An examination of assessment tools in relation to Watson's theory of human caring - Research Paper Example

? An Examination of Assessment Tools in Relation to Watson’s Theory of Human Caring An Examination of Assessment Tools in Relation to Watson’s Theory of Human Caring Tools that expand the abilities of nurses to assess and evaluate clients in the various stages of health, illness and stress are particularly an important part of the knowledge that nurses should have and ultimately impact on the quality of healthcare. Besides this, Watson’s theory of human caring enables nurses to integrate mind-body-spirit dimensions of assessment tools hence delivering better services to patients. The advent of evidence-based practice means that the use of assessment tools is influenced by the data available on them in terms of cost, length, ease of use and suited populations. When using such data, it is also important to evaluate its validity to ensure that the correct assessment tools are utilized. This study will investigate all these aspects focusing on three assessment tools; Dysfunctional Attitude Scale, Health Self-Determination Index (HSDI) and the Spiritual Perspective Scale. The impact of these tools on assessment phase and quality care provided by nurses will be evaluated followed by their application to homeless individuals. Assessment Tools Dysfunctional Attitude Scale (DAS) This is an assessment tool that was developed to measure the pervasive/silent maladaptive cognitive vulnerability exhibited by depressed individuals (Antony and Barlow, 2010). It is based on the view that such depressed individuals bear negative attitudes with regard to life and this can be analyzed through determining the views of an individual to self, world and future. This is what is usually referred to as the cognitive triad that can be used to tell apart depressed from non-depressed individuals based on their pessimism. The Dysfunctional Attitude Scale is a self-report 7-point likert scale that measures the occurrence of attitudes that portray underlying dysfunctions and how intense such attitudes are (Weissman and Beck, 1978 cited in Graaf et al., 2009). The original Dysfunction Attitude Scale was based on 100 items but was later simplified into DAS-A and DAS-B parallel forms that contain 40 items only. The result of this is that the DAS test is an inexpensive, easy to perform and relatively short undertaking. Graaf et al. (2009) performed DAS on populations whose demographic factors significantly correlated with depression including the unemployed individuals, individuals who were occupationally disabled and individuals with low levels of education. The dysfunctional attitudes measured among such populations include attitudinal approval, entitlement and achievement which perfectly interrelate with the mind-body-spirit dimensions as put forward by Watson hence resulting in a better assessment by nurses translating to better treatment. In terms of reliability and validity of the evidence, Graaf et al. (2009) and many other researchers have performed psychometric experimental studies on DAS and generated reliable and valid results. This is demonstrated through correlation analyses and actual distinction between individuals with and without depression hence the DAS is safe for application in clinical practice. DAS is particularly important as a tool for nurses during the assessment stage as it allows the nurse to get a grip of the major underlying factors behind depressed individuals and as a result aid in the proper interventional measures for example through pharmacopsychotherapy that will deal with both biomedical aspects and psychological aspects of illness. Perceived Stress Scale Cohen, Kamarck and Marmelstein (1983, cited in Peters, 2007) designed a measurement of the level to which individuals perceived their life situations as being stressful in terms of unpredictability, overload and inability to control. It uses 14 items in a likert scale with responses ranked as “never” to “very often.” Seven of the items in the scale are positive and through the test the level of self-perceived stress can be determined with higher scores translating to higher perceived stress. The holistic approach of nursing to practice as involving mind-body-spirit is maintained through the Perceived Stress Scale especially with regard to psychosocial aspects of illness. The 14 items in the Perceived Stress Scale are easily comprehensible hence making its performance an easy undertaking for clinical purposes. The fewer items and its relative ease also mean that it takes considerably shorter time to administer and is also cheap. The population that can be tested through the Perceived Stress Scale is considerably wide owing to the fact that it bears much generality in its items and is designed for use in populations with at least a junior high school level of education hence opening its applicability to large sections of communities. The Perceived Stress Scale also has the advantage of being modifiable to include other measures that can make the study more meaningful via correlations. This is achievable through prompting the patients to name the stressors