THE DEVELOPMENT OF AN UNMET NEEDS APPRAISAL SCALE FOR LONG-TERM CARE SERVICE USERS

Abstract

Abstract Background Taiwan’s Long-Term Care (LTC) Plans 1.0 and 2.0 aimed to provide accessible LTC services since 2007. Currently, >40% of the people needing LTC are covered by these plans. Past studies have indicated that high unmet needs among LTC users may lead to adverse outcomes. Thus, whether the LTC services meet the needs of both the care recipients and their family caregivers merits further study. The purpose of this study was to develop a suitable “unmet needs appraisal scale (UNAS) for long-term care service users” and pilot test this tool on older Taiwanese adults. Methods The tool was developed through a systematic literature review. The tool underwent two rounds of the Delphi method with 26 experts, and the tool reached a high consensus among the experts. The UNAS includes 11 items assessing activities that need more assistance, including daily activities, psychological health, and spiritual health. We pilot tested the tool in older Taiwanese adults and examined the tool properties, including reliability and validity. We included short-form 8 as a concurrent validity measure. Result: The survey was conducted in 6 counties, and 255 service user questionnaires were collected. The overall Cronbach's α value was 0.91, indicating good internal consistency. Our confirmatory factor analysis also showed good construct validity [χ2 = 146.514, p < 0.001, CFI = 0.98, RMSEA = 0.06, SRMR = 0.02]. The UNAS scores showed a moderate negative correlation with quality of life scores (r = –0.452, p < 0.001), demonstrating good concurrent validity of the unmet needs scale.