Chapter 2 52 2.3.2 Assessment of needs Patients reported a mean total needs of 4.31 (SD 3.48, range 0-17) which was similar to the total number of needs rated by staff (4.44 needs, SD 3.56, range 0-14, Wilcoxon z=-0.359, N=78, p=0.720, Table 2). The mean number of met needs rated by patients (mean 3.50, SD 2.81, range 0-14) and staff (mean 3.95, SD 3.18, range 0-12) were also comparable (Wilcoxon z=-1.702, n=78, p=0.089, Table 2). The mean number of unmet needs, however, was rated significantly higher by patients (0.81, SD 1.23, range 0-6) than by staff (0.49, SD 0.91, range 0-4, Wilcoxon z=-2.497, n=78, p=0.013). No unmet needs were reported by 56.4% (n=44) of the patients and by 69.2% (n=54) of staff. According to the patients, 19% of their reported needs were unmet while according to staff this was 11%. Patients rated the proportion of their needs as unmet considerably higher in the psychological (22%) and social (35%) domains, as compared with staff (9% and 16%). In the other domains the ratings were comparable between patients and staff (12 versus 16% and 10 versus 8%), (Table 2). With regard to individual needs, household skills, physical health, medication and psychological distress were the most frequently rated met needs, both by patients and staff. The most frequently reported unmet needs rated by both patients and staff were company and daytime activities. The percent agreement calculation between patients and staff was high (84.1%), with the lowest for company (62.8%), followed by medication (62.9%), physical health (65.6%), psychological distress (73.1%) and daytime activities (75.9%). The Cohen’s kappa coefficient agreement between patients and staff rating was moderate (mean κ 0.45, SD=0.21). Poor agreement between patient and staff was found for needs regarding behavior, intimate relationships, and company (κ < 0.2).
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