title: Validation of the longer-term unmet needs after stroke (LUNS) monitoring tool: a multicentre study.
abstract: OBJECTIVE
  To evaluate the acceptability, test-retest reliability and validity of the Longer-term Unmet Needs after Stroke monitoring tool.
  
  
  METHODS
  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.
  
  
  METHODS
  Stroke survivors living at home across England.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Bradford Teaching Hospitals NHS Foundation Trust and University of Leeds, UK.
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004739:England; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011788:Quality of Life; D015203:Reproducibility of Results; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: LUNS; Stroke; longer-term; monitoring tool; unmet needs