Assessment Tools Related to Adolescent Pregnancy - Coursework Example

Assessment Tools Related to Adolescent Pregnancy Vulnerable populations come in many forms and require distinct levels of preparedness. For example, “married adolescent girls have many profound needs, and yet they have little power to meet those needs and to make autonomous decisions affecting their own welfare” (Scholl, 2006). The vulnerability of these girls is intensified by their lack of education, social ties, and economic stability. Any sense of preparedness, therefore, must address this vulnerability directly on the basis of what Watson (2006) would call a theory of caring. This theory “encompasses a humanitarian, human science orientation to human caring processes…” (para. 1). The human science aspect of Watson’s theory of caring implies that the theory is more than an expression of compassion toward adolescents who are pregnant. As I will show, the theory of caring can also be linked with practical applications. The theory integrates the dimensions of mental, physical, and spiritual levels of well-being which can therefore be measured by particular health assessment tools. These tools are non-physical measures and are informed by a more total approach to a person’s health. For example, the risk of infection is associated with adolescent pregnancy. The assessment tools which are linked with an integration of mind-body-spirit, however, would look beyond the physical aspect of the infection. These tools might seek to incorporate, among other factors, the role that stress plays in the person’s overall health. By taking the presence of stress into account, a more total approach is hopefully acquired by which nurses can have an enhanced ability to recognize treatable symptoms. For the remainder of this essay I will focus on describing assessment tools and how they are related to adolescent pregnancy. I will provide information on the cost of the tool, the manner in which it is used, and its effectiveness in improving the quality of health care. Again, this is significant because of the great variety of issues faced by these girls which in turn makes them a vulnerable population. The distinct level of preparedness which is required by this population can be brought to light most effectively through the realization that more than one tool is available. For example, the stress of this adolescent pregnancy situation would be determined best by an assessment tool which acknowledges this stress. Having a greater variety of tools at their disposal allows nurses to treat a greater variety of symptoms. To begin, the Beck Depression Inventory (1961), published by Aaron T. Beck, is suited for adolescents who are pregnant since it at least gives them an outlet for those emotions which might seem both ambiguous and overwhelming. It is designed for those people ages 13 and over and is basically a 21-question, multiple-choice self-report inventory. The questions are designed to reveal a state of depression in a way which doesn’t depend on the biases of any other psychological perspective. These questions are linked with a triad of potentially negative viewpoints. This triad involves the world, the future, and the self. This makes sense in light of the pregnant adolescent’s need to find answers about her lack of resources and whether or not she is to blame. If a girl feels, for example, that the world isn’t helping her to become stable in an economic way, she might still indicate only a mild sense of depression as long as she has the support of her family. However, if a pregnant adolescent lacks social ties along with everything else she is faced with, she is more likely to report a more severe level of depression. In this second example, she is caught in a negative triad of cognitions in which she feels like a bad person because the world has ignored her and the future seems bleak. The Beck Depression Inventory uses a scale of 0-3. The lowest level, for example, would state, “I do not feel sad.” The highest level would indicate, “I feel sad in an unbearable way.” The scores are then totaled to determine either a lack of depression or a mild, moderate or severe state of depression. This scoring is generally performed by a staff member of a psychological facility and takes about 3 minutes to complete. Those who perform the tests can obtain 25 of them for $35.00. As stated, the Beck Depression Inventory seems relevant to an adolescent who is pregnant because it offers an outlet for expressing negative emotions. The validity of the test, however, can be undermined for this same reason. In other words, because a young girl perhaps lacks the social ties through which to communicate her emotions, she may tend to exaggerate these emotions in a self-report about them. The results of the test would therefore be distorted. She may be reporting a level of depression that is not consistent with the way she actually feels. Further, the Hassles and Uplifts Scales by Lazarus & Folkman (2007) is a suitable assessment tool for adolescents who are pregnant because the tool provides a calming alternative to the adolescent’s recognition of pregnancy as a source of stress. “Instead of focusing on highly charged