NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Discussion
Mini-Mental State Exam (MMSE)
Health care providers alway use the Mini-Mental State Exam (MMSE)While gathering subjective and objective data to evaluate the mental health status of the elderly. MMSE is a standardized tool used to assess cognitive function changes over time. The 11 items measuring orientation, registration, attention and calculation, recall, ability to follow commands, and language it takes approximately 5 to 10 minutes to administer NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Discussion. The maximum score is 30. A score 20 or less may be associated with dementia, and a score of 26 or higher is not associated with dementia.Higher education is associated with higher MMSE scores, even when dementia is present. MMSE has been translated into multiple languages and adapted for many cultures, and in some cases external validity, sensitivity, and specificity have been evaluated (Ball et al., 2019).
This test is often used to help diagnose Alzheimer’s disease and dementia. This quantitative-styled survey scores one’s as either zero (incorrect), one (correct), six (item administered, participant does not answer), or nine (test item not administered/unknown). Out of thirty points, a score that ranges between twenty to twenty-four marks mild dementia; thirteen to twenty defines moderate dementia; and anything less than twelve is classified as severe dementia (Alzheimer’s Association, 2019) NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Discussion. This tool is often used to get a baseline on the degree of dementia and used to evaluate the effectiveness of medications that function to delay the progression of the disease. While the MMSE provides useful information that adds to a mental health diagnosis, this test should not be the only information used. The National Institute on Aging (2017) asserts that in addition to neuropsychological tests such as the MMSE, providers also use laboratory tests and brain scans to validate a diagnosis of dementia. NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Discussion
The MMSE method has many advantages. The method is popular and it has a large quantity of data that is readily available to find standards that can be used for comparison in various circumstances and settings. It has been made popular because of its standardized structure that can be applied universally that has enabled it to be accepted by many as a measurement unit and a basis for assessing the severity of CI and DEM (Palsetia et al., 2018). Again its structure enables assessment of various cognitive aspects and its rating scale has been accepted globally for measuring mental functioning It is very quick and easy to practice where it involves less instructions which can be administered in ten minutes and therefore it can be administered with less training and is widely taught in most institutions.. Their scoring system is standardized which makes it easy to calculate the results. The method can be applied using different languages since instructions are simple and can be applied NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Discussion
The test method also has several disadvantages. The main disadvantage is the fact that the method is not very useful in identifying mild impairment (Palsetia et al., 2018). It also offers problems in detecting changes that occur in severe dementia. The method does not give accurate information for people who are educated because of the ceiling effect (Palsetia et al., 2018). Furthermore, the method does not offer fine details for impairments such as neglect, aphasia and apraxia that occur for people in post-stroke NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Discussion. The method does not put more emphasis for memory loss since it is given only three points while orientation and language are given more most points (Palsetia et al., 2018). This shows that the method is not dedicated to assess the core domain for cognitive ability (Palsetia et al., 2018). Furthermore, the lack of full standardization for the method offers another problem. Three words for the registration stage are critical in the memory stage but there are no criteria for choosing these words. Freedom is given to the examiner to choose these three words of which the choice can be affected by several factors such as frequency of use, familiarity, imaginability others. Other items that are not standardized are drawings and calculations. Besides, some of the instructions require reading and writing skills which limits its use on illiterate people.
In conclusion, MMSE has become a very popular tool for assessing cognitive impairment for older people. Some of the reasons for its popularity is because of shorter instructions, ease of administering and ease of translating the instructions into different languages all over the world. The method fits well for the older generation because it takes a few minutes to complete it. The method reliability was proved to be adequate and its validity was also adequate with a high sensitivity and specificity.
Alzheimer’s Association. (2019). Medical tests. Retrieved from
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to
physical examination: An interprofessional approach (9th ed.) St Louis, MO: Elsevier
National Institute on Aging. (2017, December 31). Basics of Alzheimer’s disease and dementia.
Palsetia, D., Rao, G. P., Tiwari, S. C., Lodha, P., & De Sousa, A. (2018). The clock drawing test
versus mini-mental status examination as a screening tool for dementia: A clinical
comparison. Indian journal of psychological medicine, 40(1), 1-10.
Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales
Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy.
Photo Credit: [shironosov]/[iStock / Getty Images Plus]/Getty Images
- Review this week’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.
- Consider the elements of the psychiatric interview, history, and examination.
- Consider the assessment tool assigned to you by the Course Instructor. NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales Discussion
By Day 3 of Week 2
Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.
Read a selection of your colleagues’ responses.
By Day 6 of Week 2
Respond to at least two of your colleagues on 2 different days by comparing your assessment tool to theirs.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!