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J Neurosci Nurs. 2013 Dec;45(6):320-8. doi: 10.1097/JNN.0b013e3182a3ce40.
The purposes of this study were to develop and validate a measure of unmet resource needs of the caregivers of survivors of stroke and to describe the caregivers' unmet needs during 1 year. A longitudinal, descriptive design was used to test the reliability and validity of the Unmet Resource Needs (URN) measure. Item development was based on literature review and preliminary study findings. A stress and coping conceptual model framed the hypotheses. Psychometric testing was based on 6-month postdischarge data (n = 166). Content and structural construct validity, internal consistency reliability through 1 year, and concurrent validity were tested. Change in URN over time was examined. Content validity was supported by floor and ceiling effects less than 5%. Principal axis factoring yielded a 12-item, two-factor solution reflecting general and technology unmet needs. Internal consistency reliability was satisfactory for the total scale and subscales at all times, excepting the baseline three-item technology scale (α = .56). Concurrent validity was supported by significant correlations with model constructs (threat, positive problem solving, depression, preparedness; p < .01) in the expected direction. Functional status and resource use were not associated with the URN. Repeated measures analysis of variance (n = 123) indicated a significant decrease in unmet needs from baseline to 3, 6, and 12 months postdischarge (p < .001). Nevertheless, 42% reported one or more unmet needs at year 1. Assessment and counseling on unmet needs is indicated throughout the caregiving trajectory to reduce negative outcomes.
本研究旨在开发和验证卒中幸存者照顾者未满足资源需求的测量工具,并描述照顾者在 1 年内的未满足需求。采用纵向描述性设计来测试未满足资源需求(URN)测量工具的信度和效度。项目开发基于文献回顾和初步研究结果。应激和应对概念模型为假设提供了框架。心理测量测试基于出院后 6 个月的数据(n = 166)。测试了内容和结构构念效度、1 年内的内部一致性信度以及同时效度。检查了 URN 随时间的变化。内容效度通过低于 5%的地板和天花板效应得到支持。主成分因子分析得出了 12 项、两因素的解决方案,反映了一般和技术方面的未满足需求。除了基线的三项技术量表(α=0.56)外,总量表和子量表在所有时间的内部一致性信度均令人满意。与模型结构(威胁、积极问题解决、抑郁、准备度;p <0.01)的显著相关性支持了同时效度,方向符合预期。功能状态和资源利用与 URN 无关。重复测量方差分析(n = 123)表明,从基线到出院后 3、6 和 12 个月,未满足需求显著下降(p <0.001)。然而,在第 1 年仍有 42%的人报告存在一项或多项未满足的需求。在整个照护过程中,需要评估和咨询未满足的需求,以减少负面结果。