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- Rehabilitation Measures Database
- Needs Assessment Checklist
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Atomized Content
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Adult NAC revised Jul 08.pdf
Purpose
Assesses patient attainment of rehabilitation outcomes through a self-rating of perceived independence at mobilization and prior to discharge, used specifically for patients with Spinal Cord Injury (SCI).
Link to Instrument
Instrument Details
Acronym NAC
Area of Assessment
Activities of Daily Living
General Health
Range of Motion
Social Relationships
Social Support
Incontinence
Assessment Type
Patient Reported Outcomes
Administration Mode
Paper & Pencil
Cost
Free
Diagnosis/Conditions
- Spinal Cord Injury
Populations
Spinal Injuries
Key Descriptions
- The Needs Assessment Checklist consists of nine rehabilitation domains, each with specific indicators:
1) ADL (29 indicators)
2) Skin Management (14 indicators)
3) Bladder Management (10 indicators)
4) Bowel Management (7 indicators)
5) Mobility (17 indicators)
6) Wheelchair and Equipment (33 indicators)
7) Community Preparation (24 indicators)
8) Discharge Coordination (32 indicators)
9) Psychological Issues (19 indicators) - Scores are derived by summing sub-scale items; a “percentage achieved” is also calculated for each of the 9 sub-scale's ranging from 0-100% with higher scores indicating greater independence.
- This score is used in Goal Planning Meetings to establish rehabilitation goals that include explicit behavioral targets.
Number of Items
199
Time to Administer
60minutes
Required Training
Reading an Article/Manual
Age Ranges
Adult
18 - 64
years
Elderly Adult
65 +
years
Instrument Reviewers
Initially reviewed by the Rehabilitation Measures Team; Updated by Jennifer Kahn, PT, DPT, NCS, Candy Tefertiller, PT, DPT ATP, NCS, and SCI EDGE task force of the Neurology Section of the APTA in 2012
ICF Domain
Body Function
Activity
Participation
Measurement Domain
Activities of Daily Living
Motor
Sensory
Professional Association Recommendation
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations
Abbreviations: | |
HR | Highly Recommend |
R | Recommend |
LS / UR | Reasonable to use, but limited study in target group / Unable to Recommend |
NR | Not Recommended |
Recommendations for use based on acuity level of the patient:
Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 weeks post) | Subacute (CVA 2 to 6 months) (SCI 3 to 6 months) | Chronic (> 6 months) | |
SCI EDGE | R | R | LS |
Recommendations based on SCI AIS Classification:
AIS A/B | AIS C/D | |
SCI EDGE | R | R |
Recommendations for entry-level physical therapy education and use in research:
Students should learn to administer this tool? (Y/N) | Students should be exposed to tool? (Y/N) | Appropriate for use in intervention research studies? (Y/N) | Is additional research warranted for this tool (Y/N) | |
SCI EDGE | No | No | No | Not reported |
Considerations
- The Child Needs Assessment Checklist (ChNAC) is also available (see Webster & Kennedy, 2007; for more information)
- NAC is a measure of an individual’s perceptions of their own independence and may be subjective and influenced by other factors.
- NAC assesses both verbal and physical independence so individuals have potential to reach 100% on all subscales.
Do you see an error or have a suggestion for this instrument summary? Pleasee-mail us!
Spinal Injuries
back to PopulationsNormative Data
Subacute, Chronic SCI: (Berry & Kennedy, 2003;n= 43; 13.9% = complete tetraplegia, 37.2% = incomplete tetraplegia, 23.3% = complete paraplegia, and 25.6% = incomplete paraplegia; mean age = 42.19 (14.6) years)
NAC Means (SD) | ||||
Subscale | Number of items | Scale mean | Scale SD | α |
ADL | 29 | 59.07 | 25.88 | 0.9697 |
Skin Management | 14 | 25.67 | 10.54 | 0.8830 |
Bladder Management | 10 | 22.81 | 7.23 | 0.8356 |
Bowel Management | 7 | 13.91 | 6.27 | 0.8097 |
Mobility | 17 | 24.28 | 13.30 | 0.8729 |
Wheelchair and Equipment | 33 | 46.09 | 27.27 | 0.9527 |
Community Preparation | 24 | 39.28 | 12.73 | 0.7805 |
Discharge Coordination | 32 | 47.86 | 25.52 | 0.9251 |
Psychological Issues | 19 | 45.49 | 7.99 | 0.7347 |
SCIM Self-Care | 6 | 12.63 | 7.61 | 0.9608 |
Respiration and Sphincter Management | 4 | 23.84 | 10.60 | 0.6454 |
Mobility | 8 | 14.02 | 11.21 | 0.9288 |
Full-Scale Score | 18 | 50.49 | 26.91 | 0.9227 |
HADS Anxiety | 7 | 5.14 | 4.32 | 0.8463 |
Depression | 7 | 5.51 | 4.17 | 0.8122 |
Test/Retest Reliability
Subacute, Chronic SCI: (Berry & Kennedy, 2002)
Test-retest reliability (mean time between two tests 7.2 (2.88) days), compared by correlating clinical NAC subscale scores with test-retest NAC subscale scores.)
