Advanced Theoretical of nursing
Assessment Tool for Patient Symptoms
Healthcare workers perform patient assessments in their daily activities. Patient assessment is vital because it helps healthcare workers establish patient needs and the effectiveness of the treatment modalities, which play a crucial role in decision-making. The theory of unpleasant symptoms suggests that symptoms exist together and influence each other in that they have a multiplicative effect on each other rather than an additional effect. The theory goes far as to propose that the treatment of one symptom simultaneously leads to the treatment of another sign. The theory suggests further that the symptoms can be physical, psychological or situational. For healthcare workers to effectively perform the assessments of symptoms, they must utilize an assessment tool that acts as a guide in completing the task (Peterson & Bredow, 2020). This paper will discuss the important parameters to look for in an assessment tool about The Model of Unpleasant Symptoms.
According to the model of unpleasant symptoms, an assessment tool must contain the following. First, the instrumentmust have a provision for the signs, which are physiological, psychological and situational. Psychological factors include all those stimuli that affect the state of the mind example, mood,which is a critical sign in patients with bipolar disorder (Chatani et al., 2021). Moreover, patients could experience physiological symptoms that present secondary to an alteration of the normal physiological functions of the body, which include an increase in heartbeat secondary to adrenaline surge or a decrease due to the parasympathetic action of the vagus nerve supplying the heart. In addition, the other cluster contains situational symptoms resulting from experiencing a stimulus during specific periods and are short-term. The situational symptoms include loss of appetite and sadness (Chatani et al., 2021).
Secondly, after identifying the signs, the tool must give a provision for assessing the factors that influence the symptoms. Factors influencing symptoms include aggravating and relieving factors. Aggravating factors refer to those activities that when a patient engages in, they worsen the presenting symptoms; a good example is the pain that comes with a peptic ulcer patient staying hungry for a long. In this case, the hunger worsens the situation by the patient feeling much pain. Relieving factors, on the other hand, consists of activities that comfort the patient; a good example is the relief of headache by sleep. Often, patients have perceived relieving factors before coming to the hospital. Lastly, performance outcome is critical as it will determine health-seeking behaviors. Primarily, when symptoms impair the performance of patient routines, the result will be seeking care to restore performance capacity (Peterson & Bredow, 2020).
In conclusion, we have seen that the theory of unpleasant symptoms is crucial in designing patient assessment tools. The idea presents three symptoms which include physical, psychological, and situational. Physiological factors include stimuli the patient perceives as pain, which can be rated. Additionally, we have looked at psychological symptoms which affect the mental faculties, followed by physiological symptoms that present due to alteration of the normal body function and situational, which are short and present as per the occasion. Lastly, we have seen that the tool must assess the main symptoms, the factors affecting the symptoms, and the outcome.
Chatani, Y., Nomura, K., Hiraike, H., Tsuchiya, A., & Okinaga, H. (2021). Multiple Physical Symptoms Are Useful to Identify High-Risk Individuals for Burnout: A Study on Faculties and Hospital Workers in Japan. International Journal of Environmental Research and Public Health, 18(6), 3246.
Peterson, S. J., & Bredow, T. S. (2020). Middle range theories: application to nursing research and practice (5th ed.). Wolters Kluwer.
Ana Madalys Cedeno
Miami Regional University
MSN5270 Advanced Theoretical Perspectives of Nursing
Prof. Trigoura Leanne
The theory of unpleasant symptoms (TOUS) was created for use by nurses in their clinical work and as researchers. It attempted to explain how numerous symptoms could interact and be multiplicative or additive, as well as how one symptom could affect how other symptoms are experienced as well, either positively or negatively. We must evaluate symptoms while keeping in mind that everyone’s perception of them is subjective and that the level of intensity and the amount of anguish they cause reveals how each person interprets them. The most popular tools for measuring and evaluating patient symptoms focus on performance, particularly functional aspects like daily activities and tasks performed. For patients who are towards the end of their lives or who are in severe condition, some of these functional evaluation techniques are inappropriate. Self-report and quality-of-life evaluation techniques can therefore examine how symptoms impact a patient’s performance.
An evaluation instrument for patient symptoms should quantify the symptoms in terms of their frequency, time, and intensity. The frequency and duration of symptoms additionally, as the link between the event’s beginning and the precipitating event is crucial. The evaluation instrument should determine the individual’s interpretation of the symptoms, as well as their severity, which corresponds to the description that describes the symptom’s location and how it affects that person particularly (Peterson, 2019).
