Health Appraisal, Risk Assessment, and Lifestyle

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Health Appraisal, Risk Assessment, and Lifestyle

• Dianna Spies Sorenson,
• PhD, RN, CNS

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What Is It?

• An assessment of /- behaviors or lifestyle
  habits that have short or long term effects on
  health

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Differences in Terms

• Conceptual/philosophical differences between
  health risk appraisal, health and lifestyle
  assessments exist, although the terms are
  sometimes used interchangeably
• Read the definitions in literature describing the
  purpose(s) of tools used, as the data you gather
  may differ from what you want
• All 3 can be assessed together or separately

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Considerations for Choosing An Assessment/Appraisa
l

• Is the assessment comprehensive?
• Bio
• Psycho
• Social
• Spiritual
• Environmental

• Ease of Administration?
• Self-Administered
• Provider Administered
• Cost?
• Cost of the tool
• Cost to administer
• Cost to score

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Considerations for Choosing An Assessment/appraisa
l Cont

• Are the results what you want?
• Positive behaviors recorded?
• Negative behaviors recorded?
• Valid reliable?
• Literature to support?
• Developer credentials?

• Consistent or congruent with the theoretical base
  chosen for practice?
• Do the results lead you to logical direction for
  intervention?

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Example AIDS Risk Assessment Risk Reduction
Counseling Guide
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Introduction

• The purpose of risk assessment is to provide
  appropriate specific counseling to improve the
  health of the patient.

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Introduction

• This sheet should not be used as a checklist, but
  rather as a guide for assessment
  patient-centered risk reduction counseling.

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Introduction

• As with any patient encounter, it is important to
  introduce yourself start to develop a
  comfortable relationship before the assessment
  begins.

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Introduction

• In addition, a short discussion of the need for a
  thorough assessment of risk can decrease the
  patients anxiety about this session.

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Introduction

• Tell the patient that some of the questions may
  be embarrassing or uncomfortable, but that you
  are only asking them to provide better care.

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AIDS Risk Reduction Is Based on the Harm
Reduction Philosophy

• Asks these questions at EACH step of the process
  
• What is safer, healthier, or less risky than what
  you are doing now?
• Of the full spectrum of things that are safer,
  healthier, and less risky, what, if anything, are
  you willing to try?

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Think Broadly!

• Risk reduction is comprehensive and not just
  limited to the overt and logical sources (I.E.
  In AIDS risk reduction, assessment and
  intervention are beyond sexual activity)
• APNs must think out of the box
• Comprehensive
• Beyond the individual to groups and communities
• Care management must include resources for
  further education, and counseling support to
  address actual and potential barriers to change

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Safety Issues
15
General Health History
16
Substance Abuse/Addiction
17
Sexual History
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Critical Thinking

• What do driving practices, surgical
  interventions, sex, have to do with AIDS?
• What are the co-morbid lifestyle choices that
  relate to AIDS risks?
• Who, besides the identified patient, is at risk?
• What additional risks besides AIDS can you
  identify through this assessment?

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Your Turn .

• Identify a health issue you want to assess
• Epidemiological
• History
• Behaviors observed
• Familial reports
• Other data sources
• What assessment questions do you need to ask to
  get a better picture?
• Co-morbid lifestyle behaviors
• Assessment tools available?

• Where do you start to intervene?
• What is safer, healthier, or less risky than what
  you are doing now?
• Of the full spectrum of things that are safer,
  healthier, and less risky, what, if anything, are
  you willing to try?