affecting them and rank them in order of impact. The use of test-retest correlation analyses in studies involving Perceived Stress Scale ensure that there is internal consistency of the generated data hence reliability which ultimately results in conclusions that the results from such studies are valid for adoption in clinical practice (Peters, 2007). This is a scale that facilitates gathering of as much information as possible from the patient during the assessment stage besides allowing for specific stressors to be identified and hence dealt with. It also provides for increased bonding between the patient and the nurse which also aids in assessment. Spiritual Perspective Scale Reed (1987 cited in Dunkin and Dunn, 2009) designed the Spiritual Perspective Scale to determine individuals’ perceptions on the degree to which spiritual views and practices are held. This scale is designed to elicit personal perceptions regarding spiritual views and their associated activities through a likert type scale from which the means of all items is used to generate values between 1.0 and 6.0 where the higher the test score the greater the perspectives of an individual’s spiritually. The spiritual basis of this scale further reinforces application of Watson’s theory of human caring in nursing. The number of items in the likert is usually relatively low hence the scale is much easier and cheaper to administer and takes a relatively shorter period. The Spiritual Perspective Scale is applicable to a wide range of adult populations including the terminally ill patients, drug addicts, patients with chronic mental illnesses and even healthy individuals. Reliability and validity of the evidence is assured through the reliable psychometric properties achieved in the studies. The reliability has been demonstrated to be above 0.90 using Cronbach’s alpha and correlation while all aspects of validity have also been demonstrated (Dunkin and Dunn, 2009; Kim, 2008). The Spiritual Perspective Scale also facilitates assessment through bonding between the patient and the nurse and increasing cooperation while at the same time giving the nurse insight into any links between illnesses as are self reported and the patient’s spirituality. Application of the Assessment Tools to Homeless Populations The Dysfunctional Attitude Scale can be applied for homeless individuals to trace depression through demonstration of negative attitudes of patients towards their lives. Such an assessment would reveal views of inadequacy and deficiency associated with physical, moral or mental aspects. The assessment will as a result pinpoint disturbances in emotions arising from misconceptions and irrationalities among the homeless populations. The Perceived Stress Scale finds applications in the homeless populations through enabling establishment of the emotional state of an individual regarding their current plight besides enabling the nurse to find out exact stressors associated with homelessness for instance, lack of food, lack of education and worries about the future. The Spiritual Perspective Scale is an especially important tool for assessment of homeless individuals since spirituality determines a person’s reaction to suffering. The degree of spiritual perspectives and associated practices in the patient can give the nurse insight on resolution of the homeless person to overcome their plight or resigning to fate. All the studied assessment tools find importance in fortifying the nurses’ approach to homeless individuals based on the crucial tenets of mind-body-spirit approach besides being cheap, easy to perform as evidenced by reliable and valid data. The ultimate result is delivery of better healthcare services on the nurses’ front. References Antony, M. M, & Barlow, D. H. (2010). Handbook of assessment and treatment planning for psychological disorders. Guilford Press. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress, Journal of Health and Social Behavior, 24, 386-396. Dunkin, J., & Dunn, L. L., (2009). Spiritual perspectives and health: A random survey in a southern state, Online Journal of Rural Nursing and Health Care, vol. 9, no. 2. Graaf, L. E., Roeloffs, J., & Huibers, M. H. (2009). Measuring dysfunctional attitudes in the general population: The dysfunctional attitude scale. (form A) Revised, PubMed Central 33(4): 345–355. Kim, S. S. (2008). Interdepndence of spirituality and well-being among Korean elders and family Caregivers. University of Arizona. Retrieved September 19, 2011 from http://www.nursing.arizona.edu/Library/081_Kim_Suk-Sun.pdf Peters, B. M. (2007). The relationships among physiological and perceived stress, quality of life, self-care, and impairment in doctoral students. State University of New York at Buffalo. Counseling, School and Educational Psychology. Reed, P. G. (1987). Spirituality and well-being in terminally ill hospitalized adults. Research in Nursing and Health, 10(5), 335-344. Weissman, A., & Beck, N. (1978). Development and Validation of Dysfunctional Attitude Scale: A Preliminary Investigation. American Educational Research Institution. Retrieved September 19, 2011 from http://www.eric.ed.gov/PDFS/ED167619.pdf Read More