NAC subscale | r value |
ADL | 0.884 |
Skin Management | 0.904 |
Bladder Management | 0.694 |
Bowel Management | 0.783 |
Mobility | 0.883 |
Wheelchair and Equipment | 0.883 |
Community Preparation | 0.830 |
Discharge coordination | 0.805 |
Psychological Issues | 0.748 |
All correlations significant at 0.01 level (two-tailed) |
Internal Consistency
Subacute, Chronic SCI:(Berry & Kennedy, 2002;n = 43, complete, incomplete, paraplegia, tetraplegia )
Acute SCI: (Kennedy et at, 2003;n= 147, mean age = 40.7 (16.5) years; complete tetraplegia (18%), incomplete tetraplegia (14%), complete paraplegia (16%), and incomplete paraplegia (11%))
NAC subscale | Berry 2002 alpha | Kennedy 2003 alpha |
Across all subscales | Excellent0.8587 | Excellent0.83 |
ADL | Excellent0.9697 | Excellent0.9467 |
Skin Management | Excellent0.8830 | Excellent0.8478 |
Bladder Management | Excellent0.8356 | Adequate0.7753 |
Bowel Management | Excellent0.8097 | Excellent0.8741 |
Mobility | Excellent0.8729 | Excellent0.8358 |
Wheelchair and Equipment | Excellent0.9527 | Excellent0.9239 |
Community Preparation | Adequate0.7805 | Adequate0.7146 |
Discharge coordination | Excellent0.9251 | Excellent0.8855 |
Psychological Issues | Adequate0.7347 | Poor0.6729 |
Criterion Validity (Predictive/Concurrent)
Subacute, Chronic SCI: (Berry & Kennedy, 2002)
Concurrent Validity: NAC, SCIM and HADS:
Subscale | |||||||
SCIM Self-care | SCIM Respiration and Sphincter Management | SCIM Mobility | SCIM Full Scale | HADS-Anxiety | HADS-Depression | HADS (combined scales) | |
ADL | 0.850 (Excellent) | 0.783 (Excellent) | |||||
Bladder and Bowl | 0.681 (Excellent) | 0.754 (Excellent) | |||||
Mobility | 0.691 (Excellent) | 0.696 (Excellent) | |||||
Psychological (mood) | -0.709 (Excellent) | -0.633 (Excellent) | -0.726 (Excellent) | ||||
Psychological (Full scale) | -0.501 (Adequate) | -0.466 (Adequate) | -0.523 (Adequate) |
SCIM = The Spinal Cord Independence Measure
HADS = Hospital Anxiety and Depression Scale
All correlations are significant at the 0.01 level (two-tailed)
Bibliography
Berry, C. and Kennedy, P. (2002). "A psychometric analysis of the Needs Assessment Checklist (NAC)." Spinal Cord 41(9): 490-501.Find it on PubMed
Duff, J., Evans, M. J., et al. (2004). "Goal planning: a retrospective audit of rehabilitation process and outcome." Clinical rehabilitation 18(3): 275.Find it on PubMed
Kennedy, P., Evans, M., et al. (2003). "Comparative analysis of goal achievement during rehabilitation for older and younger adults with spinal cord injury." Spinal Cord 41(1): 44-52.Find it on PubMed
Kennedy, P. and Hamilton, L. R. (1999). "The needs assessment checklist: a clinical approach to measuring outcome." Spinal Cord 37(2): 136-139.Find it on PubMed
Webster, G. and Kennedy, P. (2007). "Addressing children's needs and evaluating rehabilitation outcome after spinal cord injury: the child needs assessment checklist and goal-planning program." J Spinal Cord Med 30 Suppl 1: S140-145.Find it on PubMed
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