Assessment Tools in Nursing

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Table of Contents

Introduction
Dysfunctional Attitude Scale
Mini-Mental state exam
Adult Life Stress Measurement
Conclusion
References

Introduction

The assessment tool is intended to review the nursing requirements of an older person requiring long-term care. The tool is intended to summarize a methodical formulation to evaluation at the same time implementing specialized decision-making that takes place in the associations among a nurse and another individual. For this cause, the tool receives the assessment through an arranged approach, moving from a broad ‘narrative-based measurement of ‘domains’ of care need to a concentrated evaluation of features of possibility and complication.

Dysfunctional Attitude Scale

Form A of the Dysfunctional Attitude Scale (DASA; Weissman, 1979; Weissman & Beck, 1978) is a 40-item self-report feedback form intended to gauge the suppositions and attitudes connected with the cognitive content of depression (Beck, 1976). According to Beck’s hypothesis, these statements and beliefs reproduce fairly steady and lasting cognitive outlines that influence the association of previous experience, understanding of present experiences, and expectations about potential experiences. Dysfunctional models are assumed to take action as cognitive vulnerabilities that act together with pertinent ecological significance to set off and uphold clinical symptoms of the disease, especially depression.

The DAS-A is one of the most widely used measures of dysfunctional attitudes and has been frequently engaged to test Beck’s cognitive vulnerability stress model of depression (e.g., Hankin, 2005). It has also been used as a gauge of results for the management of depression (e.g., Blatt, 1995). Even though a large amount of this investigation employs the total score acquired from the DAS-A, more current studies (e.g., Blatt et al., 1995) has started on using subscales meant at tapping into further precise extents of cognitive susceptibility, particularly an accomplishment measurement (also pertained to as Performance Evaluation, Perfectionism, etc.) and an interpersonal dimension (Need for Approval, Dependency, etc.).

Since the DAS-A total score and subscale scores are so extensively used, it is significant to appreciate the feature organization of the DAS-A. Studies using a total score create the unspecified supposition that the gauge exhibit a common factor that accounts for the greater part of the whole discrepancy of the scale scores, therefore representing that the entire score is a measure of a particular construct (Revelle, 1979).

It is above all important to understand the DASA factor associations in an adolescent population where depression is frequent. Results from a 10-year longitudinal study demonstrate depression occurrence rates increasing from 3% at age 15 to 17% at age 18 (Hankin et al., 1998), and one more study illustrates an apparent and sharp point of variation in depression vulnerability rate curves between ages 15 and 19 (Burke, 1990). Particular in the increase in rates of clinical depression throughout this life stage, adolescent samples are perfect for studying the functions of detailed cognitive susceptibilities and environmental significance in the beginning and protection of depressive symptomatology.

Mini-Mental state exam

The Mini-Mental State Examination (MMSE) is a generally used assessment tool for determining disease intensity and dementia development in Alzheimer’s disease (AD) (Folstein, 1975). MMSE consists of stuff that assesses orientation, attention, working memory, executive function, language, and immediate and delayed verbal recall (Strauss, 2006). Every item is practically relying on understanding oral directions and reacting orally, by talking or writing. Studies have exposed that over time, patients with AD demonstrate a steady decrease in their MMSE scores (Apostolova, 2006). Though, there has been a modest investigation on the usefulness of this assessment to follow the development in non-AD dementias.

Numerous studies have used the MMSE to gauge the rate of cognitive diminution in patients with FTLD. One study establish that patients with bvFTD showed a standard yearly decline of 6.7 points on the MMSE, considerably better than the 2.3-point yearly decline displayed by patients with AD (Rascovsky et al, 2005). In contrast, additional studies have accounted that patients with bvFTD demonstrated fewer declines on the MMSE than patients with AD (Pasquier, 2004).In recent times, the amount of cognitive decrease calculated by the MMSE has been evaluated in the language and behavioral deviations of FTLD and AD patients (Chow, 2006).

Given some of the boundaries of the MMSE for determining the cognitive decrease in non-AD dementias, measurements of ADL may be more dependable in following disease intensity and development in these non-amnestic conditions (Kertesz, 2003). Even though several research have evaluated the rate of decline on the

MMSE among AD and the deviations of FTLD (Rascovsky et al, 2005), no studies have contrasted rates of decline in bvFTD and PPA as calculated by the MMSE against a gauge of ADL (Chow, 2006). Osher et al (2008) support and suggest that both the MMSE and ADLQ may be sufficiently measured to follow severity and disease development in bvFTD. Osher et al (2008), suggest that the MMSE is successful in identifying and staging the indications that go with frontal lobe worsening, which comprise behavioral disinhibition as well as, awareness, working memory, and decision-making functions insufficiency.

Adult Life Stress Measurement

Stress is involving several factors and multifaceted perception, which involves a course caused by several factors (i.e. hereditary and environmental and their connections), and personality dissimilarities (i.e. prior vulnerabilities, capability to manage) and this process is the basis for change in hypothetical stability within physiological systems, which is normally seen as a contributor to disease (Le Moal, 2007).

To recognize this stress model and to build up well-organized involvement programs, significant and practical measurement methods are vital (Wietzman , 2004). There are numerous diverse measurement techniques, of which biochemical and physiological measures are often long and not easy to deal with and understand (Noble, 2002). Questionnaires may be the most complete method to assess stress frequently, and particularly in great samples. There are several questionnaires, measuring dissimilar features of stress (Cohen, 1997). Some of these questionnaires are inadequate by their duration and too much respondent load. Shorter instruments are particularly advantageous in clinical settings as well as in longitudinal studies, but these are less in amount (Coste, 1997).

