170 Unit 2 BUILDING THENURSE–CLIENTRELATIONSHIP
- The components of a thorough psychosocial
assessment include the client’s history, gen-
eral appearance and motor behavior, mood
and affect, thought process and content,
sensorium and intellectual process, judg-
ment and insight, self-concept, roles and
relationships, and physiologic and self-care
considerations. - Several important factors in the client can in-
fluence the psychosocial assessment: ability to
participate and give feedback, physical health
status, emotional well-being and perception of
the situation, and ability to communicate. - The nurse’s attitude and approach can
greatly influence the psychosocial assess-
ment. The nurse must conduct the assess-
ment professionally, nonjudgmentally, and
matter-of-factly, while not allowing personal
feelings to influence the interview. - To avoid making inaccurate assumptions
about the client’s psychosocial functioning,
the nurse must be sensitive to the client’s
cultural and spiritual beliefs. Many cultures
have values and beliefs about a person’s role
in society or acceptable social or personal be-
havior that may differ from the beliefs and
values of the nurse.- Accurate analysis of assessment data in-
volves considering the entire assessment and
identifying patterns of behavior as well as
congruence among components and sources
of information. - Self-awareness on the nurse’s part is crucial
to obtain an accurate, objective, and thor-
ough psychosocial assessment. - Areas that are often difficult for nurses to
assess include sexuality and self-harm
behaviors and suicidality. Discussion with
colleagues and experience with clients can
help the nurse to deal with uncomfortable
feelings. - The client’s safety is a priority; therefore,
asking clients clearly and directly about
suicidal ideation is essential.
For further learning, visit http://connection.lww.com.
- Accurate analysis of assessment data in-
REFERENCES
Adams, R. L., & Culbertson, J. L. (2000). Personality
assessment: adults and children. In B. J. Sadock &
V. A. Sadock (Eds.), Comprehensive textbook of psy-
chiatry, Vol. 1(7th ed., pp. 702–722). Philadelphia:
Lippincott Williams & Wilkins.
American Nurses Association. (2000). Statement on
psychiatric-mental health nursing practice and
standards of psychiatric and mental health nursing
practice.Washington, DC: American Nurses
Publishing.
American Psychiatric Association. (2000). Diagnostic and
statistical manual of mental disorders(4th ed., text
revision). Washington, DC: Author.
Chow, T. W., & Cummings, J. L. (2000). Neuropsychiatry:
Clinical assessment and approach to diagnosis. In
B. J. Sadock & V. A. Sadock (Eds.), Comprehensive
textbook of psychiatry, Vol. 1(7th ed., pp. 221–253).
Philadelphia: Lippincott Williams & Wilkins.
Hanna, D. R. & Roy, Sr. C. (2001). Roy adaptation model
and perspectives on family. Nursing Science Quarterly,
14 (1), 9–13.
McBride, L. & Walden-McBride, D. (1995). Balancing the
heart of patient care. Home Healthcare Nurse, 13 (4),
46–49.
Schultz, J. M., & Videbeck, S. (2002). Lippincott’s manual
of psychiatric nursing care plans(6th ed.). Philadel-
phia: Lippincott Williams, & Wilkins.
Schutle, N. S. & Malouff, J. M. (1995). Sourcebook of adult
assessment strategies.New York: Plenum Press.Critical Thinking Questions
1.The nurse is preparing to do a psychosocial
assessment for a client who is seeking help be-
cause she has been physically abusive to her
children. What feelings might the nurse expe-
rience? How does the nurse view this client?
2.The nurse has discovered through the assess-
ment process that the client drinks a quart of
vodka every 2 days. The client states this is
not a problem. How does the nurse proceed?
What could the nurse say to this client?
3.The nurse is assessing a client who is illiter-
ate. How will the nurse assess the intellectual
functioning of this client? What other areas of
a psychosocial assessment might be impaired
by the client’s inability to read or write?