Assessment Analysis in Mental Health Nursing

Introduction to Assessment Analysis in Mental Health Nursing

The mental status examination is the physical examinations that evaluate the person mental health status by passive observation and direct questioning (Voss & M Das, 2020). The report will include mental status assessment of the patient recently admitted to the emergency department after found confused on the road.

Mental Status Assessment

Level of Consciousness:

Clinical Assessment: Glasgow Coma Scale

Assessment Questions:

  • Why are you roaming around the street alone?
  • Are you living alone or have any family member with you?

References: The Glasgow coma scale is considered to be an important assessment when it comes to impaired consciousness that is important in the treatment process. The scale is evaluating the patient based on three aspects that are eye-opening, motor and verbal response. The individual score of the three domains will cumulatively describe the patient mental state. The GCS score lies between three to fifteen that help to identify the current state of the patient (Alhassan et al., 2019).

General Appearance:

Clinical Assessment: Head to toe assessment

Assessment Questions:

  • Why he is wearing such a dirty cloth?
  • What are your age and cultural background?

References: The head to toe assessment is important to evaluate the overall appearance of the patient to identify the issue. Head to toe assessment starts with the physical assessment followed by surveying about the different health-related aspect. The physical appearance is important to evaluate the individual mental and physical state. The assessments of the physical appearance help to understand the issue that is increasing complication for the patient. The nurse should conduct the assessment to understand and survey patient perspective over his appearance.

Behaviour:

Clinical Assessment: Behavioural assessment tool

Assessment Questions:

  • Describe how you spend your free time and what are your hobbies?
  • Explain a situation where you find yourself stuck in a difficult situation?

References : The behavioural assessment tool is important to identify the behavioural issue that is increasing complication for the patient. The psychological aspect of the individual is evaluated to identify the individual perspective concerning the behaviour. The behavioural assessment tool is also important to identify the level of consciousness in the patient. Behavioural interaction is important to identify the health status of the patient and it also depicts the mental status of the individual (Gilutz et al., 2015).

Mood & Affect:

Clinical Assessment: Patient Health Questionnaire

Assessment Questions:

  • How you control your stress during a difficult situation?
  • Have you been depressed or angry due to any particular reason?

References: Patient Health Questionnaire is important to identify the issue with the patient health status that is important for the framing of the intervention. The patient health questionnaires help to identify the mental disorder concerning the disturbance in the mood of the individual. Five domains are important to identify the mood of the patient that includes question-related to depressive, anxiety, somatoform, alcohol and eating disorder (Maroufizadeh et al., 2019).

Speech:

Clinical Assessment: Speech assessment

Assessment Questions:

  • Are you a talkative or a shy person?
  • Is he is facing issue while speaking one specific word?

References: Speech assessment is considered to be important to evaluate the speech pattern of the individual. The speech assessment is necessary to identify the speech disruption that can increase complication for the patient. There are different speech defect and speech assessment is important to provide the right intervention to the patient. The different aspects that are considered in the speech assessment include fluency, comprehension, repetition, word-finding, reading and writing. These aspects help to identify the issue with the speech of individual to help the patient with the right intervention (McAlister & Yanushevskaya, 2019).

Thought Content / Stream:

Clinical Assessment: Critical thinking assessment tool

Assessment Questions:

  • Do you have encountered any situation that leads to the misinterpretation of the situation?
  • What are the thoughts you encounter while facing any emotional or psychological issue?

References: Critical thinking assessment tool is important to evaluate the thought process of the individual and it helps in understanding the thought process. Critical thinking assessment tool helps the health care professional to evaluate individual logic, relevance, thought process in response and goal direction of the individual. The critical thinking assessment tool is important to analyse the disturbance in the thought process that increase the complication of the patient (Barrows, 2018).

Intellectual Performance:

Clinical Assessment: Stanford–Binet Intelligence Scales

Assessment Questions:

  • What are the different continents and which is the largest
  • Name the different heads of the governmental department?

References: The intellectual performance assessment is necessary to identify the intelligence of the individual that is important to evaluate the patient mental status. Different factors are used in the Stanford-Binet Intelligence scales that are knowledge, quantitative reasoning, visual-spatial processing, working memory and fluid reasoning. The score directly indicates the intellectual level of the individual that is necessary to evaluate the patient health status (Twomey et al., 2017).

Perception:

 Clinical Assessment: A perception assessment tool

Assessment Questions:

  • What is our thought concerning the burning issue in politics?
  • How are you feeling after this session and what are your thoughts concerning your health?

