166 Unit 2 BUILDING THENURSE–CLIENTRELATIONSHIP
may not be able to get out of bed. Therefore, the nurse
must assess the client’s usual patterns of eating and
sleeping then determine how those patterns have
changed (Chow & Cummings, 2000).
The nurse also asks the client if he or she has any
major or chronic health problems and if he or she
takes prescribed medications as ordered and follows
dietary recommendations. The nurse also explores the
client’s use of alcohol and over-the-counter or illicit
drugs. Such questions require nonjudgmental phras-
ing; the nurse must reassure the client that truthful
information is crucial in determining the client’s plan
of care.
Noncompliance with prescribed medications is
an important area. If the client has stopped taking
medication or is taking medication other than as pre-
scribed, the nurse must help the client feel comfort-
able enough to reveal this information. The nurse
also explores the barriers to compliance. Is the client
choosing noncompliance because of undesirable side
effects? Has the medication failed to produce the de-
sired results? Does the client have difficulty obtain-
ing the medication? Is the medication too expensive
for the client?
DATA ANALYSIS
After completing the psychosocial assessment, the
nurse analyzes all the data that he or she has collected.
Data analysis involves thinking about the overall as-
sessment rather than focusing on isolated bits of in-
formation. The nurse looks for patterns or themes in
the data that lead to conclusions about the client’s
strengths and needs and a particular nursing diagno-
sis. No one statement or behavior is adequate to reach
such a conclusion. The nurse also must consider the
congruence of all information provided by the client,
family, or caregivers and his or her own observations.
It is not uncommon for the client’s perception of his
or her behavior and situation to differ from that of
others. Assessments in a variety of areas are necessary
to support nursing diagnoses such as Chronic Low
Self-Esteem or Ineffective Coping.
Traditionally data analysis leads to the formula-
tion of nursing diagnoses as a basis for the client’s
plan of care. Nursing diagnoses have been an integral
part of the nursing process for many years. With the
sweeping changes occurring in health care, however,
the nurse also must be able to articulate the client’sBox 8-3
➤ MCMASTERFAMILYASSESSMENTDEVICE—CONT’D
STATEMENTS SA A D SD- We discuss who is to do household jobs.
- Making decisions is a problem for our family.
- Our family shows interest in each other only when they can get something
out of it. - We are frank with each other.
- We don’t hold to any rules or standards.
- If people are asked to do something, they need reminding.
- We are able to make decisions about how to solve problems.
- If the rules are broken, we don’t know what to expect.
- Anything goes in our family.
- We express tenderness.
- We control problems involving feelings.
- We don’t get along well together.
- We don’t talk to each other when we are angry.
- We are generally dissatisfied with the family duties assigned to us.
- Even though we mean well, we intrude too much into each other’s lives.
- There are rules about dangerous situations.
- We confide in each other.
- We cry openly.
- We don’t have reasonable transport.
- When we don’t like what someone has done, we tell them.
- We try to think of different ways to solve problems.
From Schutle, N. S., & Malouff, J. M. (1995). Sourcebook of adult assessment strategies.New York: Plenum Press, Brown University/
Butler Hospital Family Research Program, © 1982.