A Method for Appraising Family Public Health Nursing Needs

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Abstract
As a measure to help define the public health nursing needs of families, a scale was devised for estimating the competence of the family in relation to 9 areas of concern that would ordinarily fall within the scope of nursing and which appeared to be constant whatever the medical diagnosis or health condition. Estimations were made at the instigation of service and subsequently at 3-month intervals. In addition, the nurse providing care estimated the expected change in family competence, for each scaling period. The method was subjected to an administrative trial in which characteristics of cases of nurses using the scaling form were compared with those when no specified procedure was used and when a descriptive form was used, and with those of a specially assigned supervising nurse who used the scaling form and the descriptive form. Number and distribution of problems identified, conformity of stated problems with the nursing action taken, and case-by-case agreement of staff nurse and supervisor in relation to problems found using both forms, and in relation to expected change and actual change when the trial form was used were compared. This method appeared to produce a more systematic approach to analysis, somewhat different distribution of problems and greater conformity between problem and action taken than occurred when no specified procedure was followed, or when a descriptive form was used. Nurses judgment of family problems was closer to that of the independent judgment of a nursing supervisor when this method was used than when the descriptive form was used. This mean agreement level was 85.4% of possible agreements when the scaling form was used and 36.1% when the descriptive form was used.

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