Objective and Subjective, Paediatric and Geriatric Assessments

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Table of Contents

Introduction
Health Assessment
Objective and Subjective Assessment
Paediatric and Geriatric Assessment
Conclusion
Reference List

Introduction

Assessment is the first step in health service provision. A health service provider must be able to receive all necessary information before making a decision. Assessment is usually a challenging task. Without taking dire care in assessment, a health care provider may end up making an erroneous conclusion over a client’s health needs. The consequences of erroneous assessment may be severe especially when the wrong health service is provided. Because of the varying nature of patients, assessment should be conducted depending on a client. Because of their nature, assessment for pediatric and geriatric clients cannot be the same as in other clients. The paper evaluates the aims of subjective and objective assessment and proposes that objective assessment is vital in assessing pediatric and geriatric clients.

Health Assessment

Assessment is defined as the process through which a health service provider such as a physician or a nurse collects and interprets data about a client.

Assessment is the first step taken in health provision. After a health service provider receives a client, he/she have to assess the client to decide on appropriate health service (Keller & Weber, 2009, p. 67). In essence, the effectiveness of health care services is highly dependent on the accuracy of data collected during the assessment. Failure at the assessment stage can compromise the whole process of health care provision. The main objective of the assessment is to collect the necessary data required in deciding on a client’s health needs and the services that should be provided. Information about a client is required in health care provision. This information is made available through various types of assessment. There are four types of assessment. They include initial assessment, ongoing partial assessment, problem-oriented, and emergency assessment. The initial assessment is a major assessment that is conducted before health care provision begins. This assessment aims at obtaining a comprehensive account of the health state of a client, which includes medical health history (Thompson & Bowers, 1992, p. 56). Ongoing assessment consists of progressive data that is collected about a client. This assessment is aimed at assessing the progress of a patient and enables time intervention. A problem-oriented assessment is a comprehensive assessment that is conducted on a specific client’s health concerns. Emergency assessment, on the other hand, constitutes of assessment that is conducted during a life-threatening situation.

Objective and Subjective Assessment

Objective and subjective assessments are the basic methods of conducting a health assessment. Both methods are important and provided data that can supplement each other. By conducting an objective assessment after a subjective assessment, a health service provider is able to obtain important information about a client’s health situation and be able to decide on health care services to provide (Keller & Weber, 2009, p. 107).

The subjective assessment aims at obtaining subjective data about a client. Subjective data consist of data on health history that is obtained directly from a client. The data consist of the actual reasons as to why an individual visits a health service. A health service provider such as a nurse uses interviewing skills to obtain the data. Subjective data include the patient’s main complaint, history of the current health concern, medical history, related health history of family members, an account of daily activities, and psychosocial history (Thompson & Bowers, 1992, p. 53). The data is an account of a client’s personal experience on a health concern.

A client provides the symptoms that he/she observes and enables a health provider to make the judgment of health needs. The accuracy of subjective data is highly dependent on a patient. A patient must be able to communicate the symptoms in a clear manner to enable a health service provider to make a conclusive decision. About eighty percent of diagnoses can be made accurately by using accurate subjective data.

Subjective data has to be verified by a client. The data can be obtained from a client, the client’s family, and that close. The data can also be obtained from a client record or reported from other health care providers. The main method of obtaining this data is through interviewing the client (Thompson & Bowers, 1992, p. 61). To obtain the data, a health provider requires having good interpersonal and interviewing skills. The health care provider must have good communication and listening skills. He/she must also be able to show empathy in order to motivate a client to provide all important information.

After the subjective assessment is conducted, a health care provider needs to conduct an objective assessment to verify findings. Objective assessment leads to objective data that can be obtained through inspection, palpation, auscultation, or percussion. The data is obtained physical examination of a client. A health care professional is guided by the health history obtained from a patient. Data collected through objective assessment includes physical characteristics such as posture and color, body functioning such as respiratory and heart rate, appearances such as hygiene and dressing. Objective data also includes data collected using assessment instruments such as temperature, blood pressure, weight, or weight. Results derived from laboratory testing also constitute objective data (Stevens, 2004, p.89).

