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Validation of the electronic Holistic Needs Assessment.

Snowden, Austyn; Fleming, Mick


Mick Fleming


Macmillan Cancer Support UK have developed an electronic Holistic Needs Assessment (eHNA) to: (1) help people living with cancer express all their needs, (2) help those helping them better target support. eHNA consists of 48 items each ranked from zero (no problem) to 10. There has been no psychometric analysis of this tool and so its validity and reliability are untested. The aim of this study was to evaluate the psychometric properties of the eHNA by examining its construct validity. Objectives were to (a) test whether the eHNA measured holistic concerns and (b) analyse the factor structure of the eHNA. Objectives were achieved through a secondary analysis of 5421 responses to eHNA using concurrent application of Rasch analysis and principal component analysis. All the items bar one fit with the Rasch rating model and were equivalently important to people. Differential item functioning was evident according to whether people were described as curative or not. A 12-factor solution explained 46 % variance. Of this the emotional/spiritual factor explained the most variance accounting for 15 %. The eHNA was internally consistent and conceptually coherent with the construct of holistic needs assessment. Clinical focus is best directed to the individual items highlighted by the patient except where patients check too many problems for the clinician to accurately prioritise. In these cases only, the emotional/spiritual factor may help identify appropriate clinical action. Strengths and weaknesses of the analyses are discussed, particularly in relation to ‘at risk’ subsamples such as those classified as non-curative.

Journal Article Type Article
Acceptance Date Oct 6, 2015
Online Publication Date Oct 19, 2015
Publication Date Oct 19, 2015
Deposit Date Oct 30, 2015
Publicly Available Date Oct 30, 2015
Journal SpringerPlus
Electronic ISSN 2193-1801
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 4
Pages 623
Keywords Cancer; Holistic needs assessment; Validity; Reliability; Rasch analysis; Factor analysis;
Public URL
Publisher URL
Contract Date Oct 30, 2015


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