Assessment tools and patient questionnaires

Assessment tools and patient questionnaires, such as The Flinders Partners in Health Scale and the Patient Activation Measure, are often used to engage a person in their own health care and health outcomes.

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Assessment tools and questionnaires are not diagnostic tools and do not replace taking a health history.

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Take these steps before using an assessment tool or questionnaire:

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• Be clear about why you are asking someone to complete the tool or questionnaire.

• Explain to the person why the questions are relevant to their situation, eg, to help everyone to focus on what really matters to them.

• Choose how you are going to administer the tool or questionnaire, eg, orally, in writing, electronically, in the waiting room before an appointment or during an appointment.

• Consider how factors such as language barriers and cultural perceptions may affect a person’s ability to understand the tool or questionnaire.

• Consider whether it is better to ask a couple of open-ended questions, such as “What is it about your diabetes that you find difficult?”, rather than using a long, written questionnaire.

• Decide how you will use the results. If people go to the effort of completing an assessment, you need to both discuss with them the information they have provided and use that information.

 

Selecting an assessment tool

 

When selecting an assessment tool, ask yourself the following questions:

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• What is the purpose of using the tool? For example, it may be to find out initial information and then monitor progress over time.

• What health issues am I trying to identify? For example, do you want to understand a person’s health needs to develop a care and support plan, or do you have concerns about their mental health?

• What is the validity of the tool? How well does the tool work?

• How can the tool or questionnaire be integrated into your practice workflow and systems? Useful implementation guidance on health assessment in primary care can be found here.

• Has your team been trained in how to use the tool?

 

Be aware a person’s responses may change over time for reasons other than treatment. This is called a ‘response shift’. For example, prior to a care plan conversation, a person may score themselves quite highly on an item such as taking medications or managing symptoms. However, on a follow-up assessment they may allocate a lower score to that item.

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This may be because they have realised, as a result of the care planning conversation, that they were not doing as well as they originally thought. This makes it important that responses be discussed so differences such as this are not taken as signs of failure or regression.

 

Assessment tools and questionnaires

 

This is a list of a few validated broad-based tools that can be used as part of delivering long-term condition care. Some tools can measure progress over time. Most of the tools and questionnaires do not require the person administering them to be trained, although some do come with user guides. In either case, you need to discuss in your team how to interpret and use any tool you consider introducing. Some of these tools can only be used under licence.

 

Hua Oranga

Hua Oranga measures outcomes consistent with Māori concepts of health and wellness, but it can be used with anyone who finds the domains relevant.

 

Hua Oranga uses the application of the 4 dimensions of Te Whare Tapa Whā:

·       ​te taha wairua (spiritual wellbeing)

·       te taha hinengaro (mental and emotional wellbeing)

·       te taha tinana (physical wellbeing)

·       te taha whānau (family and relationship wellbeing).

 

Hua Oranga can be used in a general health setting and is also being extensively used in mental health settings, as it recognises the interconnectedness of all aspects of health.

 

If used more than once with an individual, change or outcome can be measured. A 5-point scale is used to rate the domains.

 

Hua Oranga has 3 schedules reflecting the different perspectives of the people involved in the wellbeing of the tangata whaiora (client/consumer). All 3 questionnaires are similar and contain 4 sections or domains.

 

Ideally the questionnaires are completed by the tangata whaiora, a clinician and a whānau (family) member. However, this may not always be possible and it may be useful to start with self-assessment by the tangata whaiora. 

 

If all 3 parties are able to complete the questionnaires this provides an opportunity to discuss the similarities and differences in perceptions and feelings that are important to supporting wellbeing.

 

A copy of Hua Oranga is available here: