How useful this tool is “to assess functional impairment in three interrelated domains

1 hour ago

Abiola Damola

Week 2 Forum

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I was assigned the Sheehan Disability Scale (SDS). Clinicians use this tool for individuals who are functionally impaired by psychiatric or medical symptoms, and as a treatment outcome measure that would be sensitive to change as well as drug placebo differences over time (Harm Research Institute, 2017). SDS is used to assess functional impairment in three interrelated domains; work/school, social and family life. It is a self-report tool where the patient rates the extent of impairment from their disease in the three domains of their life using a ten point visual analog scale (CQAIMH, 2017). This visual analog scale improves test sensitivity by using a discretized analog (Discan) scaling metric to simultaneously anchor the impairment spatio-visually, numerically and verbally-descriptively (Harm Research Institute, 2017).

Knowing that this is a self-reporting tool one can argue that the results from this test are not reliable. A study conducted on 225 patients with Bipolar Disorder showed that: the SDS total and item scores significantly discriminated between (self-rated) overall health status, clinician-rated functional status, and clinician-rated depression, evidencing known group validity, is a reliable measure of disability, and is responsive to change over time when used in subjects with BD (Arbuckle et al., 2019).

The Sheehan Disability Scale is essential for the PMHNP to assess the functional status and functional impairment for the clients during the assessment (Wheeler, 2019). This tool is not only used in the psychiatric setting due to its generic design. It’s also used in many other chronic medical illnesses and by researchers and practicing clinicians. You stated how useful this tool is “to assess functional impairment in three interrelated domains.” I certainly agree it is essential to assess clients related to their diagnosis. For instance, clients who have impairment associated with major depressive disorder (MDD) have an impact on their social and economic affecting their work, having a low quality of friendship, and have an increase in disrupting their family. Therefore, those clients need to be assessed by completing the SDS because they’re affected by mental illness and functional impairments. According to Arbuckle et al. (2019) it’s vital for clinicians to carefully pay special attention to patients who score five or greater on any of the scale because such high scores are associated with significant functional impairment.

References

Arbuckle, R., Frye, M. A., Brecher, M., Paulsson, B., Rajagopalan, K., Palmer, S., & Degl’ Innocenti, A. (2019). The psychometric validation of the Sheehan Disability Scale (SDS) in patients with bipolar disorder. Psychiatry Research, 165(1), 163–174.

CQAIMH.org, (2017). Sheehan Disability Scale. Retrieved from: http://www.cqaimh.org/pdf/tool_lof_sds.pdf

Harm Research Institute.org. (2017). Sheehan Disability Scale (SDS). Retrieved from: https://harmresearch.org/index.php/about-us/david-v-sheehan-md-mba/sheehan-scales-and-structured-diagnostic-interviews/sheehan-disability-scale-sds/

Wheeler, K. (2019). Psychotherapy for the advanced practice psychiatric nurse(2nd ed.). Springer Publishing Company.

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