An assessment tool should take into account these symptoms as well as the patient’s gender, age, comorbidities, illness or dysfunctions, and physiological findings that may be connected to the illness or its treatment because these symptoms are situational, psychological, and physiological and are influenced by a variety of factors. The patient’s interpretation of the symptom and his or her sense of self-efficacy should be taken into account via comprehensive assessment methods. The physical environment influences a person’s symptom experiences, therefore factors like temperature, noise, social status, occupation, available resources, and the rapport between nurses and medical staff all play a role (Peterson,2019).
A tool for evaluation should measure the quality of life in order to help with the design of therapies to address symptoms that are simultaneously present and are interacting with one another to alter the symptom experience. Monitoring performance results and making adjustments to the care plan as needed are crucial (Lenz, 2018).
Peterson, S., & Bredow, T. S. (2019). Middle Range Theories (5th Edition). Wolters Kluwer Health. https://online.vitalsource.com/books/9781975149062
Lenz, E. R. (2018). Application of the theory of unpleasant symptoms in practice: A challenge for nursing. Investigación en Enfermería: Imagen y desarrollo, 20(1). https://doi.org/10.11144/javeriana.ie20-1.atus
– Saturday, December 3, 2022, 6:57 PM
Number of replies: 2
Theory of Unpleasant Symptoms and Building an Assessment Tool
The process of analyzing a patient’s symptoms is an important part of nursing care. The treatment of patients’ symptoms is the primary responsibility of nurses. They are primarily doing evaluations of them, determining the elements that may affect alterations, devising preventive and therapeutic remedies, and aiding patients with continued monitoring and self-management. The purpose of developing the Theory of Unpleasant Complaints was to aid nurses in comprehending the emotions of their patients (TOUS). In an attempt to expand nursing knowledge and practice, the goal of this research was to draw attention to significant facets of the symptom experience (Haas, 2017). In this piece of study, the issue is analyzed, and a discussion is had about the characteristics that a nurse would seek for in a symptom assessment tool for patients.
The three primary components that make up the Theory of Unpleasant Symptoms are as follows: The performance result, as well as the symptoms, and the variables that impact the symptoms. Using the patients’ own views and descriptions as the basis, this technique classifies patients’ symptoms. In addition, the notion postulates that a patient’s level of pain, length of symptoms, severity of symptoms, and quality of symptoms might change. This hypothesis also analyzes the potential impact that symptoms might have. Physiological characteristics such as age and gender, in addition to disease-specific variables, are included in this category. The presentation of symptoms may be influenced by a variety of variables, including cognitive and emotional aspects (Lenz, 2018). This is because they affect the patient’s perspective of the symptoms that they are experiencing. When evaluating a patient’s symptoms, it is essential to take into account the whole situation. These include the patient’s physical and social environments, both of which may have an impact on the symptoms that the patient experiences. On the other hand, the impact of the symptoms manifests themselves in physical, social, and mental ways.
Aspects to Consider When Designing an Evaluation Instrument for Symptoms
According to Silva-Rodrigues et al. (2019), a symptom evaluation instrument has to have many characteristics in order to be useful. To begin, the evaluation instrument should provide a section for patients to describe any symptoms they are experiencing. The patient’s own description of their symptoms is one of the most reliable sources of data that nurses may use to assess the severity of the disease and the response to treatment. In addition, the evaluation instrument has to place an emphasis on the many different circumstances that have an effect on the patient’s stated symptoms. The evaluation tool is required to take into consideration a variety of factors, including but not limited to child development, growth, physiology, and situational concerns. For example, the healthcare professional has a more comprehensive understanding of the child’s cancer experience and treatment as a result of these inquiries. In addition, the evaluation tool has to take into consideration other elements that have an effect on the symptoms that a child patient experience. Additional aspects to consider include age, gender, culture, and language.
It is possible that something like a patient symptom evaluation instrument may be built on top of the Theory of Unpleasant Symptoms as well. Within the context of the systematic review, the patient’s symptoms were investigated from a variety of perspectives. Prevalence rates, severity, and fluctuations in severity throughout the course of time were the three important characteristics (Silva-Rodrigues et al., 2019). Because of this conclusion, it is necessary to look for an evaluation method that provides information on the prevalence rates, severity, and intensity swings of the symptoms. In addition to this, TOUS may serve as a foundation for the development of a patient symptom evaluation instrument. According to this article, the notion may be able to assist explain the link between the concurrent diseases of a patient and the symptoms of their malignancy.
