محاضرة 12

Diagnosing Health Problems
Supervisor
Dr. Mansour Abdulla Falah
Preparation by
Msn student. Muntadher Mohammed
Introduction
Needs Assessment
The strategy chosen for collecting needs assessment data depends on the size and *
nature of the aggregate, the purpose for collecting information and the resources
.available to the nurse
Data collected directly from an aggregate may be more insightful and accurate; *
therefore community health nurses sometimes conduct community needs
.assessments
STEPS IN THE NEEDS ASSESSMENT
PROCESS
.Identify aggregate for assessment .1
.Engage community in planning the assessment .2
.Identify required information .3
.Select method of data gathering .4
.Develop questionnaire or interview questions .5
.Develop procedures for data collection .6
.Train data collectors .7
.…Continue
.Arrange for a sample representative of the aggregate .8
.Conduct needs assessment .9
.Tabulate and analyze data .10
.Identify needs suggested by data .11
.Develop an action plan .12

definition
The next step of the nursing process is synthesizing assessment data *

in which the nurse examines data and creates a list of all actual and
.potential problems
* Then the nurse develops diagnostic statements about the community’s

health.
* These statements, or diagnoses, specify the nature and cause of an actual

or potential community health problem and direct the community health
nurses’ plans to resolve the problem.
:The diagnosis consists of four components
.the identification of the health problem or risk -1
.the affected aggregate or community -2
.the etiological or causal statement -3
.the evidence or support for the diagnosis -4
Each of these components has an important role to play in the *

.nursing process
.The problem represents a synthesis of all assessment data *
.Muecke (1984) developed a format that assists in writing a community diagnosis
The “among” phrase specifies the aggregate that will be the beneficiary of the *
.nurse’s action plan and whose health is at risk
The “related to” phrase describes the cause of the health problem and directs *
.the focus of the intervention
the health indicators are the supporting data or evidence, drawn from the *
.completed assessment
CASE STUDY
Application of the Nursing Process Assessment and Diagnosis
School nurses frequently address a broad range of student health problems. In

the West San Antonio School District, school nurses generally reserve several
hours a week for home visits. In a recent case, a teacher expressed concern for a
high school junior named “John,” whose brother was dying of cancer. In a health
class, John shared his personal fears about cancer, which caused his classmates to
.question their own cancer risks and how they might reduce them
Assessment
The school nurse visited John’s family and learned that the 25-year old
son had testicular cancer. Since his diagnosis 1 year earlier, he
had undergone a range of therapies that were palliative but not
curative; the cancer was advanced at the time of diagnosis. The
nurse spent time with the family discussing care, answering
.questions, and exploring available support for the entire family

.…Continue
.The nurse first collected information about testicular cancer *
Second, the nurse reviewed the nursing and medical literature for key *
.articles discussing client care, diagnosis, and treatment
Epidemiological studies provided additional data regarding testicular *
cancer’s distribution pattern in the population and associated risk
.factors
The nurse learned that young men aged 20 to 35 years were at the *
.greatest risk. Other major risk factors were not identified
Community Diagnosis
There is an increased risk of undetected testicular cancer among
young men related to insufficient knowledge about the disease and
the methods for preventing and detecting it at an early stage, as
.demonstrated by high rates of late initiation of treatment

Planning
:The long-term goal was

Students will identify testicular lesions at an early stage and seek •
.care promptly
:The short-term goals were

Students will understand testicular cancer and self-detection •
.techniques
.Male students will report regular testicular self-examination •
Intervention
:The nurse conducted the two sessions in a health education class
At the beginning of the class period, students participated in a*

group exercise, and the nurse asked them about their knowledge of
.testicular cancer
.The nurse showed a film and led a discussion about cancer screening*
In the second session, the nurse advised the male students about the*
.frequency of self-examination
Evaluation
After completing the class sessions, the nurse administered the
.questionnaires she had developed for evaluation purposes
Analysis of the questionnaires indicated that knowledge levels were
.very high immediately after the classes

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Diagnosing Health Problems

.Arrange for a sample representative of the aggregate .8

.Conduct needs assessment .9

.Tabulate and analyze data .10

.Identify needs suggested by data .11

.Develop an action plan .12

The next step of the nursing process is synthesizing assessment data *

* Then the nurse develops diagnostic statements about the community’s

* These statements, or diagnoses, specify the nature and cause of an actual

Each of these components has an important role to play in the *

Application of the Nursing Process Assessment and Diagnosis

School nurses frequently address a broad range of student health problems. In

had undergone a range of therapies that were palliative but not

curative; the cancer was advanced at the time of diagnosis. The

nurse spent time with the family discussing care, answering

.questions, and exploring available support for the entire family

There is an increased risk of undetected testicular cancer among

young men related to insufficient knowledge about the disease and

the methods for preventing and detecting it at an early stage, as

.demonstrated by high rates of late initiation of treatment

:The long-term goal was

:The short-term goals were

At the beginning of the class period, students participated in a*

After completing the class sessions, the nurse administered the

.questionnaires she had developed for evaluation purposes

Analysis of the questionnaires indicated that knowledge levels were

.very high immediately after the classes

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