Detecting nurse-perceived patient treatment difficulty of psychiatric patients in hospital: an evaluation of a patient assessment sheet.
Many changes have occurred in hospital psychiatric care, including decreased length of hospital stay and increased patient acuity. These changes highlight the need for nurses to adequately assess and formally document patient treatment difficulties. The purposes of this study were to determine the ability of the Patient Assessment Sheet (PAS) to predict patient 'problems' that psychiatric nurses perceived as associated with patient treatment difficulty, and to identify the patient problems missing from the PAS. These purposes were accomplished by comparing the PAS to the Hospital Treatment Rating Scale (HTRS). A correlational design and multiple linear regression technique were used. Eight psychiatric registered nurses assessed a total of 110 patients, admitted consecutively to one inpatient psychiatric unit. The HTRS and the PAS were used independently for each patient. Four PAS items (active affect, passive affect, aggression toward self, and patient confusion) significantly predicted 38% of the variance from the HTRS; and three HTRS items (isolation and withdrawal from relationships, noninvolvement in treatment, and wide variability in mood) significantly predicted 22% of the residual variance from the HTRS. The identified PAS and HTRS items help to make visible patient problems associated with nurse-perceived patient treatment difficulty. This identification is potentially important for both clinical and political purposes.
Faculty of Nursing, University of Toronto, 50 St. George Street, Toronto, Ontario, M5S-3H4, Canada.
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D000339:Affect; D000374:Aggression; D003221:Confusion / Q000451:nursing; D006801:Humans; D009730:Nursing Assessment / Q000379:methods*; D011237:Predictive Value of Tests; D011568:Psychiatric Nursing / Q000379:methods*