When evaluating a patient’s symptoms, a symptom evaluation tool should thus take into consideration any comorbid conditions that the patient may have. Additionally, the instrument assists in the identification of symptoms that are present concurrently. It is vital to understand the Theory of Unpleasant Symptoms in order to have an overall comprehension of patient symptoms. Hence, the evaluation of the patient’s symptoms is possible using this method. The identification of symptoms, the variables that influence the symptoms, and the performance outcomes are said to be the three primary elements that make up an effective symptom assessment instrument, in accordance with this idea. Consequently, an evaluation instrument is required to incorporate all of these necessary components.
Lenz, E. R. (2018). Application of the theory of unpleasant symptoms in practice: A challenge for nursing. Investigación En Enfermería: Imagen Y Desarrollo, 20(1).
Silva-Rodrigues, F. M., Hinds, P. S., & Nascimento, L. C. (2019). The theory of unpleasant symptoms in pediatric oncology nursing: a conceptual and empirical fit?. Journal of Pediatric Oncology Nursing, 36(6), 436-447.
Name: Marlies Melgarejo Valeron
Miami Regional University.
Professor: Leanne Trigoura
Medical professionals must make the correct diagnosis for patients to receive appropriate and relevant care. In the process, they must make meaning from the disease symptoms present in the patient. The theory of unpleasant symptoms enables nurses to identify different classifications of symptoms and propose management plans or interventions which are not pharmacological (Gomes et al., 2019). In other words, the theory of unpleasant symptoms helps nurses know different symptom groups, which helps them suggest to patients effective ways to do away with unpleasant symptoms. Since nurses have medical training, they can connect a symptom to a health problem and a solution for the same. The theory of unpleasant symptoms has three main parts, including the symptoms themselves, the causes of the influence, and the aftermath of the cause experience (Gomes et al., 2019). First, the symptoms are the circumstances the patient feels in their body that cause discomfort. Symptoms tell that there is a problem in the human system. For example, one may have headaches, stomach aches, and nausea. The second element is the cause of the symptom. The cause is what made the symptom appear, which relates to what the patient ingested or what they physically experienced. Lastly, the consequences of the symptom, the far-reaching results of the symptom, or what may happen next after one experiences the symptom. Unpleasant symptoms may be psychological, physiological, or situational (Gomes et al., 2019).
The theory can be used as a guide to help nurses focus professionally when handling patients. It is crucial to note that the theory emphasizes that nurses should focus on multiple rather than one symptom to make a conclusion and propose an intervention (Lee et al., 2017). Unpleasant symptoms theory directs the nurse to focus on the intensity and frequency or severity (Cleary et al., 2022), time, and quality (Gomes et al., 2019). Therefore, nurses must consider the mentioned elements critically when looking for an assessment tool for patient symptoms. The assessment tool helps nurses carry out a comprehensive patient assessment to understand the actual problems of the patients. The nurses must consider the frequency, which entails the number of times the symptom appears, and the severity, which relates to the level of suffering caused by the symptom. The frequency and severity would help the nurse determine whether the case is urgent or not. Again, nurses must consider the time of the symptom appearance, whether it is recent or has been reoccurring with time. Such would inform the nurse how long the patient can sustain the unpleasantness of the symptom. Lastly, the quality of the symptom, which also relates to the severity and intensity. A successful patient assessment via the available tools will enable nurses to obtain the actual problems faced by the patients, hence providing the most appropriate medical intervention. To collect the information for the assessment, the nurses may ask questions and allow the patient to answer freely. The nurse can also make a basic observation by feeling, hearing, and seeing.
Cleary, N., Mulkerrin, O. M., & Davies, A. (2022). Oral symptom assessment tools in patients with advanced cancer: a scoping review. Supportive Care in Cancer, 30(9), 7481–7490. https://doi.org/10.1007/s00520-022-07169-1
Gomes, G. L. L., Oliveira, F. M. R. L. de, Barbosa, K. T. F., Medeiros, A. C. T. de, Fernandes, M. das G. M., & Nóbrega, M. M. L. da. (2019). THEORY OF UNPLEASANT SYMPTOMS: CRITICAL ANALYSIS. Texto & Contexto – Enfermagem, 28. https://doi.org/10.1590/1980-265x-tce-2017-0222
Lee, S. E., Vincent, C., & Finnegan, L. (2017). An Analysis and Evaluation of the Theory of Unpleasant Symptoms. Advances in Nursing Science, 40(1), 1. https://doi.org/10.1097/ans.0000000000000141
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