Psychometric Evaluation of the Functional Health Pattern Assessment Screening Tool (FHPAST)

The Association between Functional Health Patterns and Frailty in Hospitalized Geriatric Patients

This study investigates the association between the Functional Health Pattern Assessment Screening Tool (FHPAST) and frailty in hospitalized geriatric patients. One hundred and forty patients (mean age 78.2 years, age range 65-90) were screened for frailty using the Frail Scale during hospitalization in the geriatric unit. Among them, 57 patients were identified as prefrail (40.7%), and 83 were identified as frail (59.3%). A comparative analysis between groups in terms of the FHPAST components covering health risk, general well-being, and health promotion was performed. Correlations between FHAPST components, socio-demographic data, frailty criteria, as well as logistic regression to identify variables that better predict frailty were also sought. Frailty was mainly associated with difficulty urinating, limitations in performing activities of daily living and walking, physical discomfort, less positive feelings in controlling one's own life, lower compliance with recommendations from the healthcare provider, and engagement in seeking healthcare services. Patients with difficulty urinating and walking had a probability of 4.38 times (OR = 4.38, CI 95% [1.20-15.94]), p = 0.025) and 65.7 times (OR = 65.7, CI 95% [19.37-223.17], p < 0.001) higher of being frail rather than prefrail. The relationship between frailty and prefrailty in hospitalized geriatric patients and components of nursing Functional Health Patterns (FHP) has yet to be explored. This study provides evidence of the most prevalent needs of frail geriatric patients in hospital settings.

Psychometric evaluation of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version

OBJECTIVE

to test the factorial structure, reliability and convergent validity of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version.

METHOD

this was a psychometric evaluation of the Functional Health Pattern Assessment Screening Tool - Modified Brazilian Version. Seven hundred and seventeen participants answered the data collection instrument consisting of two parts. Part I included a structured questionnaire to collect sociodemographic data and the participants' perceptions and satisfaction with their current health status. Part II consisted of the tool being tested. The internal structure was assessed using Confirmatory Factor Analysis. Convergent validity was evaluated by the correlation of the tool scores with the rates corresponding to self-perception and satisfaction with current health status. Reliability was assessed using Cronbach's alpha.

RESULTS

the Confirmatory Factor Analysis confirmed a three-factor solution. The factor loadings were significant and varied from 0.16 to 0.75; the fit indices suggested moderate fit of the model. Internal consistency for all three components varied between 0.779 and 0.919.

CONCLUSION

the findings suggest that the tool is valid and reliable to be used in the Brazilian population, although caution is recommended when interpreting the results due to the moderate fit of the model.

BACKGROUND

(1) The FHPAST-BR is a structured, valid and reliable Nursing-driven assessment tool.

BACKGROUND

(2) The tool provides a way of organizing clinical data and easing decision-making.

BACKGROUND

(3) The FHPAST-BR can be used in clinical practice and research.

An integrative review of comprehensive nursing assessment tools developed based on Gordon's Eleven Functional Health Patterns

PURPOSE

To evaluate the content and psychometric properties of comprehensive nursing assessment tools developed based on The Eleven Functional Health Patterns Assessment Framework.

METHODS

An integrative literature review following Whittemore and Knafl's method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Searches on PubMed, Cinahl, and Virtual Health Library were conducted between September and December 2018.

FINDINGS

Six out of 146 records were included for review. Four articles were methodological studies and two were descriptive reports of the development of the tools. Tools were heterogenous in terms of their purpose, development, characteristics, and testing. Only one study provided data about construct validity. However, there were commonalities regarding the data that should be assessed in each tool.

CONCLUSIONS

Few comprehensive nursing assessment tools using The Eleven Functional Health Patterns Assessment Framework are available. Purpose, process of development, characteristics, and testing varied among the tools, and most lack robust psychometric testing.

IMPLICATIONS FOR NURSING PRACTICE

This review provided a synthesis of the literature regarding the use of a discipline-specific framework to guide comprehensive nursing assessment. The differences across the tools and the lack of psychometric testing compromise the visibility of nursing and make it difficult to emphasize the contribution of nursing knowledge to patient care.

