Significance and Components of Comprehensive Health Assessment

Introduction

Health assessment is important in clinical nursing practice. A comprehensive health assessment can help to identify the needs of patient and thus develop an individual care plan for them. There are mainly six components of comprehensive health assessment, which are psychosocial assessment, nutritional assessment, spiritual assessment, developmental assessment, cultural assessment and physical assessment, the details are as follows.

Components of Comprehensive Health Assessment and its Significance

Psychosocial assessment is to evaluate one’s physical, social, mental, spiritual, emotional status, and functional ability in the community. Through knowing all aspects of patient’s life, it helps to determine appropriate nursing care and treatment plan for patient (Roberts, 2013).

Nutritional assessment is to determine one’s nutritional status with reference to the anthropometric measurements, biochemical characteristics, clinical data, dietary practices, medical history. It can define whether patient is nourished or malnourished. By monitoring the change of nutritional status of patient, it helps in preventing, promoting health and identifying high risk patients (Encyclopedia, 2019).

Spiritual assessment is to identify one’s spiritual or religious needs, beliefs, positive and negative experiences, as well as physical and mental well-being. It can offer another way of support and thus provide a great deal of relief to suffering patients (Saguil & Phelps, 2012).

Developmental assessment is to test one’s cognitive ability, communication, emotional, behavioral functioning, social interaction, motor and sensory and adaptive skills. It can help to identify possible developmental problems and have early diagnosis and intervention (New York State, 1999).

Cultural assessment is to assess one’s cultural values, beliefs, tradition and lifestyle. Through understanding patient’s cultural needs and preferences, accepting and respecting their cultural diversity, it helps to individualize nursing care plan and thus provide unique care (Spring Institute, 2019).

Physical assessment is to perform a head-to-toe physical examination through inspection, palpation, percussion and auscultation to gather information. After obtaining physical data from patient, it can check any abnormal findings, and help to identify diagnosis and thus can treat the disease promptly (Brookside Associates, 2007).

Psychosocial Assessment

For the mental dimension, physical appearance of Paul can be observed. For example, by observing his grooming and cleanliness, which can indicate his self-care ability. Also, by observing his gait, posture, consciousness, alertness, body odour, it can tell whether he is affected under use of alcohol or else. By asking Paul to describe his illness, his speech can show his logical thinking, organization and reasoning process. Past medical history can also be asked to see the why Paul claims fatigue and thus affect his work, ask about any current treatment or recovery plan for this.

In the emotional dimension, ask Paul about any pre-existing psychosocial concerns or problem, and any change in emotion or depressive symptoms, as it may cause psychosocial distress or even psychiatric illness. Also, ask Paul to describe and list all the sources of stress, e.g. financial, health, marital, social, interrelationship problem, job stability, and identify any relaxation technique e.g. sports and methods e.g. subsidies to solve these problems. Encourage Paul to join some activities, meet some new friends and find a soulmate for emotional support to express his loneliness, hopeless and worthless.

Regarding the social dimension, interpersonal relationship and family structure and background can be asked. How is the relationship in the previous marriage, any kids? Also, the relationship between Paul’s parents or any other siblings can be asked. Family support is crucial for one’s psychosocial health as they know you more and can provide emotional support. Besides, ask to describe the relationship between friends or colleagues, which they can help and provide social support for Paul.

As for the spiritual dimension, Paul’s religious, spiritual belief, cultural background and his thoughts towards life and future can be asked. His thoughts and belief can affect his psychosocial wellness.

Apart from it, there are assessment tools which can be used in psychosocial assessment. The Scale of Psychological Well-being which developed by psychologist Carol Ryff, can be used to determine one’s psychosocial well-being. The scale consists of six components: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, self-acceptance. There are 42-items of questions to assess how the patient describe toward him and his life. For instance, for self-acceptance, higher score means patient have positive attitude towards himself whereas low score reflect he is dissatisfied towards life. In one-word, higher score indicates greater physiological well-being for each category (Seifert, 2005).

There are various internal and external factors that can influence one’s psychosocial health. In Paul’s case, he is under stress which affect his physical health and fitness, make him feel fatigue and unable to work. Also, stress change his lifestyle, diet habit and sleep pattern. The emotional changes even make him addict to alcohol. Paul’s role changes after he became bankrupt and divorced. He feels loneliness, socially isolated and is emotionally disturbed. In view of this, Stress coping is necessary, it can enhance psychosocial well-being. Besides, divorce made Paul became introverted. Loss of family support means loss sense of self-esteem, love and emotional support. The interdependent relationship e.g. family, friends, colleagues, disturb after recent change in Paul’s life. Moreover, low economic status make Paul feel hopeless and worthless, difficult to support his daily necessities. All these factors may cause psychosocial distress to Paul.

Nutritional Assessment

Nutritional history can be asked in order to assess patient’s nutritional status. A 24-hour dietary recall is one of the methods to assess food and beverage consumed during the previous day. During the recall, patient is asked to remember all food and drink they have consumed in detail in the past 24 hours. Open-ended question is designed to obtain a comprehensive and detailed diet recall, which may include the type, source, preparation method, portion size of the food (Diet Assessment Primer, 2019).

Food frequency questionnaire is another assessment tool to collect dietary data. It is a questionnaire which used to obtain the frequency, portion size information for each food and beverage item over a specific period, such as a month or even a year. As it has a longer recall time, it can obtain a more complete assessment data which may miss in 24-hour dietary recall (Thompson & Subar, 2013).

Besides, food diary is also a useful tool to gather patient’s nutritional history. The type, amount of food and beverage, the time, place of eating, all these should be included in the food dairy. Through recording the food that on meal-by-meal, it helps to identify and understand your own eating habit and pattern. The diary can record before the day of follow-up for a week to get a detailed data (McManus, 2019).

Apart from it, anthropometric measurements can assess patient’s nutritional status other than taking nutritional history. The common anthropometric measurements are weight, height, body mass index (BMI), waist circumferences and skinfold thickness. Obtaining these objective data from patient is important, it can get a baseline information and thus can monitor the progress of treatment (Casadei & Kiel, 2019).

There are some factors that affect Paul’s health in nutritional aspect. As he has financial problem, he skips lunch and has simple meal every day. Although Paul’s BMI is normal for the time being, irregular dietary may affect health and alter body weight. Since Paul suffers from emotional problem, he drinks three cans of beer a day. However, over consumption of alcohol may also cause health problem such as heart disease.

Conclusion

To conclude, comprehensive health assessment is the first step to allow early detection and intervention. Both psychosocial and nutritional health are crucial to maintain health. There are various assessment tools and skills that can help to assess patient’s psychosocial and nutritional status. Through obtaining the subjective and objective data from patient, it helps to identify the risk factors that may affect patient’s health and thus develop an appropriate and unique care plan for patient.