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The emotional needs audit (ENA): a report on its reliability and validity

Anna Tsaroucha (Staffordshire University, Stoke-on-Trent, UK)
Paul Kingston (Staffordshire University, Stoke-on-Trent, UK)
Nadia Corp (Keele University, Stafford, UK)
Tony Stewart (Staffordshire University, Stoke-on-Trent, UK)
Ian Walton (Horseley Heath Medical Centre, Birmingham, UK)

Mental Health Review Journal

ISSN: 1361-9322

Article publication date: 22 June 2012




To broaden the range of well-being outcomes that can be measured for patients with depressed mood and/or other mental health issues the aim is to determine the reliability and validity of a self-reported instrument that was designed by the Human Givens Institute to evaluate emotional distress (emotional needs audit – ENA).


The ENA was administered to 176 patients, aged between 18-65 years (mean age: 39.2 years). The acceptability of the ENA was examined as well as its internal consistency (Cronbach ' s alphas). ENA was administered at four time points and test-retest reliability was conducted between times 1 and 2. The data from three scales also administered to these patients (SWLS, CORE-OM and HADS) were used to aid the conduct of the ENA construct validity (concurrent and discriminant). Analysis of the ENA sensitivity/specificity was also performed.


All the ENA items (except one) were shown to have good acceptability. The internal consistency was also very strong (Cronbach ' s alpha: 0.84); the construct validity also revealed positive results for the ENA: concurrent validity (r=0.51-0.62; p < 0.001); discriminant validity (r=0.22-0.28; p < 0.01). Test-retest reliability was r=0.46 (p < 0.001). Finally, ENA demonstrated high sensitivity (80 per cent), and moderate specificity (35 per cent).


ENA was shown to be a valid and reliable instrument for measuring wellbeing, quality of life and emotional distress. It also allows insight into the causes of symptoms, dissatisfaction and distress. It is suggested that this tool has complementarity to standardised tools when used in clinical practice.



The authors would like to acknowledge the support and contribution from the many people involved in this project: the project reference group, the GPs and staff at the practices that participated in the study. Last, but not least, they would like to thank all the patients who participated in this study and made this validation possible.


Tsaroucha, A., Kingston, P., Corp, N., Stewart, T. and Walton, I. (2012), "The emotional needs audit (ENA): a report on its reliability and validity", Mental Health Review Journal, Vol. 17 No. 2, pp. 81-89.



Emerald Group Publishing Limited

Copyright © 2012, Emerald Group Publishing Limited

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