Primary Image

RehabMeasures Insrument

Last Updated

Purpose

The URN aims 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.

Link to Instrument

instrument details

Acronym URN

Area of Assessment

Stress & Coping

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Stroke Recovery

Populations

Key Descriptions

  • Unmet needs are defined as the caregiver’s desire for more assistance, support, or information to manage physical or emotional concerns for stroke survivors.
  • The 13-item URN scale addresses access to caregiver and survivor resources for managing emotional, physical, and behavioural consequences of stroke.
  • Responses (1 = strongly disagree to 5 = strongly agree) are summed. One item was reverse-scored.
  • Higher scores indicated greater unmet needs; the potential range of sores was 13-65.

Number of Items

13

Equipment Required

  • Paper/pen
  • Telephone

Time to Administer

5 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Yen-Yen S. Gee, MMus, and the Rehabilitation Measures Team in December 2013.

ICF Domain

Environment

Measurement Domain

General Health

Considerations

Stroke

(King et al., 2013) 

  • It would be worthwhile to identify the relationship between depression and unmet needs 

  • Modest sample size with a ratio of 12:1, participants:items; a larger sample size, along with a confirmatory factor analysis and examination of predictive validity would be useful

  • Temporal stability should be assessed with no more than 2 weeks between assessments to add support for scale reliability

  • Inclusion of an item on information needs related to stroke symptoms and prevention

  • Allow caregivers to add unmet needs, which could provide important information

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!  

Stroke

back to Populations

Normative Data

Stroke

(King et al., 2013; caregiver n = 166, survive n = 153-166; stroke survivors were enrolled in a larger invention study to improve stroke caregiver function; inclusion criteria for stroke survivors: (1) planned discharge of survivor to home; (2) primary caregiver (CG) living with the survivor; (3) CG not currently in a support group or therapy; (4) access to a telephone and sufficient hearing to use a phone (5) survivor and CG aged 21 years or older; (6) CG depression screening score over 9 on the Center for Epidemiologic Studies-Depression(CES-D); a primary CG was defined as one who supervised, assisted with, or managed care)

 

Caregiver

   

Survivor

   
 

Range

Mean (SD)

n (%)

Range

Mean (SD)

n (%)

Gender (female)

N/A

N/A

134 (80.7)

N/A

N/A

64 (39.2)

Race (white)

N/A

N/A

116 (69.9)

N/A

N/A

129 (78.2)

Relation (spouse)

N/A

N/A

111 (66.9)

N/A

N/A

N/A

Employment (full/part time)

N/A

N/A

81 (48.8)

N/A

N/A

81 (49.4)

Education (greater than equal to HS)

N/A

N/A

154 (92.7)

N/A

N/A

138 (84.7)

Aphasia (yes)

N/A

N/A

N/A

N/A

N/A

69 (45.1)

First stroke (yes)

N/A

N/A

N/A

N/A

N/A

130 (78.3)

Age

21-84

55.34 (13.38)

N/A

22-93

61.49 (15.35)

N/A

Survivor function

   

N/A

18-126

96.66 (25.64)

N/A

Internal Consistency

Stroke

(King et al., 2013)

  • Adequate internal consistency (Cronbach’s alpha greater than or equal to 0.7 for the total scale and general needs subscale at all times) 
  • The total scale coefficients ranged from 0.84 to 0.88 across four times, the general needs coefficients from 0.84 to 0.87, and the technology scale from 0.56-085
  • Poor to adequate internal consistency of item-total correlations (alpha = 0.42-0.72)
  • Poor to excellent internal consistency during 1 year

 

Unmet Resource Needs Scale: Scores and Internal Consistency Values During 1 Year (n = 123)

Data Collection

Total Scale

Alpha

General

Alpha

Technology

Alpha

Times

Mean (SD)

 

Mean (SD)

 

Mean (SD)

 

Time 1 (predischarge)

30.28 (7.02)

0.83

23.02 (5.71)

0.83

7.26 (2.30)

0.58

Time 2 (3 months)

27.57 (7.08)

0.86

20.74 (5.66)

0.84

6.74 (2.36)

0.70

Time 3 (6 months)

27.46 (7.55)

0.87

20.83 (5.85)

0.87

6.64 (2.61)

0.81

Time 4 (12 months) 

26.46 (6.77)

0.85

20.05 (5.36)

0.84

6.21 (2.49)

0.86

Criterion Validity (Predictive/Concurrent)

Stroke

(King et al., 2013)

  • Poor to adequate correlation between the time 3 URN and time 3 coping and adaptation outcome variables (Spearman = -0.11 for resource use to -0.46 for preparedness of caregiving) 

Spearman Correlations Between Time 3 Unmet Resource Needs and Time 3 Outcomes and Coping Process Variables (n = 154)

Measures

1

2

3

4

5

6

7

Unmet resource needs

-

           

Resource use

-0.11

-

         

Threat appraisal

0.34

0.16

-

       

CES-D

0.37

0.18

0.62

-

     

Preparedness for caregiving

-0.46

-0.02

-0.47

-0.42

-

   

Functional independence measure

-0.16

-0.04

-0.15

-0.29

0.14

-

 

Positive problem solving

-0.34

-0.03

-0.38

-0.38

0.35

0.15

-

Floor/Ceiling Effects

Stroke

(King et al., 2013)

  • Adequate floor effects (1.2% at baseline to 4.4% at time 4)
  • Excellent ceiling effects (absent each time, 0%)

Bibliography

Smith, A. W., Parsons, H. M., Kent, E. E., Bellizzi, K., Zebrack, B. J., Keel, G., … AYA HOPE Study Collaborative Group. (2013). Unmet Support Service Needs and Health-Related Quality of Life among Adolescents and Young Adults with Cancer: The AYA HOPE Study. Frontiers in Oncology, 3, 75. https://doi.org/10.3389/fonc.2013.00075