life events, the HSUP provides a comfortable way to evaluate positive and negative events that occur in each person’s life” (Lazarus & Folkman, 2007, para. 1). This focus on daily events is significant because it perhaps make the pregnant adolescent feel less isolated. The scale treats pregnancy as potentially positive or negative, yet still as something that others experience. Once this calming effect has been established, it is hoped that the girl can be encouraged to develop a positive course of action for her life, or at least be able to express to clinicians who evaluate the scales what her problems are. The Hassles and Uplifts scales are influenced by the theory of caring since they focus on a person’s general well-being instead of just addressing particular symptoms. The Hassles scale attempts to analyze sources of stress, while the Uplifts scale attempts to identify positive elements in a person’s life. As suggested, this helps to give the clinician or researcher a clearer picture of how the pregnant adolescent’s needs should be addressed since the adolescent is encouraged to see beyond the stress of the pregnancy. More specifically, the Daily Hassles scale contains 117 items concerning life events. For example, if neighbors drop in at an inconvenient time the question might be, “How much of a hassle was this for you?” On a scale from 0-3, the respondents’ answers can range from “none at all” to “extremely severe.” Alternatively, the Uplifts scale has 135 items that can be expressed as positive experiences on the same scale of 0-3. For example, if a pregnant girl gets enough sleep the question might be, “How positive was this for you?” Again, the respondent may provide answers which range from “none at all” to “extremely positive.” In sum, these scales seek to measure whether stress is an independent variable or is dependent on the adolescent’s pregnancy. Treatment options are developed according to these measurements. The scales cost $120.00 per 150. The scales require at least 10 minutes to finish. Lastly, as part of the integrated focus of the theory of caring for adolescents who are pregnant, “tests have shown how tapping into your spiritual core can boost self-confidence” (Kass, 2008, para. 1). The notion of spirituality and well-being is a relevant assessment tool because it takes into account the level of preparedness a pregnant girl feels on the basis of her spiritual insight. Any tool related to spiritual development is significant because a spiritual dimension is seen to influence overall health. If a girl is lacking in a spiritual foundation, nurses are hopefully given a starting point by which to determine if the specific problems she faces are independent of this lack of spiritual focus or are cause by it. Treatment can then proceed from this point. “The Index of Core Spiritual Experience, called INSPIRIT, was developed over years of research that has shown such experience to be normal and health enhancing” (Kass, 2008, part I). More specifically, the test can be taken for free over the Internet, contains a series of multiple-choice questions, and takes 10 minutes to finish. For example, the question “How spiritual are you?” can be answered over a range of possibilities from “not at all” to “very spiritual.” As in other scaled tests, the results are then interpreted to reveal the person’s overall level of spiritual well-being. In sum, this can be seen as a relevant tool for adolescents who are pregnant because it seeks to narrow the focus concerning where problems may lie. If, for example, a girl reports that she is very spiritual, yet still experiences health problems, the cause is likely to be found elsewhere. If, on the other hand, she reports a lack of interest in spiritual things, the counselor might assess this as the foundation for other problems. Assessment tools in general attempt to isolate factors which cause problems while they still address the mind-body-spirit integration of the theory of caring. This essay has attempted to define and evaluate different types of assessment tools by which adolescents who are pregnant can hopefully enjoy healthier life circumstances. This is an important topic in view of what Brown (2007) would call “a symbol of a national moral malaise” (para. 1). His reference to adolescent pregnancy as a problem of society is supported by the following fact: one million teenage girls become pregnant in this country each year. With this in mind, it is clear that more information is needed. REFERENCES Beck, Aaron. (1961). Beck Depression Inventory. Retrieved on May 9, 2008 from http://www.cps.nova.edu Brown, Robert T. (2007). Adolescent Pregnancy. Retrieved on May 9, 2008 from http://coolnurse.com Kass, Jared (2008). Spirituality and Well-Being. Retrieved on May 10, 2008 from http://www.spiritualityhealth.com Lazarus & Folkman (2007). An Alternative to the Traditional Life Events Approach to Measuring Stressors. Retrieved on May 9, 2008 from http://www.mindgarden.com Scholl, Ed. (2006). Family Planning for Married Adolescent Girls. Retrieved on May 8, 2008 from http://www.magweb.org Watson, Jean. (2006). Watson’s Caring Theory. Retrieved on May 9, 2008 from http://www2.uchsc.edu/son/caring Read More