Validation of the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool: a multicentre study
Validation of the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool: a multicentre study
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DOI：
10.1177/0269215513487082
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发表时间：
2013-11-01
影响因子：
3
通讯作者：
House, Allan
中科院分区：
文献类型：
--
作者：
Forster, Anne;Murray, Jenni;House, Allan
目的：评价脑卒中后长期未满足需求监测工具的可接受性、重测信度和效度。设计：一份调查问卷包被寄给中风后三到六个月住在家里的中风幸存者。第二批货在收到第一批货后两周寄出。背景：中风幸存者生活在英格兰各地的家中。研究对象：分两个阶段从英格兰40家医院招募中风幸存者。第一个是最佳的患者队列，第二个是捕获更广泛的中风后人群，包括那些有沟通和/或认知困难的人。如果患者需要姑息治疗或计划永久出院到疗养院或住宅，则排除在外。主要测量方法：问卷包包括卒中后长期未满足需求工具、一般健康问卷-12、法国活动指数和简短表格-12。结果：第一阶段数据的中期分析（n = 350）表明该工具足够稳健，可以进入第二阶段（n = 500）。报告了联合研究人群的结果。在招募的850名患者中，199名（23%）有沟通和/或认知困难。中位年龄为73岁（28-98岁）。问卷包回复率为69%。对于新工具，缺失数据为3.5%，重测信度为中等至良好（项目一致性百分比为78-99%，kappa统计量为0.45-0.67）。确定未满足的需求始终与并发措施的较差结果相关。结论：卒中后长期未满足需求工具是可接受的、可靠的、可自行完成的，并可用于识别卒中后长期未满足需求。
Objective: To evaluate the acceptability, test-retest reliability and validity of the Longer-term Unmet Needs after Stroke monitoring tool.Design: A questionnaire pack was posted to stroke survivors living at home three or six months after stroke. A second pack was sent two weeks after receipt of the completed first pack.Setting: Stroke survivors living at home across England.Subjects: Stroke survivors were recruited from 40 hospitals across England, in two phases. The first with an optimal cohort of patients, the second to capture a broader post-stroke population, including those with communication and/or cognitive difficulties. Patients were excluded if they required palliative care or if permanent discharge to a nursing or residential home was planned.Main measures: The questionnaire pack included the Longer-term Unmet Needs after Stroke tool, General Health Questionnaire-12, Frenchay Activities Index, and Short Form-12.Results: Interim analysis of phase 1 data (n = 350) indicated that the tool was sufficiently robust to progress to phase 2 (n = 500). Results are reported on the combined study population. Of 850 patients recruited, 199 (23%) had communication and/or cognitive difficulties. The median age was 73 years (range 28-98). Questionnaire pack return rate was 69%. For the new tool, there was 3.5% missing data and test-retest reliability was moderate to good (percentage item agreement 78-99%, kappa statistic 0.45-0.67). Identification of an unmet need was consistently associated with poorer outcomes on concurrent measures.Conclusions: The Longer-term Unmet Needs after Stroke tool is acceptable, reliable, can be self-completed, and used to identify longer-term unmet needs after stroke.