The purpose of this paper is to examine the tools that evaluate on-physical measures while applying Watson’s Theory of Human caring that integrates the mind-body-spirit dimensions to the three assessment tools chosen. In this paper, I will describe each tool and the population for which it might be useful, assessment tool data such as cost, length and each in using the tool. I will also discuss the population at which it is best designed, and the validity of information gained. In addition, how this tool could enhance the assessment phase of the nursing process and how it impact quality of health care delivered by the nurse will be discussed. These assessment tools will be applied to adolescent and teenage pregnancy chosen in Week Two in the Vulnerable Population and Self- Awareness assignment.
Definition of Assessment Tools
Assessment is the deliberate and systematic collection of data to determine the client’s current and past health status and functional status and to determine the client’s present and past coping patterns. Nursing assessment include two steps. The first step involves collection and verification of data from a primary source (the client) and secondary sources (e.g., family, health professionals, and medical record) (Potter & Perry, 2005). Assessment tools are the materials needed to establish data collection. Data collected may be subjective (client’s perception) or objective (data measured by collector). Example of objective data includes client’s body language, facial expression, vital signs e.t.c. The three assessment tools chosen for this paper are: Beck Depression Inventory, Perceived Stress Scale and Well-Being Picture Scale.
Beck Depression Inventory
There are many assessment and diagnostic tools that either measure intelligence, aptitudes, achievements, and behaviors so it was no surprise when Beck Depression Inventory (BDI) was created in 1961 by Aaron T. Beck, a pioneer in cognitive therapy, with the sole purpose of determining the severity and intensity level of the symptoms of depression. Depression Inventory is defined as a validated measure that has been instrumental in leading to numerous diagnoses due to its most recent revisions that more closely resemble the diagnostic criteria for depression (Farinde, 2013). The Beck Depression Inventory is a widely utilized 21-item self-report scale in both clinical and research studies. The most recent version; The Beck Depression Inventory-11 which is a completely self-administered format, is a depression rating that can be used in individuals that are ages 13 years and older, and rates symptoms of depression in terms of severity on a scale from 0 to 3 based on the 21 specific items.
Patients that endorse multiple items on the questionnaire (i.e. sadness, pessimism, past failures, loss of pleasure, guilty feelings, punishment fears, self-dislike, and so forth) typically have higher scores with a maximum score of 63 compared to others. For the general population, score of 21 or greater is associated with depression but for individuals who have been clinically diagnosed, scores from 0-9 represent minimal depressive symptoms, scores of 17 to 29 indicate moderate depression, and scores of 30 to 63 indicate severe depression (Farinde, 2013).
Perceived Stress Scale
Stress has long been a major research concept in health science since it is linked to various health outcomes and illnesses, including cancer, diabetes, cardiovascular disease, asthma, and rheumatoid arthritis (Lee, 2012). The Perceived Stress Scale (PSS) is one of the more popular tools for measuring psychological stress. It is a self-reported questionnaire that was designed to measure “the degree to which individuals appraise situations in their lives are stressful.” The Perceived Stress Scale items evaluate the degree to which individuals believe their life has been unpredictable, uncontrollable, and overloaded during the previous month. The assessment items are general in nature rather than focusing on specific events or experiences (Lee, 2012).
According to Lee (2012), the original instrument is a 14-item scale (PSS-14) that was developed in English, with 7 positive items and 7 negative items rated on a 5-point Likert scale. Five years after the introduction of PSS-14, it was shortened to 10 items (PSS-10). A four-item PSS (PSS-4) was also introduced as a brief version for situations requiring a very short scale of telephone interviews and the PSS is currently translated into 25 languages other than English. The criterion validity of the PSS was evaluated only in a few studies; the criteria used were all questionnaires that showed a weak to moderate association, demonstrating unsatisfactory criterion validity (Lee, 2012).
Well-Being Picture Scale
The theoretical framework that has guided the investigation of well-being from a Rogerian perspective is based upon the observation and measurement of health-related variables that are unique to the Science of Unitary Human Beings. Rogerian-science derived principles and the concepts of well-being. The term well-being, as a measure of health, is compatible with the concepts and variables that are unique to the development of knowledge (Reis and Alligood, 2008). The Well-Being Picture Scale is a 10-item non-language based pictorial scale that measures general well-being within the unique human environment field process. Each item on the scale has a numeric value of I to 7, with 70 being the maximum score possible and 10 being the lowest score possible. Higher scores indicate higher well-being. Conceptually, the instrument appraises the energy field in regard to frequency and intensity of movement, awareness of oneself as energy, action emanating from the energy field, and power as knowing participation in change within the mutual human and environmental energy field process.
The WPS was reported by all participants to be easily understood (Reis and Alligood, 2008). This scale can be used by all individuals regardless of their ethnic groups. How these tools enhance the assessment phase and quality of health care Using the Beck Depression Inventory in the assessment phase of the nursing process will facilitate and aid the treatment of depression in all ages. This assessment tool will aid the early diagnosis of depression and reduce further complications of depression. Depression is common in Adolescents who are undergoing stress as a result of pregnancy, low self-esteem and diseases. The nurse can affect the quality of health care delivered to patients by reassuring them and referring them to appropriate health care providers.
Using Perceived Stress Scale in the assessment phase of the nursing process, the nurse is better able to identify patients at higher risk for stress, help these patients to identify and implement coping skills during difficult times. This process improves the quality of patient care and outcome. Pregnant adolescent undergoes a significant amount of stress and challenges as a vulnerable population. Using the Well Being Picture Scale in the assessment phase of the nursing process, the nurse is better able to detect a patient’s well-being and health. The nurse is able to detect if the patient is healthy or not. This is more of a primary prevention for patients of all ages. This assessment tool is mostly recommended for pregnant women. Health care providers are able to follow up with patients to monitor their wellness or impact of diagnosis on their general health. Application of tools to Adolescent pregnancy
Adolescent girls face pressures that are unique to their population and make them especially vulnerable. Girls carry disproportionate domestic world burden and are denied leadership opportunities and active community affairs (Bailey, 2012). These factors made the life of adolescent girls stressful and complicated which could cause depression. Beck Depression Inventory, Perceived Stress Scale and Well-Being Scale are tools that can be used during the assessment phase of the nursing process in adolescents. Adolescent girls who become pregnant may develop depression while trying to balance school, child, work and relationships, thereby, making all three tools helpful to the nurse during initialInventory, Perceived Stress Scale and Well-Being Scale as assessment tools help facilitate better nurse-patient relationship and better care for our patients
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