Measurement is an ancient science that started from human beings’ curiosity about the size of the earth that we live in. At some point, we turned to look at ourselves and tried to find numbers to describe “the size” of human beings in terms of physiological, psychological, and social health. Measurement science in nursing has been developing rapidly and vigorously. Experts have created more and more complicated measurement techniques to collect and analyze data; an increasing number of huge measurement systems have been developed. However, is this the right direction for nursing measurement?
As a nurse researcher for more than 25 years, I have seen a lot of patients facing heavy measurement burden, such as filling up multiple questionnaires during routine clinical assessments and as research participants. However, it is hard for patients to benefit directly from the massive data that they generously share with us. I have also seen health professionals spending a lot of time calculating, analyzing, and explaining the results of measurements, especially from some newly developed tools or measurement systems. My observations have made me believe that, for nursing measurement, the easier, the better.
So when we say the word “easier,” what are we truly talking about? From my perspective, “easier” refers to 3 key aspects of the measurement, which include clear and precise indicators selected for measurement, simple and easily implemented measurement processes, and intelligible presentation and explanation of results.
First, the characteristic of “easier” can be realized by carefully selecting measurement indicators that very likely reflect the real situation of patients. Much attention has been paid to and progress has been made in recent years in figuring out connections among various physiological indicators, medical outcomes, and patient outcomes based on medical big data. However, the connections among outcomes based on identified clinical nursing problems where all physiological, psychological, and social indicators should be taken into consideration have not been fully studied and discovered. The value of “big data” should not be underestimated because we could learn the true feelings of patients and the details of diseases, which might provide clues to predicting health change. Undeniably, the journey to clear and precise nursing problem-specific indicators will be long and challenging and will likely rely on complicated measurement techniques and systems, data mining, and data analysis.
Second, we must make the process of measurement simple and easily implemented for both health professionals and patients. The implementation of the measurement should be fully based on the workflow of the health professionals and patients’ treatment process. This means that an appropriate process of measurement must reflect proper timing, the approximate time required, and the way in which measurements are taken and should be designed based on sufficient clinical investigations and evidence so that the process of measurement could be a simple and easily implemented part of different clinical situations.
Third, we must make the results of measurement easier to be read and understood. Complex calculations and operations are the work behind the scenes of researchers and software programs. When we present the results to health professionals and patients, they should be intelligible and visual. In addition, each number presented should contain information that matters for research and clinical situations. For example, the Patient-Reported Outcomes Measurement Information System, developed by National Institutes of Health, provides standard scores, charts, and the position of the scores for each person.1 The results not only reflect the health status of the individual but also help build up a preliminary understanding of that population, which should be the tendency in the future when presenting and explaining the results of each measure.
To sum up, we must always keep in mind that measurement is only a tool. The truth of measurement lies in the deep understanding of patients’ true feelings and preferences, and the resolutions of nursing care challenges.
Changrong Yuan, PhD, RN, FAAN
Editorial Board Member, Cancer Nursing
School of Nursing, Fudan University, Shanghai, China