Need assessment 2 55 Table 3. Spearman’s Correlations of patient Characteristics With Total Numbers of Unmet and Total amount of Needs, According to Patients and Staff (N=78) Variable Patient Staff Unmet total unmet total rho p rho p rho p rho p Clinical Age 0.016 p=0.886 0.166 p= 0.145 0.161 p=0.158 0.297 p=0.008 MMSE -0.163 p=0.154 -0.461 p<0.001 -0.129 p=0.260 -0.336 p=0.003 GAFp -.244 p=0.031 -.412 p<.001 -.120 p=0.293 -.468 p<0 .001 CES-D 0.181 p=0.112 0.420 p<0.001 0.049 p= 0.671 0.240 p= 0.034 YMRS 0.142 p=0.216 0.235 p=0.038 0.062 p=0.588 0.153 p=0.181 Social Networksize -0.260 p=0.021 -0.292 p=0.009 -0.128 p=0.266 -0.246 p=0.030 Social participation -0.269 p=0.017 -0.307 p=0.006 -0.332 p=0.003 -0.365 p=0.001 MANSA -0.334 p=0.003 -0.494 p<0. 001 -0.257 p=0.024 -0.343 p=0.002 Note: In bold are the correlations that are statistically significant. MMSE, Mini Mental State Examination; GAFp, Global Assessment of Functioning; CES-D, Center for Epidemiologic Studies Depression Scale; YMRS, Young Mania Rating Scale; MANSA, Manchester Short Assessment of Quality of Life; 2.4 Discussion Our cohort of older patients with bipolar disorder had most of their needs in the items of household skills, physical health and medication. This is in accordance with the literature on older patients and their needs using the CANE (Arvidsson 2001; Hancock et al. 2003; Meesters et al. 2013; Walters et al. 2000). These needs were acknowledged by the staff and mostly met. However, a number of unmet needs were underestimated by staff, especially in the social domain, resulting in one out of five reported needs rated as unmet. These findings are in line with the Cohen’s Kappa, all of the good to very good strength items (k>0.6) were situated in environmental and physical domains, whereas most of the psychological or social items had a poor to fair strength (k<0.4). Although the absolute number of unmet needs was low, it does require the attention of staff since unmet needs impair quality of life (Field et al. 2002; Stein et al. 2014), change the motivation for treatment (Stobbe et al. 2014) and raise the number of contacts with
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