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December 02, 2024
April 16, 2022
To: Bruce Williams, Social Worker
17 Jones Street,
North Sydney, New South Wales, 2060
Sender: <Your Name>, Psychologist
Post Office Box 99
North Sydney, New South Wales, 2060.
Subject: Referral Letter for Mrs. Glenda Smith
Dear Mr. Bruce,
This letter provides a summary for the client, Mrs. Glenda Smith, whom I evaluated under the psychiatrist's guidance after her admission to Sunrise Hospital on January 30, 2020. The letter further addresses the results of the patient's mental health evaluation, which will be beneficial in formulating the treatment plan for Mrs. Glenda.
Mrs. Glenda is a 65-year-old female who was born and reared in rural Australia. She attended a local school till year 12 and began employment at the age of 14. She is married to Mick, aged 70, and has two children, twin sons named George and Tim. All of her parents are dead. Glenda has just retired.
Mrs. Glenda was referred for psychiatric evaluation after her admission to Sunrise Hospital under the Mental Health Act (2016). She was seen roaming the streets and seemed bewildered. Moreover, her deficiency in recent and immediate memory concerned the psychiatrist, prompting a referral for a mental evaluation exam. The assessment was necessary to evaluate Mrs. Glenda's cognitive abilities and assist in determining the most appropriate medical care options for her, as stipulated in the Act. She was primarily referred for a mental examination to see whether she has any mental disability contributing to her disorientation and short-term memory loss.
Mrs. Glenda had a Mini Mental State Examination (MMSE) as per the recommendation. The evaluation notably measures orientation to time and place, understanding, reading, motor abilities, mood, memory, speaking, thinking processes, and visual perception, among other factors (Larner, 2013). The evaluation of these areas was essential to determine whether Mrs. Glenda had any limitations.
Through the MMSE, I determined that Mrs. Glenda had challenges with temporal and spatial orientation, understanding, reading, and writing. Despite his intellectual capacity being assessed as ordinary, she attained a score of 21 on the scale, which falls short of the threshold score of 23. The score indicates the likelihood that Mrs. Glenda has dementia. This conclusion is supported by impairments including disorientation, cognitive difficulties, fragmented mental processes, and deficits in immediate and recent memory.
It is advised that Mrs. Glenda get instructions in a more clear and concise manner to enhance her understanding. Additionally, additional laboratory tests are required to confirm the client's dementia diagnosis. If substantiated, it will be advised that she be treated with caution, acknowledging her difficulties in comprehension, eyesight, and orientation. Moreover, as a social worker, you want to facilitate clothing and grooming for Mrs. Glenda and promote engaging and pleasurable activities to prevent disarray and additional disorientation, respectively (Sorrentino et al., 2021). This information will facilitate the provision of more culturally sensitive and professional care to Mrs. Glenda at home.
Results of Psychometric Evaluation
I am certain that the information provided will provide Mrs. Glenda more support. If you need the whole evaluation report or further information about the customer, please feel free to contact me at your convenience.
Respectfully,
<Your name>
Analysis: Advantages and Disadvantages of Psychometric Assessment
Psychometric testing is intended to assess an individual's cognitive talents, behavior, or personality. From a psychological perspective, it offers the most effective method for assessing an individual's mental condition and talents (Spencer et al., 2013). The implementation of the test is contingent upon the specific parameters of interest required. In a clinical context, mental health metrics like attention, emotional stability, organization, understanding, mood, and thinking processes may be assessed by psychometric testing. Similar to Mrs. Glenda's situation, psychometric testing is beneficial in healthcare environments to provide further insights on a patient's possible deficiencies. Nonetheless, psychometric testing sometimes encounters several limitations that may diminish its efficacy in clinical settings.
Psychometric testing is one of the most dependable methods for mental health assessments. Psychologists use various psychometric assessments to see whether their clients exhibit deficiencies indicative of a probable mental issue or condition (Cohen et al., 2021). For example, the MMSE indicated that Mrs. Glenda may have dementia, a condition characterized by confusion, disorganization, memory impairment, and challenges in understanding intricate instructions (Velayudhan et al., 2014). Moreover, the self-reporting and observational methods used in the majority of psychometric assessments are more precise and practical for therapeutic application. Ideally, the tests provide precise information consistently, enabling other medical professionals to formulate an intervention strategy from an educated perspective (Warrens, 2015).
Test theory posits that substantial sample sizes are often required for tests to achieve reliability and validity (Cohen et al., 2021). Nonetheless, the majority of psychometric assessments are structured as individual evaluations applicable to a single participant at a time. The scoring system used in the psychometric assessments enables the evaluation of one person at a time. The accuracy is independent of the number of individuals that have completed the measuring instrument (Wocial & Weaver, 2012). In Mr. Glenda's instance, the MMSE effectively evaluated the client and produced a comprehensive report that may indicate the possible mental issues Mrs. Glenda may possess.
Moreover, psychometric testing facilitates the measurement of people' psychological conditions. As most scales are constructed to accurately assess each answer, the quantification of data becomes increasingly feasible. Moreover, the quantification offers empirical proof when presenting the outcomes of an individual (Koziarska et al., 2013). Ultimately, psychometric assessments are culturally attuned and tailored to respect an individual's views. Typically, the assessments provide general inquiries that do not confront an individual's particular convictions. Similar to the MMSE used for evaluating Mrs. Glenda, psychometric assessments are optimally designed to address each person in a culturally sensitive manner.
