Assessment Tool Analysis: 'American Nurses Association'

Assessment Tool Analysis
NUR/440 Version 3
October 22, 2012
Sheila De Vaugh, APRN, BC

Assessment Tool Analysis Paper

The “American Nurses Association” (2012) website describes the nursing process as assessment, diagnosis, outcomes/planning, implementation, and evaluation. Another important tool is getting to know the patient, to get a full picture of the patient’s physical and mental status. Although there are several assessment tools that can be used, three tools were chosen for the purpose of this paper The Well-Being Picture Scale, the Beck Depression Inventory, and the Norbeck Social Support Questionnaire. Being informed about Watson’s caring theory and applying previous nursing knowledge allows the nurse to use these assessment
tools to help with the effectiveness of patient’s psychological well-being, and to implement a plan by providing optimum holistic care based on patient’s needs.

Well- Being Picture Scale
According to Reis and Alligood (2008) “The well-being picture scale is a 10-item non-language based pictorial scale based on Rogerian science that measures general well-being within the unique human-environmental field process.” (p.8). The scale has two pictures with a number value between the two ranging from 1 to 7. Seventy is the highest score possible and 10 the lowest. Patients are asked what picture they feel most like.
Higher scores indicate a higher level of well- being. Low scores indicate a lower level of well-being. The test is easy to administer and can be used on anyone. It is especially easy to be used with people who don’t speak English, the elderly, seriously ill, and young children.
Figure 1. Sample items from the Well-being Picture Scale.

Source: Gueldner, S.H., Michel, Y., Bramlett, M.H., Liu, C.F., Johnston, L.W.,
Endo, E., Minegishi, H., & Carlyle, M.S. (2005). The well-being picture scale. A revision of the index of field energy. Nursing Science Quarterly, 18 (1), 48

By using this test, health care providers can get a sense of how the patient is feeling in regards to well- being. Sometimes in the seriously ill, elderly, and minority groups, nurses do not get a sense of how the patient is truly feeling. This can be due to many factors such language barriers, inability understand verbal questions, and difficulty hearing. Data suggests that there is validity to the well-being picture scale when used on the Hispanic population, elderly, and young children. Provided that health care facilities would allow such a test to be used during the admission assessment phase is unknown, but the WPS would show to be useful in helping the nurse make proper decisions and referrals based on the results.

Beck depression Inventory
The beck depression inventory (BDI) is an instrument created to measure the intensity, severity, and depth of depression in patients with psychiatric diagnosis (Beck, 2006). The BDI is useful for assessing adults and adolescents 13 years and up. The instrument is easy to use and takes about 15 minutes. There are 21 questions, each question is given a range from zero to three. At the end of the questionnaire, scores are tallied, the higher the score, the greater the depression. A very low score indicates no depression, just normal ups and downs. This is not a diagnostic tool, but rather a tool to determine the how bad the symptoms are so treatment can be recommended if needed.
The validity of the BDI has shown to be consistent. According to Eack and Greeno (2008) “The BDI has been a subject to a large number of psychometric evaluations among a variety of populations, which has shown that the instrument is highly consistent, temporarily reliable, and converges with other measures of depressive symptomology, such as a structured clinical interview when used in a community setting.” (p. 467). Although there has been much research done on various populations, there is not much data to support whether the BDI is the best screening tool for the elderly or the minority population.
This test can be used by nurses or other qualified health care professionals on patients showing signs of depression. The severity could be documented, and professional recommendations could be made or instituted based on findings.

Social support questionnaire
The Norbeck Social Support Questionnaire (NSQQ) is a network-based social support inventory. It was created to measure three functional types of social support, affect, affirmation, and aid. (Gigliotti & Samuels, 2011).
This questionnaire is also done by the patient or the person taking the questionnaire with no support from an interviewer.
The patient chooses up to 24 networks and specifies the relationship (spouse, parent, friend etc.), people who provide personal support to the participant. The person involved lists and rates how much affection, affirmation, and aid each network member provides rating each member (0-4) on six functional support questions measuring the three types of support: affect, affirmation, and aid. According to Gigliotti & Samuels, 2011, example questions are as follows. “Affect: How much does this person make you feel liked or loved? Affirmation: How much can you confide in this person? Aid: If you needed to borrow $10, a ride to the doctor, or some other immediate help, how much could this person usually
help?” The NSQQ has been used in different populations.
Most studied are women at the child bearing age, but other populations have been studied with fewer results provided. Information on how long the test takes to complete could not be obtained. NSSQ would be beneficial prior to any medical or surgical procedure, during the primary assessment to hospital stay, primary care physicians’ office, and a mental health facility. There have been several studies that have shown that social support can lead to a more positive outcome after a procedure, stroke or myocardial infarction (Gordy, 1996). Watson’s theory on caring is being utilized by the nurse when he her she takes the extra time during assessment phase. The nurse can determine how the patient is doing psychologically and apply this knowledge to the nursing processes to implement a plan of care based on the patient’s physical and psychological needs.
Well-being and social support are essential to providing quality care to the patient. Using the results from the tools discussed and using Watson’s theory will allow the nurse to practice the art of caring, provide compassion, and promote healing while using previous nursing knowledge and implementing care to the best of the nurses ability. According to Peterson (2000), “Through the use of the nursing process, nurses can completely utilize social support to enhance health and promote effective coping for the clients facing uncertainties.”
(p.1)

Resources
American nurses association. (2012). Retrieved from http://www.nursingworld.org
Beck, A.T., Steer,R.A., & Brown, G.K. (2006). RCMAR measurement tools. Retrieved from http://www.musc.edu/dfm/RCMAR/Beck.hyml
Chantal, C. (2003). A pragmatic view of Jean Watson's caring theory. International Journal for Human Caring, 7(3), 51-61.
Eack, S.M., & Greeno, C.G. (2008, May). Screening for anxiety and depression in community mental health: The beck and depression inventories. Journal of Mental Health, 44(), 465-474.
Gigliotti, E. (2002, September/October). A confirmation of the factor structure of the Norbeck social support questionnaire. Nursing Research, 51(5), 276-284.
Gigliotti, E., & Samuels, W.E. (2011). Use of average Norbeck social support questionnaire scores. ISRN Nursing, 2011(), 1-6.
Gordy, M. (1996). . Retrieved from http://www.hon.ch/library/papers/gordy.html
Peterson, J.A. (2000, June/July). Nurses providing social support now and in the future. Kansas Nurse, 75(6), 1-6.
Reis, P.J., & Alligood, M.R. (2008). Well-Being in pregnancy: A pilot study using the well-being picture scale. Visions, 15(1), 8-17.