What is the FNQ-P?

The Family Needs Questionnaire – Pediatric Version (FNQ-P), which consists of 40 items, provides clinicians with a tool for assessing the degree to which the unique needs of families have been met across six categories: Health Information, Emotional Support, Instrumental/Practical Support, Community Supports, Professional Support, and Involvement with Care. The self-administered FNQ-P is suitable for use with families of children and youth with acquired brain injury across the care continuum (i.e. acute rehabilitation, post discharge, and in the community).


How was the FNQ-P developed?

The FNQ-P was developed by Caron Gan (RN, MScN, RP, Advanced Practice Nurse/Family Therapist, Clinical Team Investigator) and Virginia Wright (PT, PhD, Senior Scientist - Professor) and at Holland Bloorview Kids Rehabilitation Hospital with funding from the Centre for Leadership in Acquired Brain Injury and Holland Bloorview Chair in Pediatric Rehabilitation (held by Wright).

In response to the identified clinical and research gap around the needs of families of children and adolescents with acquired brain injury (ABI), development and validation of the Family Needs Questionnaire – Pediatric Version (FNQ-P) was conducted across a three-phase Research Ethics Board approved study which was carried out from 2014 to 2017.

In phase I, we adapted the well-validated adult Family Needs Questionnaire (FNQ-R) (Kreutzer, Serio, & Bergquist, 1994) with permission from the lead author. The original FNQ-R was designed for use with caregivers of adults with a brain injury to provide information on family needs at varying post-injury time intervals. Based on a factor analysis, six factors were identified and labeled as FNQ subscales: Health Information, Emotional Support, Instrumental Support, Professional Support, Community Support Network, and Involvement with Care (Serio, Kreutzer, & Witol, 1997). The FNQ-R in adult rehabilitation programs has been used extensively in research of families after brain injury.

Using a modified Delphi process involving 11 clinicians and seven caregivers, the adult FNQ-R was adapted so that it can be used with families of children and adolescents with ABI. The item content for the pediatric version, Family Needs Questionnaire – Pediatric Version (FNQ-P) was developed over 3 rounds of anonymous voting and revisions.

In phase II of our research, we established the face and content validity of our FNQ-P. In phase III, we established its test-retest reliability within a four centre international validation study involving partners from Astrid Lindgren Children’s Hospital in Sweden, Sydney Children’s Hospital in Australia, and the Children’s Rehabilitation Hospital in Lithuania. FNQ-P test-retest reliability was evaluated via intraclass correlation coefficients (ICCs) (target ICC > 0.80, with lower limit 95%CI > 0.70). The FNQ-P demonstrated good test-retest reliability across the four international sites .

Construct validity testing was conducted across these same four sites and a fifth site, the Children’s Trust for Children with Brain Injury in the United Kingdom. Construct validity was  evaluated using Pearson correlation with a target r > 0.70 to indicate moderate to strong association between the FNQ-P and the parent completed Family of Burden of Injury Inventory [FBII; short form] and Strengths and Difficulties Questionnaire [SDQ]. The lack of relationship between FNQ-P score and age, injury severity, or time post-injury suggests family needs that are independent of these factors. The weak association with family burden suggests that family needs require assessment regardless of level of burden. The lack of association with SDQ scores suggests that family needs are independent of problems experienced by the child. The important message from this is that it is essential to assess family needs directly since needs cannot be assumed based upon the characteristics of the child, the injury, or burden reported by family.

References:

Burgess, E.W., Drotar, D., Taylor, H.G., et al. (1999). The Family Burden of Injury Interview: reliability and validity studies. J Head Trauma Rehabil. 14(4), 394-405.

Goodman, R. (1997). The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 43:1159-1167.

Kreutzer, J., Serio, C., & Bergquist, S. (1994). Family needs after brain injury: A quantitative analysis. Journal of Head Trauma Rehabilitation. 9(3):104-115.

Serio, C, Kreutzer, J & Witol, A. (1997). Family needs after traumatic brain injury: a factor analytic study of the Family Needs Questionnaire. Brain Injury, 11(1):1-9.


How is the FNQ-P administered?

Detailed instructions for completing the questionnaire are provided at the start of the FNQ-P. For each item, the family member respondent is asked to indicate whether each need has been ‘not at all met’, ‘met very little’, ‘somewhat met’, ‘met a lot’, or ‘completely met’ by circling the corresponding number below. For needs that are not applicable at the time of administration, the respondent checks the ‘not needed’ box.

After completion of the FNQ-P, the clinician should review the form with the respondent(s) and request completion of any omitted items. Detailed administration guidelines are in the FNQ-P manual, available for free download through Flintbox, a third-party site.

To access the FNQ-P, visit Flintbox.

You will be required to set up a Flintbox account (free of charge) and provide your email address. Flintbox will only use your email to confirm your download.


How are the FNQ-P scores used and reported?

Detailed FNQ-P scoring, and interpretation guidelines are in the FNQ-P manual, available for free download through Flintbox, a third-party site.

To access the FNQ-P, visit Flintbox.

You will be required to set up a Flintbox account (free of charge) and provide your email address. Flintbox will only use your email to confirm your download.


What do the FNQ-P items look like?

Please visit FNQ-P Sample Items 2017.