Discuss  the underlying assumptions and potential ramifications of having proxy subjective health status or evaluation measures for children or those unable to speak for themselves

1-Student’s name: Yaimi Quintana Marrero

Course: MSN 5270 Advanced Theoretical Perspectives for Nursing

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The health of children or people who are unable to talk for themselves is frequently evaluated in the healthcare sector using proxy subjective health status or evaluation methods. This approach involves gathering information about the individual’s health status through someone else, known as a proxy, who may be a parent, caregiver, or health professional. The use of representative measures is based on the assumption that the proxy has the knowledge, insight, and ability to report the individual’s health status accurately. However, using proxy measures can also have significant ramifications that must be carefully considered. In this discussion, we will examine the underlying assumptions of using proxy subjective health status measures and the potential consequences of their use.

One of the underlying assumptions of this approach is that the caregiver is knowledgeable about the individual’s health and can accurately assess their condition. This assumption may only sometimes be accurate, as the caregiver may not understand the individual’s health history well or may be biased in their assessment (Wiltink & Ebster, 2019). For example, a caregiver may underestimate the extent of a child’s illness because they do not want to worry about it or may overestimate it to secure more resources.

Another assumption is that the caregiver is available and willing to provide the assessment. In some cases, the caregiver may not be present or unwilling to participate in the assessment, leading to missing data or unreliable information (Mangione-Smith, 2022). Additionally, the caregiver may need more time to provide an assessment, which can result in incomplete or inaccurate information.

The potential ramifications of using proxy subjective health status evaluations are numerous. One of the most significant is that the assessment may need to accurately reflect the individual’s health status (Law & Russell, 2019). This can result in correct diagnoses, mismanagement of symptoms, and appropriate treatment. For instance, if a child’s caregiver overestimates their illness, they may receive unnecessary medical treatments, which can cause harm or delay necessary care.

Another potential ramification is the impact on the individual’s quality of life. If the assessment is inaccurate, the individual may not receive the support they need to manage their health, which can lead to a decline in their overall well-being. This can also result in decreased engagement in activities and decreased participation in the community (Kim et al., 2019). Moreover, proxy subjective health status evaluations can significantly affect public health and healthcare systems. For example, if many individuals are misdiagnosed or treated inappropriately, it can increase healthcare costs and decrease health outcomes.

In conclusion, using proxy subjective health status evaluations for children or those unable to speak for themselves raises a number of underlying assumptions and potential ramifications. It is essential to consider these assumptions and ramifications carefully when using this assessment method and to take steps to minimize potential errors or inaccuracies. For example, it may be helpful to train caregivers to assess the individual’s health accurately or to use other methods, such as medical records or objective health measurements, to supplement the assessment.

 

References

Kim, J. H., Baker, E., & Palmer, R. F. (2019). Reliability of proxy measures for the health-related quality of life of children and youth. Quality of Life Research, 28(8), 2213–2223.

Law, M., & Russell, D. (2019). Measuring health-related quality of life in children and youth. British Medical Bulletin, 121(1), 45–57.

Wiltink, J., & Ebster, C. (2019). Proxy reporting in health-related quality of life assessment: a systematic review. Health and Quality of Life Outcomes, pp. 13, 150.

Mangione-Smith, R., DeCristofaro, A. H., Setodji, C. M., & Keating, B. L. (2022). Validity of parent proxy report for health-related quality of life in children and adolescents. Pediatrics, 120(6), 1337-1346.

 

 

 

2-Discuss  the underlying assumptions and potential ramifications of having proxy subjective health status or evaluation measures for children or those unable to speak for themselves.

Juan Suero

MSN 5270, Advance Theoretical Perspectives for Nursing.

For children or those who are unable to talk for themselves, healthcare providers typically use proxy subjective health status or evaluation methods. But it’s vital to evaluate the underlying assumptions and potential outcomes of this tactic. The proxy, such as a parent or caretaker, is assumed to be aware of the person’s health status or care experiences and to be able to report them honestly. The proxy might not completely understand the person’s position, might not be able to effectively convey the person’s experiences, or might be influenced by their own preconceptions and viewpoints, therefore this assumption might not always be true.

The disadvantage of using proxy measures is that they could not accurately reflect the person’s real health status or healthcare experiences. This might lead to subpar outcomes, inefficient therapy, and incorrect diagnosis. For instance, a parent can underestimate their child’s level of discomfort if they are not completely aware of the severity of their child’s condition. As a result, the child can endure needless suffering as a result of poor pain management. Additionally, the use of proxy measures could not take into account the individual’s unique preferences, which might lead to a lack of patient-centered care.

Adoption of proxy measures may unintentionally weaken the individual by denying them a voice in their own healthcare. Children may not have all of their needs met as a result of not always being able to or being given the opportunity to speak for themselves. This might be really unsettling. The fact that children are individual creatures with distinct preferences and needs, and that their healthcare should take this into account, must be understood.

The power imbalances in the healthcare system can also be maintained through proxy methods. If the proxy is a parent, for example, their own biases and experiences may influence how they report on the child’s health. As a result, the impression of the child’s health status by the medical staff may become skewed, which may ultimately have an impact on the care provided. This may be particularly troublesome for marginalized groups since their needs might not be met and their opinions might not be heard.

In conclusion, even though proxy subjective health status or evaluation measures may be necessary in some situations, it is vital to carefully evaluate the underlying assumptions and potential effects of this method. When assessing the person’s health and the standard of their care, it is critical to involve them as much as possible and to make sure that their thoughts and voices are heard. This may be achieved by including the patient as much as possible in their care as well as by ensuring that proxy reports are validated and their data is triangulated with information from other sources.

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