indications for construct validity were found for five out of six need categories. The results show that, when evaluating home health care, the full range of needs has to be considered and the presence of unmet needs can be used as an indicator of the quality of home health care.

Activities of Daily Living↗