https://orcid.org/0000-0002-8823-3006
Abstract
Background
We report the development and psychometric testing of a Supportive Needs Assessment tool for Cirrhosis (SNAC).
Methods
The 50-item SNAC was administered to patients (n=465) diagnosed with cirrhosis recruited from five metropolitan hospitals in Queensland, Australia. Items were assessed for ceiling and floor effects, and exploratory factor analysis was used to assess the factor structure. Identified factors were assessed for internal consistency and convergent validity to validated psychosocial tools.
Results
Exploratory factor analysis identified 4 factors (39 items), which together accounted for 49.2% of the total variance. The 39-item SNAC met the requirements of a needs assessment tool and identified a range of needs important to patients with cirrhosis that were grouped in four subscales: “Psychosocial issues”, “Practical and physical needs”, “Information needs”, and “Lifestyle changes”. Cronbach's alpha values for the four subscales ranged from 0.64 to 0.92. Convergent validity was supported by a strong correlation between the total SNAC score and that of the Chronic Liver Disease Questionnaire (CLDQ; Spearman rho −0.68; p<0.001), and moderate correlations with the Distress Thermometer (Spearman rho 0.53; p<0.001) and seven subscales of a generic health-related quality of life instrument (Short Form 36; Spearman rho ranged from −0.48 to −0.57; p<0.001). The SNAC discriminated patient groups with respect to sex (p=0.013), age group (p<0.001), and hospital admission status (admitted vs not; p<0.001).
Conclusion
These data provide initial evidence for the validity and reliability of the SNAC, an instrument designed to measure type and amount of perceived unmet practical and psychological needs of people diagnosed with cirrhosis.
Acknowledgments
PC Valery was supported by a NHMRC Career Development Fellowship (#1083090). SM McPhail was supported by a NHMRC fellowship (#1090440). The funders had no role in study design, data collection, data analysis, interpretation, or writing of the manuscript. We thank the staff and patients of the participating hospitals for their assistance and cooperation in performing the current study. We thank Joo Hyun Kwon, Isanka Umayangani Ratnasekera, Francisca Powell, and Stefania Massignam for assistance with patient recruitment and interview.
Author Contributions
PCV and EEP contributed to the conception and design of the study. EEP, RS, PJC, TR, and RG assisted with identification of patients for the study, and CMB and RG recruited participants. PCV performed the data analysis. GH and SMM provided statistical advice. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.