General observation and use of the four physical assessment techniques of inspection, percussion, palpation, and auscultation are used to obtain objective data. Objective data can also be obtained from the client’s medical record, which constitutes report on the assessment carried out by other health professionals. Family members or people close to a client can also contribute to objective data. Objective assessment plays an important role in health assessment. Data collected through this process is objective and less likely to be biased. Through objective assessment as a health care professional can verify symptoms narrated by a client.

Paediatric and Geriatric Assessment

The pediatric and geriatric clients are special in a way. Both have limitations that cannot allow health assessment for normal clients. The unique nature of children calls for a unique assessment procedure. A child has low cognitive and communication development. The child’s parents or caretakers are responsible for reporting a child’s health concern. Young children cannot be able to communicate their feeling. Even older children who can be able to communicate, may not be able to communicate clearly to support a decision. Geriatric clients also have limitations that can hinder health assessment. Some of the clients may have lost memory or other capabilities. Limitations in pediatric and geriatric patients call for the health care professional to rely more on objective assessment (Matza, Swensen & Flood, 2004, p. 82).

Children at different ages often require assessment. Pediatric assessment is often carried out a child is reported to have some health issues. This assessment aims to identify the health needs of a child and prescribe appropriate actions. Pediatric assessment relies highly on information provided by a parent or a caregiver. In the assessment, a health care professional first interviews the person accompanying a child to determine the concern. Through the interview, a health professional carrying out a pediatric assessment can obtain helpful background information to proceed with the assessment. Physical examination constitutes the major part of paediatric assessment. Specific approaches to physical examination are however used while taking into consideration the difference between children and adults. The person carrying out paediatric assessment is supposed to have a good understanding of growth and development patterns (Matza, Swensen & Flood, 2004, p. 82). The person is also supposed to be able to communicate effectively with a child client and its parent. Physical examination includes standard measurements such as temperature, weight, and height. Besides standard measurement, sensory issues such as smell vision, and smell are examined. A paediatric assessor may then focus on specific evaluations such as development.

Geriatric assessment is an important procedure in healthcare for elderly people. It enables the health needs of an elderly person to be identified and optimization of health care provision. The assessment is recommended when an elderly person show such symptom as memory loss and confusion (Stuck, Siu & Wieland, 1993, p.1089). Just as in paediatric assessment, objective assessment is mainly used. Geriatric assessment is usually a comprehensive assessment and is thus carried out by a multidisciplinary team. Geriatric assessment team aims to evaluate various factors that can affect an elderly person’s health. Unlike paediatric assessment, geriatric assessment can be carried in various settings such as in a hospital, nursing home, or even the patient’s home.

Conclusion

Quality of health assessment contributes highly to the quality of health services. Health assessment enables the health needs of an individual to be identified appropriate measures to be taken. Subjective and objective assessments are the basic methods for health assessment. Subjective assessment relies on the personal account of a health care client while objective assessment relies on objective data collected through general observation and physical examination. For pediatric and geriatric clients, objective assessment is more applicable. The nature of paediatric and geriatric clients hinders subjective assessment necessitating objective assessment.

Reference List

Keller, J. & Weber, J. (2009). Health Assessment in Nursing. New York: Lippincott Williams & Wilkins.

Matza, L., Swensen, A. & Flood, E. (2004). Assessment of Health-Related Quality of life in Children: A Review of Conceptual, Methodological, and Regulation Issues. Value in Health 7(1) pp. 79-92.

Stevens, A. (2004). Health care needs assessment: the epidemiologically based needs. London: Radcliffe Publishing.

Stuck, A., Siu, A. & Wieland, G. (1993). Comprehensive geriatric assessment: a meta-analysis of controlled trials. The Lancet 342(8878) 1032-1036.

Thompson, J. & Bowers, A. (1992). Health assessment: an illustrated pocket guide. Massachusetts Mosby Year Book.

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