References: Perception assessment tool is important to evaluate the response of the individual concerning the different factor. The individual response is a direct picture of the individual reflex action concerning the stimulus that depicts the individual attentiveness. The perception assessment tool helps the health care professional to identify the organizing and interpretation skills concerning the stimulus. There are different stages of the perception that includes stimulation, organization, interpretation, evaluation, memory and recall that are important in the evaluation process (Sarceda-Gorgoso et al., 2019).

Judgement:

Clinical Assessment: A judgment assessment tool

Assessment Questions:

  • What are the major problems that are you are facing right now?
  • What are the thoughts that increase the stress and anger in you?

Reference: When it comes to evaluating the judgmental aspect of any individual judgmental assessment tool is important to analyse the judgmental skills of the patient. The judgmental skills are important for the individual that includes information processing, decision making and reaction to feedback. The assessment process is important to identify the judgmental processing of the individual that is important to identify the issue or disturbance in judgmental processing of patient (Escudier et al., 2017).

Insight:

Clinical Assessment: Insights assessment scale

Assessment Questions:

  • If you find a dog injured over the road then what will you do?
  • What are the things that seem unnatural to you?

References: The insight assessment scale is important to understand the insights processing of the individual that is important to evaluate the individual understanding concerning the specific things. The insights’ understanding is important to identify the motivational force cornering the individual action in a specific situation. The assessment will help to understand individual pattern related to the knowledge and reaction toward a particular thing that is important to understand thinking pattern (Wikström & Eklöf, 2019).

Recovery Focused Care Plan

The recovery is an important factor when it comes to mental health as it focuses on empowering the individual skills to deals with the situation (Coffey et al., 2018). The first recovery process that is suitable for the patient in the assessment is the empowerment that helps to improve his health status. According to Bailo et al., (2019) patient empowerment is necessary to improve the quality of care that helps to decrease the recovery time.

Cognitive-behavioural therapy is considered gold standard intervention when it comes to the mental illness of the patient (Ruggiero et al., 2018). The nurse can help the patient while understanding the cognitive behavioural therapy importance and increase participation. Environmental change intervention is useful to help the patient-facing mental issue and it helps in the healing process (Chauhan et al., 2017). The nurse can help to change the surrounding environment by providing different referrals that are necessary to provide quality care to the patient.

The psychosocial, intervention is important to improve patient engagement in the society that will help to reduce the mental illness (Ambekar & Mongia, 2018). The therapist and nurse can collaborate to improve patient participation in the social gathering that is important for the mental state of the patient. All three interventions are framed to improve the individual capability to support and improve the mental state of the patient as per the recovery-focused care model.

The connectedness is the second recovery process that is right for the patient and it will help to improve the patient participation in the care. Educational intervention is important to support and improve the individual knowledge concerning the disorder as well as management technique (Cusack et al., 2018). The nurse can use their therapeutic communication to help the patient to understand the importance of the management process that is necessary to decrease complication. 

A relaxation technique is important to decrease the mental stress condition and it utilizes the muscle relaxation, box breathing and guided imagery to relax the individual (Norelli et al., 2020). The nurse can assist the patient to understand the relaxation exercise and implement them correctly to gain benefit. Lifestyle modification intervention is important to improve the mental as well as physical health of the patient by improving the daily routine of exercise and dietary pattern (Yamaoka et al., 2019). The nurse can help the patient by collaborating with aerobics instructor and dietician to support the patient physically as well as mental health status.

These three interventions will help to improve the care process that is based on the person-centred approach. This will help to provide the right care concerning the patient health status and it reduces the recovery time.

References for Assessment Analysis in Mental Health Nursing

Alhassan, A., Fuseini, A.-G., & Musah, A. (2019). Knowledge of the Glasgow coma scale among nurses in a tertiary hospital in Ghana. Nursing Research and Practice, 2019, 1–7. DOI:10.1155/2019/5829028

Ambekar, A., & Mongia, M. (2018). Planning research in psychosocial interventions. Indian Journal of Psychiatry, 60(Suppl 4), S575–S582. DOI: 10.4103/psychiatry.IndianJPsychiatry_27_18

Bailo, L., Guiddi, P., Vergani, L., Marton, G., & Pravettoni, G. (2019). The patient perspective: investigating patient empowerment enablers and barriers within the oncological care process. Ecancermedicalscience, 13(912), 1-15. DOI: 10.3332/ecancer.2019.912

Barrows, S. D. (2018). Do sub-Saharan countries in Africa have the Dutch disease? Asian Social Science, 14(5), 14-28. DOI:10.5539/ass.v14n5p14

