Assessment Tool Analysis

Assessment Tool Analysis

The caring model of nursing, informed by Jean Watson's Theory of Caring is a foundation for the professional nurse's discipline and actions. Within the theory core is the respect and appreciation for the patient's mind, body, and spirit (Watson Caring Science Institute, n.d.). Most nurses exhibit clinical skills that they learn in nursing school, such as how to insert a catheter or start an intravenous line. A competent nurse goes beyond the physical needs of his or her patient to address the needs of mind and soul. To do this, a nurse must have tools to aid in the assessment of such needs. Behaviorists and psychosocialists have formulated assessment tools to discern a patient's perceived stress, ways of coping, and social support.

Nursing Assessment Tools

Perceived Stress Scale

The Perceived Stress Scale (PSS), developed by Sheldon Cohen, is a 10 item questionnaire; items are scored from zero to four. The scores are tabulated to determine whether the patient has low, moderate, or high acuity stress (afterdeployment.org, n.d.). Questions are asked such as "In the last month, how often have you been upset because of something that happened unexpectedly?" and "In the last month, how often have you been angered because of things that were outside of your control?" (afterdeployment.org, n.d., questions 1 & 9). Cohen bases the validity of the PSS on the assumption that the impact of an event correlates with the perceived stressfulness of that event (Cohen, Kamarck, & Mermelstein, 1983). The tool is useful for all populations. The ten-question self-report is easy to comprehend and score. The tool is free of charge, although one should obtain permission from the publisher. According to Cohen, et al. (1983), the PSS has test and retest reliability. The scale is a good predictor of health related outcomes. The PSS also can be used to determine if stress is a risk factor for behavioral disorders or disease (Cohen et al., 1983). The PSS is appropriate for nurses to assess anyone's level of perceived stress. For Gary Allen, an adult with Down Syndrome who lives in The Neighborhood, the tool could enable his health care professional and his father to understand Gary's perception and acuity of stress. Once understood, stress could be addressed. Gary's nurse could teach Gary positive methods to deal with stress. Discussing life stressors is the first step to coping with them. A cognitively disabled person would be able to answer the questions, although he or she may need help reading them.

Ways of Coping Questionnaire

Coping is a person's strategy to handle a stressful event or stressful chronic situation. The Ways of Coping Questionnaire (WOCQ) measures coping strategies using a 66-question survey (Mind Garden, 1988). Folkman and Lazarus developed the WOCQ to identify the thoughts and actions that a person may use to cope. The coping factors that the WOCQ measures are confrontive coping, acceptance of responsibility, distancing, escape-avoidance, self-control, planful problem-solving, social support seeking, and positive reappraisal (Mind Garden, 1988). The WOCQ permission license cost $425. One can purchase a sample questionnaire for $134.95. The WOCQ has been administered to and found useful for diverse populations for the purpose of assisting people to cope in a variety of taxing situations.

The WOCQ is generally reliable. According to Kiefer & MacDonald (2011), "Regarding the score reliability of the WAYS, the present study indicated relatively stable score reliability patterns for many of the instrument subscales that exceeded an established minimum criterion of .70" (Kieffer & MacDonald, 2011, p. 34).

The Ways of Coping Questionnaire would be useful for Gary Allen's social worker or nurse to use to determine if Gary has positive coping skills during the stressful time of his mother's illness. It is lengthy; Gary would need help reading and answering the questionnaire. A weakness of the WOCQ is that it may not identify different ways of coping. Kiefer & MacDonald (2011) found evidence that certain populations such as gynecological patients and prisoners may use coping resources other than what the general population uses.

Using the WOCQ, a nurse can distinguish the coping skills and strategies of his or her patient. It can be useful as a tool to quantify and qualify coping tactics. This can lead to patient education on ways of constructive versus destructive coping. The tool can also measure the number of resources a patient may have access to.

Social Support Questionnaire

Social support is the existence of people who a person can rely on. Social support encompasses care, value, and love. Social support allows one to adapt successfully. The support may be in the form of tangible items like money, or intangible elements like someone listening and validating feelings. It may also initiate from significant others such as family, or non-significant sources (Gangemi, Faraci, Menna, & Mancini, 2010). The Multidimensional Social Support Questionnaire (MSSQ) is a social support measure that quantifies and qualifies perceived and received support. It also measures the value one places on oneself, or the perceived worthiness of social support. Seventy-eight questions encompass