1. What areas of information are missing from this appraisal that would be helpful to you as a clinician?
Though the appraisal was quite thorough, it did lack appropriate information regarding patient and family medical history (Chowdhury et al., 2002). While the patient’s lifestyle has an undisputed influence on any health problems he or she might be experiencing, insight into medical history has the potential to reveal genetic propensities that might weigh heavily on the patient’s health (2002).
Also missing from this appraisal form is information regarding medications currently being taken by the patient. This is also useful to the clinician as it gives an idea of previous/existing conditions as well as the possibilities for side-effects, allergies, and interference with the drugs that might be presently prescribed for the patient (Nordenberg, 2000).
2. How can this tool be used to create a plan of care?
This tool could be used to create a lifestyle change care-plan. The tool probes a wide variety of life-style areas and has the potential to reveal areas in which the patient has compromised his or her health by making and perpetuating bad lifestyle choices. Dietary assessments can be made and regimens created to improve the patient’s nutrition. Physical activity level is also made very accessible by this tool, and exercise plans can be created and modified for the patient starting with the assessment made using this tool.
3. What areas of the appraisal had you not considered previously in your assessments that you now recognize as being beneficial?
The safety issues and the environmental issues were areas I had not previously considered in my assessments. I do see the necessity of these factors now, as decisions made regarding safety and environment can contribute as much to the well-being of a patient as diet and exercise. If, for example, a patient is routinely involved in mixing drinking with driving, then life expectancy will likely be reduced, even in the presence of regular exercise, proper diet, and good family medical history.
4. Would you use this appraisal with all assessments?
Because of the nature of the lifestyle questions, which seem to be better suited for certain demographics, I would not use this appraisal with all assessments.
If not, which aggregates or situations would you implement it with?
I believe that the nature of the lifestyle questions dictate that the appraisal in its entirety is best suited for a healthy young population. The aged and aging might be able to relate to the dietary and safety questions, but will likely not be able to relate to those areas concerning strenuous physical activity.
If you do not implement it with all clients, what measures will you include in order not to miss at-risk persons?
I will incorporate many of the questions but not all of the sections.
For example, the physical activity sections might be modified to accommodate lower levels of strain for geriatric patients. Furthermore, since falling is a hazard for older patients, balancing activities may also be included in that section. The dietary section could also be modified to include some of the areas necessary for geriatric patients, such as increased consumption of protein, calcium, and other minerals that deplete with aging.
5. What two things would you suggest to improve this health risk appraisal tool?
In order to improve the tool, I would include measures of such lifestyle areas as stress levels and the patients’ financial capabilities. These too have the potential to increase the risk of illness in patients or to preclude their ability to properly care for their illnesses.
6. How could this tool be adapted to meet the time constraints of the nurse yet be comprehensive at the same time?
One way to expedite time in the process of collecting the information would be to distribute the assessment to the patients prior to their meeting with the nurse. This way, the patients will be granted the time to fill it out at their leisure before bringing it in at the time of consultation.
7. How can the nurse use information gained from this appraisal to encourage or motivate others to change their behavior or lifestyle?
The point system that the test utilizes has the potential to motivate patients, as higher scores boost morale and lower ones demonstrate that greater efforts would improve the patients’ lives. The breakdown of the test into areas also allows the patient to pinpoint the areas where changes would be appropriate. Therefore, stressing the benefits of behavior and lifestyle change in those areas would also encourage the patient to do what is necessary to get these desirable results.
8. How can the nurse ensure honest responses for the client in answering personal questions?
In order to promote honesty, the nurse would ensure the confidentiality of the consultation as well as of the results of the assessment. Meeting in a private area would emphasize this, as would the use of envelopes as containers for the completed questionnaires. The nurse should also formally assure the patient of the confidentiality with which the information provided will be treated, and see to it that all other workers adhere to privacy guidelines.
Chowdury, M. V. Chongsuvivatwong, A. F. Geater, H. H. Akhter, T. Winn (2002). “Taking a medical history and using a colour scale during clinical examination of pallor improves detection of anaemia.” Tropical Medicine & International Health 7 (2), 133–139.
Nordenberg, T. (2000). “Make no mistake: medical errors can be deadly serious.” FDA Consumer Magazine. U.S. Food and Drug Administration. Retrieved on March from http://www.fda.gov/fdac/features/2000/500_err.html