Free «Assessment Tool Analysis and Watson’s Theory of Human Caring» Essay Sample
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Three tools selected for the purpose of this paper are a mini-mental state exam, adult life stress measurement, and a spiritual perspective scale. They will be described from the perspective of their administration to the population of the elderly. In addition, the essay will explain how the application of the Watson’s theory of human caring leads to the integration of the mind-body-spirit dimensions, which should be considered by nurses attending to patients.
Mini-Mental State Examination (MMSE)
It is the most commonly used tool in assessing individuals with complaints of difficulties in mental abilities, including memory, language, and attention. It is made up of a series of tests and questions, and if answered correctly, each scores points. Its popularity can be attributed to a number of desirable features. Firstly, the administration of this assessment tool is flexible owing to the fact that there are three different versions, from which one can choose the most suitable for a particular patient. Forms are also user-friendly, and scores are easy to add. Alternative Red and Blue forms make it possible to repeat the test on the same patient without significant practical effects.
Internal consistency coefficients of the MMSE range from .66 to .79 as found in a clinical sample of 1500 individuals studied to help establish examination’s reliability. Using the G coefficient, the equivalency of Red and Blue forms was determined to be ≥ .96 for the three MMSE versions. Coefficients of inter-rater reliability varied between 0.94 and 0.99 (M. Folstein, S. Folstein, White, & Messer, 2009). Normal scores range from 25 to 30, whereas according to the National Institute of Health and Care Excellence (NICE), scores for a mild impairment are 21-24, 10-20 for a moderate impairment, and less than ten for a severe impairment (as cited in Alzheimer’s Society, 2016). On average, the MMSE takes about ten minutes (Knott, 2013).
When administered to individuals already diagnosed with dementia, the MMSE can help assess changes in such a person. It can provide an indication of the severity of the symptoms, as well as the speed of dementia development. Here, it should be noted that results are to be considered alongside clinical judgment and other measures of individual’s coping ability (Alzheimer’s Society, 2016).
Adult Life Stress Measurement
The Social Readjustment Rating Scale is the most commonly used life stress assessment tool for adults developed by Thomas Homes and Richard Rahe in the late 1960s. It provides a standardized measure of the effect of various common stressors on the life of an individual. In the scale, a value is assigned to each life event in arbitrary “life-changing units,” whereby its vale is an indicator of the level of stress it causes to the patient being assessed (ACC, n.d.). Since stress is cumulative, to approximate its total level, a nurse only needs to add up the values of each event that has taken place over the past one year. Notably, interpreting the overall score can be challenging owing to significant differences in each individual’s capacity to cope with an event and his or her specific reactions to the stressor (ACC, n.d.). Nevertheless, some general guidelines have been provided. The total score of 150 or below is good since it suggests a minimal level of stress in individual’s life. It in turn means that there are low chances of such an individual developing a disorder related to stress (about 30%). However, if the score of 300 or above is obtained, such an individual has up to 80% of a chance of developing a stress-related illness in the future. The score of 150 to 199 indicates the 50% probability of getting sick (ACC, n.d.).
Nonetheless, it is important to note that the scores obtained in this scale show only rough estimation of reality due to a number of factors that negatively affect their validity. These involve variations from one individual to another in terms of circumstances, personality, resources available to a person, and the coping-strategy employed. In addition, it is best employed in assessing adults, since they have most probably experienced statistically significant stressors (ACC, n.d.)
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The SRSS enables the nurse to better assess the psychological status of an individual. The level of stress the one is experiencing is an important determinant of his or her psychological health. Physical examination, reference to individual’s health history, and general observation may not provide a clear picture of his or her stress levels and the psychological status. Considering that high stress levels (and thus poor psychological health) may translate into physical or mental health problems, the SRSS is an important assessment tool (ACC, n.d.).
Spiritual Perspective Scale
The spiritual perspective scale measures the salience of person’s spiritual perspective. It is made up of 10 items and makes use of a 6-point scale that resembles the Likert type to assess individual’s spiritual behavior and the importance he or she attaches to spiritual beliefs. The scale is relatively easy to use owing to the fact that the nurse only needs to add scores against the six points in the Likert scale. Its validity was initially determined using a sample of 300 adults, out of which 100 were healthy, 100 were hospitalized and terminally ill, and 100 were hospitalized as non-terminally ill. In these adults, Cronbach’s alpha ranging from 0.93 to 0.95 was established (Ricci-Allegra, 2015). Notably, females and individuals who had reported their religious background achieved higher scores on tthe scale as compared to males and those who had no religious beliefs. These results have showed scale’s validity. It is the most suitable for females and those with a religious background (Ricci-Allegra, 2015).
The knowledge of individual’s spiritual perspective is a very important element in the assessment phase of the nursing process. It helps the nurse to prevent value conflicts by ensuring that she does not try to impose her values on the individual and the latter. As a result, a person feels cared for and becomes more willing to cooperate with the nurse (Ricci-Allegra, 2015).
Application of the Tools to the Elderly Population
The mini-mental state examination is applicable to the elderly primarily because mental capacity and memory difficulties assessed are common in this population. It is particularly useful in the diagnosis of dementia, whereby it also facilitates an assessment of condition’s severity and progression. As for the SRRS, it helps determine stress levels and disease risks of an elderly person. It is important considering that at their age, the elderly are usually vulnerable to various life stressors that can in turn subject them to related illnesses, including dementia and Alzheimer’s disease. Stress can also facilitate their progression and severity. Lastly, in the case of the spiritual perspective scale, the elderly population is very sensitive to spiritual needs. The latter primarily entail the feeling of respect for one’s beliefs and spiritual values. As such, by assessing individual’s spiritual perspective, a nurse responds by giving the elderly person a possibility to achieve spiritual wholeness, even when experiencing health challenges.
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Watson’s Theory of Human Caring
Watson’s theory of human caring exhibits some relationships with the spiritual perspective as a necessary aspect for a nurse. Watson recognizes its central position in the second and third caritas processes. The latter suggest that it is important for a nurse to attend to and cultivate own spiritual insight, growth, spiritual dimension, and mindfulness, for the one to be sensitive to oneself and others. Nurses are encouraged to connect with their own source of faith to enable them to care, connect, and share compassion (Ricci-Allegra, 2015).
The assessment phase is critical in the nursing process since it helps in understanding the health condition of an individual. Some of the tools used for such purpose are the mini-mental state examination (MMSE), Social Readjustment Rating Scale (SRSS) as part of the adult life stress assessment, and the spiritual perspective scale (SPS). Assessing patients’ conditions, a nurse should rely on the Watson’s theory of human caring.
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