Case Study 1
The patient is aged 77 years and has a medical history of osteoarthritis and has reported for an annual physical examination. While walking into the examination room, it becomes clear that the patient is using a straight walking cane due to pain in his right hip. The most appropriate assessment tool that would be utilized as part of this case is the fall/ gait disturbance tool. The use of the fall/ gait disturbance tool plays a key role towards assessing a patient’s risk of fall, which may help eliminate the possibility of injury from such falls (Rosen & Reuben, 2011). In this case, the use of this assessment tool will be of importance considering that the patient has a history of osteoarthritis and is currently using ambulatory aide to improve on his ability to move around with ease.
Salzman (2010) indicates that the use of the fall/ gait disturbance assessment tool is especially important in testing a patient’s lower strength, gait, and balance. For this patient, different tests will be conducted as part of the assessment process with each of these tests reflecting on the patient’s likelihood of a fall. Some of the tests to be undertaken include gait speed >10m, nudging, standing straight on a chair, conducting a 360 0 turn, as well as, evaluating functional reach. Each of the tests will be undertaken for a period of 3 minutes or more, which will be of great value towards ensuring that adequate data is collected to determine the patient’s risk of falling. The patient’s current condition does not present any possible barriers that are likely to impact the tests being conducted, especially in seeking to ensure that the tests actually deliver on their respective goals. The assessment was validated for the patient through education by highlighting the specifics of what was being undertaken as part of meeting the prospective goals of the assessment. The case did not present any major issues that may affect overall effectiveness of the assessment such as language, education, prosthetics, or missing limbs.
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Case Study 2
The patient is 68 years old and has been working in a printing company for a period of 35 years. The patient complains of challenges in hearing, which is collaborated by his wife, who has accompanied him for the evaluation. While considering that the patient has not had any history of hearing impairments indicated, the most appropriate assessment tool to determine the patient’s hearing challenge is the tuning fork test. Tuning forks refer to instruments that are used in conducting brief tests with the aim of having to determine the probable presence of hearing loss (Kelly, Li, & Adams, 2018). In this case, the use of the tuning forks will be of great value towards ensuring that the patient is evaluated for the specific level at which he is experiencing challenges attributed to a hearing impairment.
In this test, the health professional strikes the tuning forks after which they are placed behind one year, specifically on the mastoid bone. The intention having to place the fork behind the ear is to determine the extent to which the patient is able to hear, which will help in the diagnosis of his hearing loss. The patient will be expected to signal in the event that he cannot hear the sound produced by the tuning fork anymore. The use of this evaluation will be of great value towards pushing for a much more effective approach through which to determine the extent of the patient’s hearing loss. Additionally, this evaluation approach will help in determining whether the patient is experiencing hearing loss in both ears or whether this is an issue within one of the ears. The assessment was validated for the patient through patient inclusion in the process, which provided them with a better sense of understanding of what was being undertaken and how this would match overall effectiveness towards improving on their health. The case did not present any major issues that may affect overall effectiveness of the assessment such as language, education, prosthetics, or missing limbs.
Case Study 3
The patient is an 83-year-old widow, who has had a medical history of depression for a period of 5 years, which may have resulted from the death of her husband. The patient’s medical history indicates that she was successfully treated using antidepressants. In a bid to assessing and determining the patient’s exact mental disorder, the most appropriate tool to use is Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-IV). DSM-IV refers to a manual, which was published by the American Psychiatric Association (APA), used as part of the diagnosis of a wide array of mental disorders by evaluating the presenting characteristics and symptoms (Fayyad et al., 2017). The use of this assessment tool for this patient would be most effective considering that it will help in the process of having to categorize some of the underlying symptoms that she is presenting as they relate to different mental conditions.
The use of DSM-IV is seen as the most accurate approach through which to not only determine the mental condition that a patient is suffering from but also determine the severity of the disorder (McGrath et al., 2016). In this case, the assessment will involve creating a summative list of the symptoms that have been presented both through physical examination of the patient, as well as, the information gathered from her daughter. The symptoms will then be compared to the specific presenting characteristics associated with possible mental disorders selected from the DSM-IV tool. The main idea is trying to find some form of consistency in the presenting symptoms and those indicated within this assessment tool. The ultimate outcome is that it will be much easier to diagnose the patient’s mental disorder, which will be of great value towards determining the treatment approaches that are to be considered. The assessment was validated for the patient through ensuring that information provided to the patient was adequate as a way of improving their cooperation, which would make it much easier to achieve best possible outcomes. The case did not present any major issues that may affect overall effectiveness of the assessment such as language, education, prosthetics, or missing limbs.
References
Fayyad, J., Sampson, N. A., Hwang, I., Adamowski, T., Aguilar-Gaxiola, S., Al-Hamzawi, A., ... & Gureje, O. (2017). The descriptive epidemiology of DSM-IV Adult ADHD in the world health organization world mental health surveys. ADHD Attention Deficit and Hyperactivity Disorders , 9 (1), 47-65.
Kelly, E. A., Li, B., & Adams, M. E. (2018). Diagnostic accuracy of tuning fork tests for hearing loss: a systematic review. Otolaryngology–Head and Neck Surgery , 159 (2), 220-230.
McGrath, J. J., Saha, S., Al-Hamzawi, A., Andrade, L., Benjet, C., Bromet, E. J., ... & Fayyad, J. (2016). The bidirectional associations between psychotic experiences and DSM-IV mental disorders. American Journal of Psychiatry , 173 (10), 997-1006.
Rosen, S. L., & Reuben, D. B. (2011). Geriatric assessment tools. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine , 78 (4), 489-497.
Salzman, B. (2010). Gait and balance disorders in older adults. Am Fam Physician , 82 (1), 61-68.