To find out the value of a questionnaire, numerous diverse measurement properties such as internal consistency and construct validity are to be measured (Terwee, 2007). The time, effort, and additional burdens to be found on those to whom the tool is managed, or on those who administer the instrument, are also imperative (SACMOTA, 2002).

The Arnetz and Hasson Stress Questionnaire were developed as an open web-based instrument for normal individual evaluation (www.pql.se). The most pertinent areas were established to be present health status, capability to sleep, skill to concentrate, worldwide stress height, power, life has power over, and social existence.

The questionnaire includes Seven Visual Analogue Scales (VAS), one for every part. VAS is an easy technique for gauging personal experience and is particularly appropriate for measuring complex constructs known to change, such as stress (Hasson , 2005). Characteristically, respondents are required to put a mark on a 100-millimeter line attached at each end by differing statements relating to the least and maximum boundaries of the measurement being calculated. Because the Arnetz and Hasson Stress Questionnaire is composed of seven scales, the least score for the complete questionnaire is zero points, whereas the maximum score is 700 points.

Conclusion

Wholistic care is generally documented as a foundation of nursing practice. The standard of nursing holds completeness (Newman, 1997). It would be supportive to offer nurses and nursing undergraduates customary, as well as unconventional, practices and tools that possibly will improve their understanding of the profession’s holistic example.

References

Weissman, A. N. (1979). The Dysfunctional Attitude Scale: A validation study. Dissertation Abstracts International, 40, 1389B-1390B.

Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.

Hankin, B. L., Abramson, L. Y., Moffitt, T. E., Silva, P. A., McGee, R., & Angell, K. E. (1998). Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107, 128-140.

Hankin, B. L., Fraley, R. C., & Abela, J. R. Z. (2005). Daily depression and cognitions about stress: Evidence from a traitlike depressogenic cognitive style and the prediction of depressive symptoms in a prospective daily diary study. Personality Processes and Individual Differences, 88, 673-685.

Blatt, S. J., Quinlan, D. M., Pilkonis, P. A., & Shea, M. T. (1995). Impact of perfectionism and need for approval on the brief treatment of depression: The National Institute of Mental Health Treatment of Depression Collaborative Research Program revisited. Journal of Consulting and Clinical Psychology, 63,125-132.

Revelle, W. (1979). Hierarchical cluster analysis and the internal structure of tests. Multivariate Behavioral Research, 14, 57-74.

Burke, K. C., Burke, J. D., Regier, D. A., & Rae, D. S. (1990). Age at onset of selected mental disorders in five community populations. Archives of General Psychiatry, 47, 511-518.

Osher, Jason E. Wicklund, Alissa H. Rademaker, Alfred. Johnson, Nancy and Weintraub,Sandra. (2008). The Mini-Mental State Examination in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia Am J Alzheimers Dis Other Demen; 22; 468. Web.

Folstein MF, Folstein SE, McHugh PR. (1975 ). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res.12:189-198.

Strauss E, Sherman E, Spreen O. (2006). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. 3rd ed. New York, NY: Oxford University Press.

Apostolova LG, Lu PH, Rogers S, et al. (2006). 3D mapping of Mini-mental State Examination performance in clinical and preclinical Alzheimer disease. Alzheimer Dis Assoc Disord.20:224-231.

Rascovsky K, Salmon DP, Lipton AM, et al. (2005). Rate of progression differs in frontotemporal dementia and Alzheimer disease. Neurology.;65:397-403.

Pasquier F, Richard F, Lebert F. (2004). Natural history of frontotemporal dementia: comparison with Alzheimer’s disease. Dement Geriatr Cogn Disord.17:253-257.

Chow TW, Hynan LS, Lipton AM. (2006). MMSE scores decline at a greater rate in frontotemporal degeneration than in AD. Dement Geriatr Cogn Disord.22:194-199.

Kertesz A, Davidson W, McCabe P, Munoz D. (2003). Behavioral quantitation is more sensitive than cognitive testing in frontotemporal dementia. Alzheimer Dis Assoc Disord.17:223-229.

Le Moal M. (2007). Historical approach and evolution of the stress concept: A personal account. Psychoneuroendocrinology. 32:S3–S9.

Wietzman ER. (2004). Poor mental health, depression, and associations with alcohol consumption, harm, and abuse in a national sample of young adults in college. J Nerv Ment Dis. 192(4):269–77.

Noble RE. (2002). Diagnosis of stress. Metabolism. 51(6):37–9.

Cohen S, Kessler RC, Gordon LU, editors. (1997). Measuring stress: a guide for health and social scientists. [New York: Oxford University Press].

Coste J, Guillermin F, Pouchot J, Fermanian J. (1997). Methodological approaches to shortening composite measurement scales. J Clin Epidemiol. 50(3): 247–52.

Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 60:34–42.

Scientific Advisory Committee of the Medical Outcomes Trust. (2002). Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res. 1:193–205.

Hasson D. (2005). Stress management interventions and predictors of long-term health. Prospectively controlled studies on long-term pain patients and a healthy sample from IT- and media companies. Doctoral thesis, Uppsala University, Interfaculty Units, Acta Universitatis Upsaliensis. 103(11):840–43.

Newman, M.A. (1997). Experiencing the whole. Advanced Nursing Science, 20(1), 34-39.

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