NSG 121 – Health Assessment
This course focuses on the concept of health assessment as the foundational step of the nursing process. Knowledge and skills necessary for the performance of comprehensive and focused health assessments will be presented. Interviewing, observation, inspection, palpation, percussion, and auscultation skills will be examined. Normal findings, variations from normal, cultural differences and appropriate equipment use will be considered.
Sample Answer
Health Assessment Interview
The aim of this essay is to analyze facilitators and barriers to healthy aging. To achieve this goal, I conducted a health assessment interview with an older individual. Examination of the patient’s situation and analysis of the interviewee’s responses with regard to maintaining a safe environment, communicating, eating, working and playing, and sleeping provided insights into making aging positive. Introducing the obtained findings is an essential part of this assessment.
Patient Situation
Overview of the Interview Set-up and Environment
For this assessment, I interviewed a 65-year-old Steve. A baptised Catholic, Steve does not follow any religion now. The man is married to a 63-year-old Kerry, and they have two sons. Steve never went to university, but he had owned an aerial and antenna business for 20 years. Previously Steve had two knee reconstructions, one on each knee. Following the most recent knee reconstruction, he developed a flu lasting for 3 weeks. The man was sick and lost 6 kilos. Some nights of the week Steve likes to have a glass of wine with dinner. He is not a big drinker. Steve often cooks dinner for his wife when she is at work late. Most of the meals contain meat, vegetables or salads. The man eats reasonably healthy. I visited Steve at his place, while having previously discussed the interview time and procedure by phone. The interview lasted for forty minutes, during which I asked Steve seven questions with regard to five activities of living. For greater objectivity, the entire interview process was tape recorded.
Techniques Used to Facilitate Data Collection
A number of techniques were applied to facilitate data collection. Most of these techniques are related to viewing an interviewee as a source of data and seeking to build rapport with him or her (Bell, Fahmy, & Gordon, 2016; Jong & Jung, 2015). Also, some techniques relate to avoiding the “interviewer effect” (West & Blom, 2017). Application of the mentioned techniques is described further in this assessment.
Collection of Cues and Information
Experience of Interviewing an Older Person
Interviewing an older person is a challenging process and it implies overcoming numerous barriers, including an interviewee’s disability and unwillingness to communicate or share knowledge. Disability is a serious barrier arising during an interview with an older individual, and in some instances, it causes a need for the assistance of a sign language interpreter or other experts (Lopes et al., 2013). Prior to the interview, I did some investigation to learn whether the interviewee had any disability that could interfere with the process of information gathering. Although Steve is a relatively healthy person, he sometimes has difficulties with remembering information. To overcome the barrier, I eliminated major physical disruptions like noise and excessive lighting. I also repeated some questions several times to make sure Steve understood them and could provide meaningful response.
Information Gathering and Clarifying Techniques
I set myself an aim to facilitate data collection and to extract as much as possible from the interview. To achieve this aim, I sought to build a rapport with Steve by making him interested in being interviewed. For instance, I explained Steve the importance of the interview and described how obtained findings could help his peers. The mentioned techniques apply to demonstrate the interviewees that the study is worthwhile and that their cooperation is important (Brunton-Smith, Sturgis, & Williams, 2012; Jong & Jung, 2015; Lipps & Pollien, 2011). To facilitate the emerging cooperation, I asked Steve open-ended questions that provided the interviewees with an opportunity to voice their thoughts and experiences (Singer & Couper, 2017). In addition to the mentioned techniques, I sought to overcome the “interviewer effect” by avoiding involvement in the situation discussed (Jackle et al., 2013; Loosveldt & Beullens, 2013). For instance, I did not give value judgments to the ideas voiced by Steve. Thereby, I provided Steve with an opportunity to express everything that seemed relevant and important to him, which resulted in a productive interview.
Process Information
Steve’s responses provided insights into facilitators and barriers to healthy aging. Since Steve had undergone surgery on his knees, maintaining a safe environment was a key facilitator to healthy aging. This observation is consistent with the findings of Simmons et al (2016), listing falling/safety concerns among the major barriers to engagement into physical activity and healthy aging. Fortunately, Steve does not have any difficulties with moving freely around and outside the house. Moreover, Steve drives the car to make shopping, get to his part-time work and for other purposes. Overall, the man’s mobility is virtually unlimited.
Although Steve does not experience major difficulties with moving, eating, working and playing, he has problems with his sleep. At times, the man sleeps a lot during the day, and eventually he wakes up at night and suffers from insomnia. Also, the man has infrequent attacks of depressed mood, during which he prefers to stay at home and to avoid contacts with relatives and friends. According to Steve and his family, these attacks commonly last for one to two days. Despite these problems, Steve has more facilitators than barriers to healthy aging.
