I 58 A tool for gathering this assessme nt diltu base CADB) is presented in Table 2-. 1. Through lhis ADB, the nurse can identifyex:istiug and potentiahvellncss statc/s, health threat.,,,. bcrilth defidts and s. t.-css poinls/foreseeable crises in a given f,i111ily. Each family has it.-. ; own,.,·uy of behaving l'c1wn rds or resp()ncling to sih1. itions j n the face of these problems. The other l:\1Je of clnta rnken during the second-level assessment reflects the exte. ut to which the famil)· can perform the health tasks on each health condition or problem identified. These dat:1 inclt1de: 1. The family"s perception of U1c condition or problem; 2. Decisions mride and approprial·eness: if none, rensons, and 3. Actions taken ;ind rt",;ults: if none, reasons; and 4. Effects of decisions and actious on other family members. Data-gathering Methods and Tools Therearcsen'!ral methods of dat;1-g,1thcri11~ Llrnt Lhe nurseca11 selet·l from, depending on nvailahilil Y of rcso11n·es such ;1s matcri. :il, manpower, time and facilities. 'l1-1e critical point fn the choic<. > is concern for :1ccur:1cy. validity. reli:1bility. and acleriuru:y of ;i;;sc!<smt·n I J:1w. Poor qua I ity/i1tm T11r. 1le and i, 1adeq uatc dala t·a 11 lead to i,1acc11 rah:ly defined hc:1lth ;1111. J 1111r. ;ing prohlcms which, in tu. rn, lead to poorly designed fnmily ou. 1"'$ing c11re plan. To ensun" quality a&<es~,nenl data, a combino1tion of methods and sout·ce. s can provide cross-cl1ecks nnd cfata validation. To illnsh-ate. a comoination orinterview, observation. oculars11rn'. '"· direcl e;,.-;1mination (ph_vsical assessment). use oflaboratory or di. ignostic lc. ~ts and nicnr J re\-i L'W can bc utili:r. t. ·u i..., ~entr·atc lir,;t-le,·d nssess~nent dr-itn using the toul. :\ssessn1c nt Dat:1 Hust. for Fau1ily Nursi J1g. Pnict-. icc (Table 2. 1). The foll<lwiug :ll'C brief dcs LTiplious ot co1111111m melhod. s of,gathering d. ita about a family. its lt,·ulth status and. state off111wtioning: 1. Obscrvt Hion. This method of data collection is done through the use of the. St'IISOI')" cap. 1citks-sigh1_ hcnring. smcl J and touch. 'fhrnugh direct ob. sen-;ition. tlw 1111rsc ~athcn, i11for111:1tio11 about the fomily"s state of being :ind hdrnvioral rcsponsl'-"-The li. u11 ily"s lwnll h st:it11s can he inferred frc1111 1 lw i<i J:;ns :, nd. symptoms or p1·oblen1 a r·tns re fleer ed in t J1c following: ii, t;on11111111intl io11. i11l~raction pa11·cn1s and intc1-pe1-sonnl rdationshirs cxpc~t1:d. used ;ind tolerated by family members; h. l~ol1 p,·n·cptions/tn:sk nssumplions by each member·, including del"ision-ru:,kin. g p. itt,c-Jus: 11ncl c. Conditions in the honlt' and environment. Dntll g11. thcrcd through this method h:n·e the :1dva11tage of being subjected t·o vnlicl:ition nnd reli11bility testing hy other observers. . 2. Physicn J Exnminution. Signitica111 data about Lhe health status of i11divid11nl f;nnily 111e111h1~r. 'i c·. 111 he ohtainccl I lirough direct examina tion. This i,-d111w 1hr1)11gh inspccli1)n, palpation. percussion, m1scultntio11, mtas11rc111c111 rif,<p,. d(ir uvdy pm·t:. ; and n:vicwing the hvdy systems. His ('SS1111 iul fort lw 11111·s1 to l1nv1 I '1C' skill in performing physical assc~sment/ i1))Jlf'11i:<al in,,rcll,· lo help llw fo111ily hu nwarc off he hc:tltb s1. itus of its 1111ml Kr:.. Dula gcncrntcd fr11111 ph~sic:11I 11sscss11w111 form n s111>s1. 1ntive p,11"1 oflirst-lc,·cl :iss,ssmt'nl which may indic:;ilc presence o(heall h deficits (illrwss slates). The ll:chniqnes employed Juri11g the physical examination process are discussed extensively hy l3kkley (2007) and Ilnrlrnusk:t s, 