Disabled people and professionals differ in their perceptions of rehabilitation needs

Abstract

Background: This study set out to explore whether there are systematic differences in unmet needs for rehabilitation services and resources as identified by disabled people and nominated key professionals. Methods: A cross-sectional interview survey of 87 pairs of community-dwelling disabled people (aged 16-65) and their nominated key professionals was conducted in southern England. The Southampton Needs Assessment Questionnaire (SNAQ) was used to examine unmet needs and the Office of Population Censuses and Surveys (OPCS) Disability and Severity Scale to examine level of disability. Results: Eighty-seven pairs of disabled people and their nominated key professionals participated. People were severely disabled (median OPCS score 8; interquartile range 6-9). Disabled participants reported significantly more unmet needs than did professionals. There was zero concordance on identified unmet needs between disabled participants and professionals in 56 per cent of cases. Concordance between disabled participants and professionals was significantly better if the disabled participant had reported more unmet needs. There was a trend for general practitioners to be poorer at reporting disabled participants' needs than other professionals. There was fair agreement between disabled participants and professionals in five areas of unmet need only (in descending order): adaptations, physiotherapy, equipment, assistance with 'non-care' activities and the use of a day centre. In all the other areas of unmet need the agreement was poor. Conclusions: Needs for rehabilitation services and resources (for disabled people) are perceived differently by disabled people and professionals. Until we know who is right about rehabilitation needs, it is important to determine both users' and providers' views when planning and commissioning services.