CHAPTER 8 : ASSESSMENT
FACTOR INFLUENCING ASSESSMENT
1. Client participation / feedback
- A thorough and complete
psychosocial assessment requires
active client participation.
- if the client is unable or unwilling
to participate, some areas of the
assessment will be incomplete or
vague.
-For example, the client who is
extremely depressed may not have
the energy to answer questions or
complete the assessment
2. Client health status
- also affect the psychosocial
assessment. If the client is
anxious, tired, or in pain, the nurse
may have difficulty eliciting the
client’s full participation in the
assessment.
- The information that the nurse
obtains may reflect the client’s
pain or anxiety rather than an
accurate assessment of the client’s
situation.
3. Clients previous experiences /
misconception about health care
- The client’s perception of his or
her circumstances can elicit
emotions that interfere with
obtaining an accurate
psychosocial assessment. I
- The nurse must address the
client’s feelings and perceptions to
establish a trusting working
relationship before proceeding
with the assessment.
4. Clients ability to understand
- The nurse must also determine the
client’s ability to hear, read, and
understand the language being used
in the assessment
- It is important that the information
in the assessment reflects the
client’s health status; it should not
be a result of poor communication.
5. Nurse’s attitude and approach
- can influence the psychosocial
assessment.
- The nurse must be aware 310 of his
or her own feelings and responses
and approach the assessment matter
of-factly
HOW TO CONDUCT THE INTERVIEW
1. Environment
- The nurse should conduct the
psychosocial assessment in an
environment that is comfortable,
private, and safe for both the client
and the nurse.
- An environment that is fairly quiet
with few distractions allows the
client to give his or her full
attention to the interview
2. Input from Family and Friends
- If family members, friends, or
caregivers have accompanied the
client, the nurse should obtain their
perceptions of the client’s behavior
and emotional state
How to Phrase Questions
1. Open ended question
- What brings you here today?
- Tell me what has been happening to
you.
- How can we help you?
If the client cannot organize his or her thoughts
or has difficulty answering open-ended
questions, the nurse may need to use more
direct questions to obtain information.
Questions need to be clear, simple, and focused
on one specific behavior or symptom; they
should not cause the client to remember several
things at once
2. Closed - ended question
- How many hours did you sleep last
night?
- Have you been thinking about suicide?
- How much alcohol have you been
drinking?
- How well have you been sleeping?
- How many meals a day do you eat?
- What over-the-counter medications are
you taking?
The nurse should use a nonjudgmental tone and
language, particularly when asking about
sensitive information such as drug or alcohol
use, sexual behavior, abuse or violence, and
child-rearing practices. Using nonjudgmental
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