Reliability, validity and acceptability of the traditional Chinese version of the carer support needs assessment tool in Hong Kong palliative care settings

Abstract

Background Among the few existing needs assessment tools for family carers, the 14-item Carer Support Needs Assessment Tool (CSNAT) is the only brief and holistic needs screening tool designed for everyday use in palliative care practices. The aim of this study was to evaluate the reliability, validity, and acceptability of the traditional Chinese version of the CSNAT in palliative care settings in Hong Kong. Methods This adopted a cross-sectional and correlation design with repeated measures. The participants were 125 family carers of palliative cancer patients and 10 healthcare providers (HCPs) that were recruited from two local hospitals. The evaluation of psychometric properties included the following: (1) content validity through HCPs including frontline physicians, nurses, social workers, and clinical psychologists; (2) construct validity between the CSNAT items and those of the validated tools that measured caregiver burden, social support, and caregiving self-efficacy; and (3) one-week test-retest reliability in a sub-sample of 81 caregivers. The acceptability of the tool was assessed by the carers using several closed-ended questions. Results The content validity index of the CSNAT at the scale level was 0.98. Each item of the CSNAT was significantly and moderately correlated with caregiver burden (Spearman’s r = 0.24 to 0.50) and caregiving self-efficacy (r = − 0.21 to − 0.52), but not for social support. All CSNAT items had fair to moderate test-retest reliability (weighted kappa = 0.21 to 0.48), with the exception of two items “managing your relatives’ symptoms, including giving medicines” and “having time for yourself in the day”. Regarding the acceptability of the CSNAT, almost all HCPs were willing to use the CSNAT for carer assessment and support. 89.6% of the carers demonstrated a comprehensibility of the CSNAT tool and 92.9% felt comfortable answering the questions. Around 90% of the carers agreed to use the tool for screening, discussing needs, and making referrals. Conclusion The traditional Chinese version of the CSNAT is a tool with high validity and acceptability and adequate reliability that measures family carers’ support needs, which should be considered for wide application in local palliative care practices.

The Nature and Types of Community Palliative and end-of-Life Care Services: A Content Analysis of Service Provider Websites in Hong Kong

“…Local research has also reported this similar finding, indicating that caregivers have unmet support needs in personal care, practical household support, providing personal care, financial, legal and work issues, and equipment to care for patients. 30,31 The current findings suggest that there is an urgent need to ease caregiver burden by designing services to address their unmet needs.…”

Mediating role of self‐efficacy between unmet needs and quality of life in palliative cancer caregivers

“…The participant profile was previously reported 19 . 125 family caregivers participated in this study and the response rate was 74.4%.…”

“…The traditional Chinese version of the 14‐item Carer Support Needs Assessment Tool (CSNAT) assesses participants' unmet support needs 9,19 . As the CSNAT tool was constructed as a screening tool, rather than a scale, each item represents a core support domain for future support.…”

“…The traditional Chinese version of the 14-item Carer Support Needs Assessment Tool (CSNAT) assesses participants' unmet support needs. 9,19 As the CSNAT tool was constructed as a screening tool, rather than a scale, each item represents a core support domain for future support. All items are categorized under two distinct domains: the support to enable caregivers to care for their relatives and the support to enable more direct support for themselves.…”

“…A person with higher caregiving SE is expected to have better confidence in caregiving skills, set up more reasonable goals of care, and invest greater efforts to manage caregiving challenges than a less self‐efficacious one 14,17 . However, a few studies have identified an inverse association between unmet support needs and caregiving SE in family caregivers of advanced cancer patients 18,19 . In accordance with the SE theory, caregivers with unmet support needs might view the caregiving situation as difficult, leading to a feeling of incompetent in caring for patients.…”