Chauhan, B. F., Jeyaraman, M., Mann, A. S., Lys, J., Skidmore, B., Sibley, K. M., & Zarychanksi, R. (2017). Behaviour change interventions and policies influencing primary healthcare professionals’ practice—an overview of reviews. Implementation Science, 12(3), 1-16. DOI: 10.1186/s13012-016-0538-8

Coffey, M., Hannigan, B., Barlow, S., Cartwright, M., Cohen, R., Faulkner, A., & Simpson, A. (2019). Recovery-focused mental health care planning and co-ordination in acute inpatient mental health settings: A cross-national comparative mixed-methods study. BMC Psychiatry, 19(1), 1-18. DOI: 10.1186/s12888-019-2094-7

Cusack, L., Del Mar, C. B., Chalmers, I., Gibson, E., & Hoffmann, T. C. (2018). Educational interventions to improve people’s understanding of key concepts in assessing the effects of health interventions: A systematic review. Systematic Reviews, 7(68), 1-12. DOI:10.1186/s13643-018-0719-4

Escudier, F., Léveillé, E., Charbonneau, S., Cole, J., Hudon, C., Bédirian, V., & Scherzer, P. (2016). Evaluating decision-making: Validation and regression-based normative data of the judgment assessment tool. Archives of Clinical Neuropsychology, 31(8), 829–838. DOI:10.1093/arclin/acw019.

Frost, B. G., Tirupati, S., Johnston, S., Turrell, M., Lewin, T. J., Sly, K. A., & Conrad, A. M. (2017). An Integrated Recovery-oriented Model (IRM) for mental health services: Evolution and challenges. BMC Psychiatry, 17(22), 1-17. DOI: 10.1186/s12888-016-1164-3.

Gilutz, Y., Lazary, A., Karpin, H., Vatine, J.-J., Misha, T., Fortinsky, H., & Sharon, H. (2015). Detailed behavioral assessment promotes accurate diagnosis in patients with disorders of consciousness. Frontiers in Human Neuroscience, 9, 1-11. DOI:10.3389/fnhum.2015.00087

Maroufizadeh, S., Omani-Samani, R., Almasi-Hashiani, A., Amini, P., & Sepidarkish, M. (2019). The reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 in patients with infertility. Reproductive Health, 16(137), 1-8. DOI: 10.1186/s12978-019-0802-x

McAlister, S., & Yanushevskaya, I. (2019). Voice assessment practices of speech and language therapists in Ireland. Clinical Linguistics & Phonetics, 1–25. DOI:10.1080/02699206.2019.1610798

Norelli, S. K., Long, A., & Krepps, J. M. (2020). Relaxation techniques. Treasure Island, United Kingdom: StatPearls Publishing.

Ruggiero, G.M., Spada, M.M., Caselli, G. (2018). A historical and theoretical review of cognitive behavioral therapies: From structural self-knowledge to functional processes. Journal Rat-Emo Cognitive-Behavioural Therapy, 36, 378–40, DOI: 10.1007/s10942-018-0292-8

Sarceda-Gorgoso, M., Pedreira, M., & Guevara-Betancourt, S. (2019). Perception of technology as an assessment tool: A comparative analysis from the learner's perspective. Digital Education Review, 35, 216-228.

Shah, S. A., Nolan, M., Ryan, M., Williams, J., & Fannon, D. (2014). Delivering recovery-focused mental health care in Ireland: Implications for services and practice development. Irish Journal of Psychological Medicine, 33(02), 121–128. DOI:10.1017/ipm.2014.75

Twomey, C., O’Connell, H., Lillis, M., Tarpey, S. L., & O’Reilly, G. (2017). Utility of an abbreviated version of the Stanford-Binet intelligence scales (5th ed.) in estimating “full scale” IQ for young children with autism spectrum disorder. Autism Research, 11(3), 503–508. DOI:10.1002/aur.1911

Voss, R. M., & M Das, J. (2020). Mental Status Examination. Treasure Island, United Kingdom: StatPearls Publishing.

Wikström, C., & Eklöf, H. (2019). Educational assessment in digital environments: Insights from different assessment contexts. Education Inquiry, 10(1), 1–3. DOI:10.1080/20004508.2019.1568779

Yamaoka, K., Nemoto, A., & Tango, T. (2019). Comparison of the effectiveness of lifestyle modification with other treatments on the incidence of type 2 diabetes in people at high risk: A network meta-analysis. Nutrients, 11(1373), 1-13. DOI: 10.3390/nu11061373

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