Support Needs Approach for Patients (SNAP) tool: a validation study

Abstract

ObjectivesPatient-identified need is key to delivering holistic, supportive, person-centred care, but we lack tools enabling patients to express what they need to manage life with a long-term condition. The Support Needs Approach for Patients (SNAP) tool was developed to enable patients with advanced chronic obstructive pulmonary disease (COPD) identify and express their unmet support needs to healthcare professionals (HCPs), but its validity is unknown. This study aimed to establish face, content and criterion validity of the SNAP tool.DesignTwo-stage mixed-methods study involving patients with advanced COPD and their carers. Stage 1: Face and content validity assessed though focus groups involving patients and carers considering appropriateness, relevance and completeness of the SNAP tool. Data were analysed using conventional content analysis. Stage 2: Content and criterion validity assessed in a postal survey through patient self-completion of the SNAP tool and disease impact measures (Chronic Respiratory Questionnaire, COPD Assessment Test, and Hospital Anxiety and Depression Scale). Content validity assessed using summary statistics; criterion validity via correlations between tool items and impact measures.Settings and participantsTwo hundred and forty patients and carers participated. Stage 1 patient and informal carer participants were recruited from two primary care practices and Stage 2 patients from 28 practices. Participating practices located in the East of England were recruited via the NIHR Clinical Research Network: Eastern.ResultsPatients and carers found the tool patient-friendly and comprehensive, with potential clinical utility. No tool items were redundant. Clear correlations were found between tool items and the majority of items in the impact measures.ConclusionsThe SNAP tool has good face, content and criterion validity. It has potential to support the delivery of holistic, supportive, person-centred care by enabling patients to identify and express their unmet support needs to HCPs.

Understanding how the Support Needs Approach for Patients (SNAP) enables identification, expression and discussion of patient support needs: A qualitative study

“…The SNAP 12,13 operationalises delivery of holistic person-centred care, providing an alternative to HCP-led approaches to identifying and addressing patient support needs. When…”

“…direct consideration of their unmet support needs). 11 The Support Needs Approach for Patients (SNAP) 12,13 provides an alternative to such HCP-led indirect approaches. Modelled on the internationally recognised evidence-based Carer Support Needs Assessment Tool Intervention (CSNAT-I) for informal carers, 14,15 SNAP is an intervention which operationalises delivery of holistic person-centred care for patients with chronic or progressive conditions.…”

‘I’m fine!’: Assertions of lack of support need among patients with chronic obstructive pulmonary disease: A mixed-methods study

“…It may be that patients with COPD who have difficulty expressing their support needs would benefit from structured forms of help with this. 23 , 24 …”

Face and content validity of the Carer Support Needs Assessment Tool (CSNAT), and feasibility of the CSNAT intervention, for carers of patients with chronic obstructive pulmonary disease

“…To enable participation, we used previously employed successful strategies including hiring attractive venues chosen with participant accessibility, comfort and convenience in mind: hotel meeting rooms (n = 3) and a community centre. 15 Refreshments were provided and travel costs reimbursed. Before the focus group discussion commenced, written informed consent was obtained and participants completed a brief demographics questionnaire.…”