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.


METHODS
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.


METHODS
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.


METHODS
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.


METHODS
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.
McWalter
G
G
Information and Statistics Division, National Health Service in Scotland, Edinburgh, UK.
Toner
H
H
McWalter
A
A
Eastwood
J
J
Marshall
M
M
Turvey
T
T
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003156:Community Mental Health Services; D003625:Data Collection; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D019981:Health Care Sector; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D015203:Reproducibility of Results