The SMNA (Berry et al. 2004), extracted from the Needs Assessment Checklist (Kenny & Hamilton 1999), was developed as a post discharge measure to assess client knowledge and ability to perform skin checks, pressure relief and prevention of skin breakdown.  It is based on the individual’s perception of his/her ability to independently perform skin management activities.

Number of items: 14 indicators.

Procedure/Administration: The self-report measure requires individuals to demonstrate or, for an individual with a high lesion, instruct their personal care attendant to perform the activities. Each item on the SMNAC receives a score ranging from 0-3 (0-complete dependence; 1-mostly dependent; 2-moderately dependent; 3-complete independence) or N/A (not applicable, representing no rehabilitation need or goal to be identified).

How scored: The items are summed to generate a total score out of 36. The value reported is a proportion (client score/36).

Interpretability: Higher scores reflect greater independence. No risk specific scores or normative data is available at this time.

Acceptability: N/a

Languages: N/a

Usability: There is minimal patient burden; however, some embarrassment may be evident.

Time to administer: 20 minutes to administer and score

Time to score: None

Training required: None, however, experience with wound care may enhance tool use

Availability:  A copy can be obtained from the author.

Equipment required: None

Summary: The SMNAC provides SCI specific information related to skin management needs. Its score may be used to identify the problems for individuals living in the community to establish priorities and goal setting or to inform community health care professionals about a clients’ ability to manage skin management activities.

Psychometric Summary:

Note: TR= Test re-test; IC= Internal Consistency; Inter-O= Inter-observer; Intra-O= Intra-observer; SS= Sensitivity/Specificity; N/a= No information.

Red light= A single study involving SCI subjects which has less than adequate findings of reliability, validity, and/or responsiveness.

Yellow light= A single study involving subjects with SCI which has adequate to excellent findings of reliability, validity, and/or responsiveness.

Green light= At least 2 studies involving subjects with SCI which have adequate to excellent findings of reliability, validity, and/or responsiveness.

References

• Berry C, Kennedy P, Hindson L. Internal consistency and responsiveness of the skin management needs assessment checklist post spinal cord injury. J Spinal Cord Med 2004;27:63-71.
• Keith RA, Lipsey MW. The role of theory in rehabilitation assessment, treatment and outcomes. In: Glueckauf RL, Sechrest LB, Bond GR, McDonel EC. (ed). Improving Assessment in Rehabilitation and Health. Sage Publications, Newbury Park, CA, 1993, p 33-60.
• Kennedy P, Hamilton LR. The needs assessment checklist: a clinical approach to measuring outcome.  Spinal Cord 1999;37:136-139.