Although psychometric testing is a widely used evaluation method in clinical settings, it has several disadvantages. Firstly, it is susceptible to reaction bias. As the majority are self-reported, a deceitful individual may mislead the evaluator into accepting falsehoods about the client (Burton & Tyson, 2015). If Mrs. Glenda deliberately answered certain questions incorrectly, the psychologist would interpret it as a deficiency in the assessed domain. Secondly, the findings of psychometric exams are difficult to understand without an interpretative guidance. Interpretation of most tests necessitates an individual proficient in the relevant domain of the instrument used and the implications of the results. Otherwise, people might find it challenging to explain the findings completely. Consequently, psychometric assessments need specialized knowledge (Carnero-Pardo, 2014). Some general practitioners may struggle to understand the data until a psychologist elucidates them. Similar to Mrs. Glenda's situation, the report must be articulated in a comprehensible manner while composing a recommendation letter.
Guidelines for Healthcare Provision
Ultimately, many psychometric assessments are inadequate in detecting the early stages of mental disorders in the people evaluated. The MMSE is ineffective in identifying early-stage dementia (Devenney & Hodges, 2016). If Mrs. Glenda had no problem in recalling her residence or shown organizational skills, it would be challenging for the psychologist to ascertain a potential diagnosis of dementia.
In a hospital environment, interprofessional communication is essential. Given that a medical team consists of professionals from several disciplines collaborating to provide treatment for a single patient, the transmission of information is critically sensitive. Sharing results and observations from professional perspectives is essential for establishing efficient patient care (Matziou et al., 2014). Nonetheless, it is essential to evaluate some pivotal elements of communication in collaborative efforts.
The clarity of information is evaluated within a multidisciplinary team. In a healthcare environment, acronyms are used daily. However, while engaging in communication, consideration is given to those who are not familiar with the acronyms. In general, communication among professionals is conducted in complete format to prevent misunderstanding of information exchanged (Foronda et al., 2016). Secondly, cultural humility is also a factor included within the multidisciplinary team. This involves adopting an interpersonal approach that is considerate of others' cultures and customs. In a clinical environment, it is essential to prevent team members' insensitivity from adversely affecting patient health or straining relationships among healthcare practitioners (Prasad et al., 2016). The promptness of information is regarded when a diverse team functions cohesively. Timely provision of information enables other experts to respond quickly, hence enhancing service delivery. Success is much more attainable when these factors are considered while communication with experts from diverse areas.
References
Burton, L., & Tyson, S. (2015). Screening for cognitive impairment after stroke: A systematic review of psychometric properties and clinical utility. Journal of Rehabilitation Medicine, 47(3), 193-203. https://doi.org/10.2340/16501977-1930
Carnero-Pardo, C. (2014). Should the Mini-Mental State Examination be retired? Neurología (English Edition), 29(8), 473-481. https://doi.org/10.1016/j.nrleng.2013.07.005
Cohen, R., Schneider, J., Tobin, R., Swerdlik, M., & Sturman, E. (2021). Psychological Testing and Assessment: An introduction to test and measurement (10th ed.). McGraw Hill.
Devenney, E., & Hodges, J. (2016). The Mini-Mental State Examination: pitfalls and limitations. Practical Neurology, 17(1), 79-80. https://doi.org/10.1136/practneurol-2016-001520
Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse Education in Practice, 19, 36-40. https://doi.org/10.1016/j.nepr.2016.04.005
Koziarska, D., Wunsch, E., Milkiewicz, M., Wójcicki, M., Nowacki, P., & Milkiewicz, P. (2013). Mini-Mental State Examination in patients with hepatic encephalopathy and liver cirrhosis: a prospective, quantified electroencephalography study. BMC Gastroenterology, 13(1). https://doi.org/10.1186/1471-230x-13-107
Larner, A. (2013). Cognitive Screening Instruments. Springer London.
Matziou, V., Vlahioti, E., Perdikaris, P., Matziou, T., Megapanou, E., & Petsios, K. (2014). Physician and nursing perceptions concerning interprofessional communication and collaboration. Journal of Interprofessional Care, 28(6), 526-533. https://doi.org/10.3109/13561820.2014.934338
Prasad, S., Nair, P., Gadhvi, K., Barai, I., Danish, H., & Philip, A. (2016). Cultural humility: treating the patient, not the illness. Medical Education Online, 21(1), 30908. https://doi.org/10.3402/meo.v21.30908
Sorrentino, S. A., Remmert, L. N. & Wilk, M. J. (2021). Sorrentino's Canadian textbook for the support worker (5th Canadian ed.). Elsevier.
Spencer, R., Wendell, C., Giggey, P., Katzel, L., Lefkowitz, D., Siegel, E., & Waldstein, S. (2013). Psychometric Limitations of the Mini-Mental State Examination among Nondemented Older Adults: An Evaluation of Neurocognitive and Magnetic Resonance Imaging Correlates. Experimental Aging Research, 39(4), 382-397. https://doi.org/10.1080/0361073x.2013.808109
Velayudhan, L., Ryu, S., Raczek, M., Philpot, M., Lindesay, J., Critchfield, M., & Livingston, G. (2014). Review of brief cognitive tests for patients with suspected dementia. International Psychogeriatrics, 26(8), 1247-1262. https://doi.org/10.1017/s1041610214000416
Warrens, M. (2015). A comparison of reliability coefficients for psychometric tests that consist of two parts. Advances in Data Analysis and Classification, 10(1), 71-84. https://doi.org/10.1007/s11634-015-0198-6
Wocial, L., & Weaver, M. (2012). Development and psychometric testing of a new tool for detecting moral distress: the Moral Distress Thermometer. Journal of Advanced Nursing, 69(1), 167-174. https://doi.org/10.1111/j.1365-2648.2012.06036.x
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