The Needs and Provision Complexity Scale: a first psychometric analysis using multicentre data.
OBJECTIVE
A psychometric evaluation of the Needs and Provision Complexity Scale (NPCS).


METHODS
The NPCS is designed to evaluate both needs for health and social support (NPCS-Needs) and services provided to meet those needs (NPCS-Gets).


METHODS
A consecutive cohort of patients were recruited from nine specialist neurorehabilitation units in London.


METHODS
Four hundred and twenty-eight patients were assessed at discharge (63.1% males; mean age 49 years) of whom 73.6% had acquired brain injury (49.5% stroke/subarachnoid, 14.7% traumatic brain injury, 9.3% 'other acquired brain injury'), 8.9% spinal cord injury, 6.1% peripheral neuropathy, 4.9% progressive neurological and 6.3% other neurological conditions.


RESULTS
The NPCS-Needs was completed by the clinical team at discharge and 212 patients reported NPCS-Gets after six months. NPCS-Gets repeatability was tested in a subsample (n = 60). Factor analysis identified two principal domains ('Health and personal care' and 'Social care and support') accounting for 66% of variance, and suggested a large general factor underpinning the NPCS. Internal consistency was high (alpha = 0.94) and repeatability acceptable. Intraclass coefficients for domain scores were healthcare 0.67 (95% confidence interval (CI) 0.48-0.80); personal care 0.83 (0.73-0.90); rehabilitation 0.65 (0.45-0.78); social/family support 0.66 (0.46-0.79) and environment 0.84 (0.74-0.90). Linear-weighted kappas for item-by-item agreement ranged from 0.42 to 0.83. Concurrent validity was demonstrated through correlations with measures of dependency and community integration.


CONCLUSIONS
Notwithstanding a 50% response rate after six months, the NPCS has good internal consistency, a robust two-factor structure, acceptable test-retest reliability and initial evidence of concurrent validity.
Department of Palliative Care Policy and Rehabilitation, King's College London, School of Medicine, London, UK Person-Centred Research Centre, School of Public Health and Psychosocial Studies and School of Rehabilitation and Occupational Studies, AUT University, Auckland, New Zealand richard.siegert@aut.ac.nz.
Richard J
RJ
Siegert
Department of Palliative Care Policy and Rehabilitation, King's College London, School of Medicine, London, UK.
Diana M
DM
Jackson
Department of Palliative Care Policy and Rehabilitation, King's College London, School of Medicine, London, UK Regional Rehabilitation Unit, Northwick Park Hospital, London, UK.
Lynne
L
Turner-Stokes
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D011594:Psychometrics; D015203:Reproducibility of Results; D012944:Social Support; D055815:Young Adult
Needs and Provision Complexity Scale; Rehabilitation; neurological disorders; psychometry; questionnaire