Reliability of the Care and Needs Scale for Assessing Support Needs After Traumatic Brain Injury

Abstract

OBJECTIVE: To investigate the reliability of the Care and Needs Scale (CANS) for measuring the level and types of support needs of people with traumatic brain injury (TBI). METHOD: Interrater reliability was examined in a cohort of 30 community clients with TBI by comparing CANS ratings completed by 2 occupational therapists (OTs) and a case manager. CANS ratings on the same clients were also completed 1 week later to examine test-retest reliability. Reliability of proxy ratings was investigated in a cohort of 40 community clients with TBI by comparing CANS ratings completed by a clinical researcher, multidisciplinary team, relative, and client. RESULTS: Level of support need as measured by the CANS showed excellent interrater reliability both within and across disciplines: ICC = 0.95 between 2 OTs and ICC = 0.93 and 0.96 between OTs and case manager. Test-retest reliability of the CANS over a 1-week period was also excellent (ICC = 0.98). Although the agreement between the clinical researcher and multidisciplinary team was excellent (ICC = 0.92), ICCs with relative and client ratings were variable, ranging from 0.37 to 0.72. CONCLUSIONS: The excellent inter-rater and test-retest reliability findings from this present study, together with the evidence for validity reported previously, indicate that the CANS is a reliable and valid instrument for application in clinical practice.