title: Development of a functional analytical nurse observation chart (FANOC).
abstract: BACKGROUND
  There has been little evaluation or development of nurse observation charts on psychiatric in-patient units since they were first introduced.
  
  
  OBJECTIVE
  We aimed to develop a new nursing chart that adds a functional and contextual assessment of the observed behaviour. We describe its initial evaluation in an in-patient setting.
  
  
  METHODS
  A member of the staff coded a participant's behaviour as either an instance of an individual's daily life problem; or an improvement; or a non-clinically relevant behaviour. We evaluated the charts in 14 in-patients and compared the coding of the behaviour against that of one of the investigators.
  
  
  RESULTS
  After brief training the inter-rater agreement resulted in Kappa = 0.496 with p < .001. Removal of a rating of neutral behaviours resulted in a higher Kappa = 0.546 with p < .001.
  
  
  CONCLUSIONS
  The inter-rater reliability was only moderate for the Functional Analytical Nurse Observation Charts. Frequent training and support from management and therapy staff is required to maintain a psychologically informed environment and observation in an in-patient setting. An area for further research is to explore the impact that a FANOC has on staff satisfaction and an individual's experience of care, and whether it can assist in determining mediators of change before an improvement in symptoms.
authors: NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and The Institute of Psychiatry, King's College London and The Priory Hospital North London, UK.
authors: David
authors: D
authors: Veale
authors: Selina
authors: S
authors: Warlow
authors: Tara
authors: T
authors: O'Donoghue
authors: Chris
authors: C
authors: Callow
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000451:nursing* / Q000523:psychology / Q000534:rehabilitation; D057215:Body Dysmorphic Disorders / Q000175:diagnosis* / Q000451:nursing* / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods* / Q000706:statistics & numerical data*; D009737:Nursing Records / Q000706:statistics & numerical data*; D009741:Nursing Staff, Hospital; D015588:Observer Variation; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000451:nursing* / Q000523:psychology / Q000534:rehabilitation; D011340:Problem Solving; D011594:Psychometrics / Q000706:statistics & numerical data*