ABSTRACT: 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.
Questions or comments about this article may be directed to Rosemarie B. King, PhD RN FAHA FAAN, at email@example.com. She is a Research Professor at Northwestern University Feinberg School of Medicine, Chicago, IL.
Robert J. Hartke, PhD MPH, is an Assistant Professor at the Department of Physical Medicine and Rehabilitation and Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, and a Psychologist at the Rehabilitation Institute of Chicago, Chicago, IL.
Jungwha Lee, PhD MPH, is an Assistant Professor at the Biostatistics Collaboration Center and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Jason Raad, MS, is a Project Coordinator, Rehabilitation Institute of Chicago, Center for Rehabilitation Outcomes, Chicago, IL.
The authors declare no conflicts of interest.