Validity of CSNAT in COPD - PEOLC15


Informal carers of patients with Chronic Obstructive Pulmonary Disease (COPD) have unmet support needs related to their caring role as well as in relation to their own health and wellbeing. Evidence relating to carers’ support needs in chronic conditions led to amendment of the Carer Support Needs Assessment Tool (CSNAT) which forms part of an intervention to identify and address carer support needs (CSNAT-I: This study explored whether this revised version of the CSNAT (CSNAT v3) was valid for COPD carers and how the CSNAT Intervention could be delivered to COPD carers.


Informal carers (family and friends in a supportive role to patients) are an important source of support for patients with chronic obstructive pulmonary disease (COPD) but have unmet support needs relating to both their caring role and their health and wellbeing. The Carer Support Needs Assessment Tool (CSNAT) underpins a carer-led intervention designed to identify and address carers’ unmet support needs, which practitioners are well-placed to facilitate. CSNAT v3 was informed by evidence relating to carers’ support needs in chronic conditions and may be suitable for use with COPD carers, but we needed to establish if the new version of the tool was valid for this group. There are two types of validity that we wanted to explore: face and content validity. Face validity tells us whether those who are using the tool feel it covers what it says it does, and content validity tell us whether it covers all the aspects it should – so it is comprehensive for COPD carers’ support needs.


To establish the whether the latest version of the Carer Support Needs Assessment Tool (CSNAT v3) is valid for COPD carers (in terms of its face and content validity) and to explore COPD carers’ views on delivery of the CSNAT Intervention in practice.


We conducted four focus groups between September-October 2019 in non-clinical settings (hotels and a community centre) involving eleven COPD carers (two to six participants per group). Two COPD patients attended one group in order that their carer could attend. Carers and and patients were recruited from British Lung Foundation Breathe Easy support groups.

The focus groups explored the relevance of the CSNAT v3 to COPD carers and COPD carers’ views on delivery of the CSNAT Intervention in practice. The groups were audio-recorded and the recordings transcribed and anonymised. The transcripts were then reviewed and analysed.

Outputs and potential impact

COPD carers found the CSNAT v3 easy to understand and complete, and all 15 questions on the tool were considered relevant and appropriate, suggesting good face and content validity with COPD carers.

In terms of delivering the CSNAT Intervention to COPD carers, we found that the demeanour, relational skills, knowledge and personal qualities of the CSNAT facilitator appeared more important to carers than being a certain type of practitioner. COPD carers considered the CSNAT Intervention (using CSNAT v3) an acceptable way of identifying and responding to their needs, and the intervention could potentially to be delivered through a range of services.

The findings of the study are being shared through:

  1. conferences aimed at health and social care practitioners and researchers
  2. publication of a paper in an academic journal
  3. briefing paper to the CCG
  4. social media (via team members’ Twitter accounts)
  5. CSNAT related meetings and webinars for health and social care staff

Funded by RCF from the Norfolk and Waveney CCGs, administered by the Norfolk and Suffolk Primary and Community Care Research Office

Related project - PEOLC07 – SUPPORT Programme (SNAP-CSNAT dyadic intervention in multi-morbidity)

PI - Morag Farquhar (University of East Anglia)

Researchers and institutions - Morag Farquhar & Kerry Micklewright (University of East Anglia)

Corresponding researcher - Morag Farquhar