Advanced practice nurses use different assessment tools and diagnostic tests in order to conduct the appropriate examination of a patient and complete the diagnostic process effectively. Nurses should choose assessment tools while focusing on the validity and reliability of the tests’ results and on their cost-effectiveness (Ball, Dains, Flynn, Solomon, & Stewart, 2015, p. 46; Qaseem et al., 2012, p. 147).
Body-mass index (BMI) used along with waist circumference (WC) for adults is the most popular assessment tool utilised in clinical settings to determine the patient’s risk in relation to overweight and obesity (Bozeman et al., 2012, p. 115). This paper aims to discuss the use of BMI with WC in the nursing practice, to evaluate the test in relation to its validity and reliability, and to discuss the issues of sensitivity, specificity, and predictive values.
BMI as the Nurses’ Assessment Tool
BMI with WC is an assessment tool which serves as an indicator of the person’s overweight and obesity. Nurses measure BMI while dividing the patient’s weight in kilograms by height in meters squared. Nurses also measure WC with the help of a tape measure and compare the results with the standards and BMI. Thus, the used standard for overweight is BMI≥ 25 kg/m2, and the used standard for obesity is BMI ≥ 30 kg/m2 (Bozeman et al., 2012, p. 115). WC standards are 94.0–101.9cm for men and 80.0–87.9cm for women (Huxley, Mendis, Zheleznyakov, Reddy, & Chan, 2010, p. 17). Having measured BMI with WC, nurses can easily and quickly receive the necessary information on the risks for a person to develop overweight or obesity as the state which influences the overall patient’s health measures.
Evaluation of BMI in Relation to Validity and Reliability
In spite of the fact that nurses do not use strict standards for discussing BMI and WC results, such an assessment tool as BMI with WC provides valid and accurate results because its purpose is to compare the received results with the BMI tables or standards. The accuracy of nurses’ actions influences validity, but the possibility of errors is rather low (Bozeman et al., 2012, p. 116). The assessment tool is also reliable because BMI and WC provide stable measures which do not change during a long period of time. Nurses can conduct BMI and WC assessments during different occasions and receive reliable results.
The Issues of Sensitivity, Specificity, and Predictive Values
Practitioners note that BMI and WC are characterised by high levels of sensitivity, specificity, and positive and negative predictive values while referring to assessing the patient’s risks in relation to overweight and obesity. In contrast, BMI and WC tools are not effective to predict the persons’ low percent of body fat according to the aspects of sensitivity, specificity, and positive and negative predictive values (Li, Chen, & Chang, 2013, p. 58). Thus, nurses mainly use BMI and WC to diagnose patients with the observed problems related to the high weight and nutritional disorders.
Conclusion
BMI with WC is an accurate and effective assessment tool to measure the patient’s risks for developing overweight and obesity. The tool is valid because of its simplicity. Furthermore, the results of the test are reliable because significant changes in measures are not observed during a long period of time. Nurses refer to BMI with WC when they need to diagnose nutritional disorders and examine the patient’s overall health state because overweight and obesity provoke a range of other pathological states.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Bozeman, S., Hoaglin, D., Burton, T., Pashos, C., Ben-Joseph, R., & Hollenbeak, C. (2012). Predicting waist circumference from body mass index. BMC Medical Research Methodology, 12(1), 115-125.
Huxley, R., Mendis, S., Zheleznyakov, E., Reddy, S., & Chan, J. (2010). Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk – a review of the literature. European Journal of Clinical Nutrition, 64(1), 16-22.
Li, W., Chen, I., & Chang, Y. (2013). Waist-to-height ratio, waist circumference, and body mass index as indices of cardiometabolic risk among 36,642 Taiwanese adults. European Journal of Nutrition, 52(1), 57-65.
Qaseem, A., Alguire, P., Dallas, P., Feinberg, L. E., Fitzgerald, F. T., Horwitch, C., & Weinberger, S. (2012). Appropriate use of screening and diagnostic tests to foster high-value, cost-conscious care.Annals of Internal Medicine, 156(2), 147–149.