[Functional Health Pattern Model Based Care Plan for a Depression Diagnosed Patient]

Depression is the most frequent disorder among mental disorders, with frequent attacks, high suicidal risks, causing loss of labour-force, as well as to loss of serious physical and psycho-social skills, and also is economically and socially overcosting. The aim of nursing care for depression diagnosed patients is to provide security, to support their independence as much as possible, to help the patient rebuild the harmony at pre-diagnosis level, and to continue their well-being. This case applied to the hospital after an attempt to commit suicide, having continuous thoughts of suicide, guilt feelings, unhappiness, unwillingness, and was hospitalised with a diagnosis of medium depressive seizure. The patient was evaluated via nursing care model of Gordon's Functional Health Patterns on the second day of hospitalisation, and was diagnosed with 'Nutrition, imbalanced: less than body requirements, hopelessness, decrease in self-esteem, impaired social interaction, risk of self-harm, ineffective individual coping'. Nursing care was applied to the medication administered patient within the framework of nursing diagnosis. It was seen that the applied care provided positive support to the healing process of the patient.

History-taking instruction for baccalaureate nursing students by virtual patient training: A retrospective study

BACKGROUND

History taking is difficult for nursing students with little clinical experience. Virtual patients (VPs) can supplement traditional teaching to some extent. However, the high cost of VPs limits their widespread personal use. "Sun Yat-sen University Nursing Education Platform" (SYSU-NEP) is a software program designed on WeChat that can provide VPs for nursing history-taking sessions. SYSU-NEP is characterized by ease of use, accessibility and capacity to facilitate autonomous learning.

OBJECTIVE

To assess history-taking instruction for baccalaureate nursing students after VP training using WeChat.

METHOD

This was a retrospective analysis of the effectiveness of SYSU-NEP, which provided 13 VPs for history-taking instruction based on the Functional Health Pattern framework. Each VP session consisted of 17 parts, and data were derived from conversations between the baccalaureate nursing students and the VPs from September 2016 to January 2017. The effectiveness of history taking was assessed by the hit rate for each of the 17 VP parts. Hit rates in this case identify the completeness of the students' patient history taking. Furthermore, software usage by the students was assessed by an automated survey on SYSU-NEP.

RESULTS

Fifty-seven students participated in 570 VP history-taking sessions. Of the 17 VP parts, the five parts with the lowest hit rates were personal history (median: 0.00, interquartile range: 0.00-0.00), Coping/Stress and Self-Perception/Self-Concept (median: 0.00, interquartile range: 0.00-0.00), Cognitive Perception (median: 0.00, interquartile range: 0.00-2.50), Activity/Exercise (median: 0.00, interquartile range: 0.00-3.00) and Sexual-Reproductive (median: 0.00, interquartile range: 0.00-12.81). Thirty-six students participated in the survey voluntarily and thirty-five students (97%) believed that the software was helpful for learning about patient history taking.

CONCLUSIONS

SYSU-NEP provides a platform for nursing students for history taking self-practice. Students' weaknesses were identified clearly through data analysis. The students were enthusiastic about the usefulness of the software.

Initial Psychometric Evaluation of the Staff Perception of the Disruptive Patient Behavior Scale

OBJECTIVE

The aim of this study is to develop and psychometrically test the Staff Perception of Disruptive Patient Behavior (SPDPB) Scale.

BACKGROUND

Disruptive patient behaviors impact work safety for nurses in hospitals. There is no standardized approach to capturing staff perceptions of these behaviors.

METHOD

A mixed-methods approach was used to develop and psychometrically evaluate the SPDPB Scale. Items were generated from a survey completed by 770 healthcare providers. A prototype 66-item instrument was developed and content validity was obtained. Evaluation of the psychometric properties of the SPDPB Scale was completed with 558 nurses. Evaluation included internal consistency reliability, principal components analysis, and internal consistency reliability derived subscales to refine the final scale.

RESULTS

The SPDPB Scale is a multidimensional measure of perceptions of disruptive patient behaviors. The analysis identified 6 components explaining 54.1% of the variance. The final scale contained 65 items.

CONCLUSION

This scale demonstrated psychometric adequacy and can be recommended to measure staff perceptions of disruptive patient behavior.

Appreciative inquiry with nurses who work with children of incarcerated parents

An appreciative inquiry study was conducted with 12 nurse-mentors who worked with children of incarcerated parents. The aim was to generate best practice knowledge for working with these children. The nurse-mentoring program, based on theorists Peplau and Erickson and colleagues, was implemented to promote optimum health outcomes among children at high risk for incarceration. Through this study method, nurse mentors discovered what was effective as they created a collective vision for future practice. An action plan was implemented, evaluated, and conclusions were drawn. Data from this study imply that nurse-mentoring can be used with other vulnerable populations. Nurses should use appreciative inquiry to transform healthcare, particularly in situations with seemingly intransigent solutions.