The Needs Assessment Checklist (NAC) is an interview-based assessment, measuring patient perception of independence in a range of tasks from 9 SCI-specific rehabilitation domains: activities of daily living (ADL, 29 items), skin management (14 items), bladder management (10), bowel management (7), mobility (17), wheelchair and equipment (33), community preparation (24), discharge coordination (32) and psychological issues (19).
ICF Domain
Activities ▶ Self Care
Administration
- Interview-based assessment
- 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.
- Approximately 60 minutes
Equipment
None
Number of Items
199 Items
Languages
English
Training Required
N/A
Availability
The NAC worksheet can be found here.
Measurement Property Summary
Number of studies reporting psychometric properties: 3
Interpretability
- MCID: not established in SCI population
- SEM: not established in SCI population
- MDC: not established in SCI population
Reliability – Moderate to High
Number of studies reporting reliability data: 3
- Moderate to High test-retest reliability:
- Overall α = 0.8238
- Subscale α = 0.694-0.904
(Berry & Kennedy 2002; n=43; 38 males, 5 females; mean (SD) age: 42.2 (14.6) years; complete and incomplete tetraplegia and paraplegia)
- Moderate to High internal consistency:
- Overall α = 0.83
- Subscale α = 0.6729-0.9467
(Kennedy et al. 2003; n=192; 147 males; 45 females; mean (SD) age: 40.7 (16.5) years, tetraplegia and incomplete SCI)
-
- Overall α = 0.889
- All subscales α = > 0.7
(Kennedy et al. 2012; n=193; 143 males, 50 females; mean age: 46.6 years; tetraplegia and paraplegia; complete and incomplete injuries)
Validity – Moderate to High
Number of studies reporting validity data: 1
- High correlation between the NAC ADL with SCIM-II (r = 0.873), the NAC Bladder & Bowel with SCIM-II (r = 0.754), and the NAC Mobility with SCIM-II (r = 0.696)
- High correlation between the NAC psychological issues (mood subsection) with HADS (r = -0.726).
- Moderate to High correlation between the NAC psychological issues (full subscale) with HADS (r = -0.523).
(Berry & Kennedy 2002; n=43; 38 males, 5 females; mean (SD) age: 42.2 (14.6) years; complete and incomplete tetraplegia and paraplegia)
Responsiveness
No values were reported for the responsiveness of the NAC for the SCI population at this time.
Floor/Ceiling Effect
No values were reported for the presence of floor/ceiling effects in the NAC for the SCI population.
Reviewers
Dr. Carlos L. Cano-Herrera, Tyra Chu
Date Last Updated
December 31, 2024
Berry C, Kennedy P. A psychometric analysis of the Needs Assessment Checklist (NAC). Spinal Cord. 2003;41(9):490-501.
http://www.ncbi.nlm.nih.gov/pubmed/12934089
Duff J, Grant LC, Gilchrist H, Jones K. Building and Sustaining Inpatient-Clinician Collaboration in Spinal Cord Injury Rehabilitation: A Case Example Using the Stoke Mandeville Spinal Needs Assessment Checklist (SMS-NAC) and Goal Planning Programme. J Clin Med. 2022; 11:3730. doi: 10.3390/jcm11133730.
https://pubmed.ncbi.nlm.nih.gov/35807024/
Eaton R, Duff J, Wallace M, Jones K. The value of the whole picture: rehabilitation outcome measurement using patient self-report and clinician-based assessments after spinal cord injury. Spinal Cord. 2022; 60: 71-80. doi: 10.1038/s41393-021-00677-7.
https://pubmed.ncbi.nlm.nih.gov/34616008/
Kennedy P, Smithson EF, Blakey LC. Planning and structuring spinal cord injury rehabilitation: the needs assessment checklist. Top Spinal Cord Inj Rehabil. 2012 Spring;18(2):135-7.
https://pubmed.ncbi.nlm.nih.gov/23459415/
Kennedy P, Evans MJ, Berry C, Mullin J. Comparative analysis of goal achievement during rehabilitation for older and younger adults with spinal cord injury. Spinal Cord. 2003;41(1):44-52.
http://www.ncbi.nlm.nih.gov/pubmed/12494320
