Scoring the Health Problem: Step-by-Step Computation
The scenario presents a
foreseeable crisis — the father's departure abroad for two years — which the nurse must score using the family health problem prioritization tool. The scoring formula for each criterion is
(score ÷ highest possible score) × weight, and the four criteria are nature, modifiability, preventive potential, and salience.
Criterion 1: Nature of the Problem
The father's departure is classified as a
health threat or
foreseeable crisis, not an actual deficit or current illness. In the standard scoring rubric, a foreseeable crisis receives a nature score of
1 out of a possible
3. The weight assigned to nature is
1. Therefore: (1 ÷ 3) × 1 =
0.33.
Criterion 2: Modifiability of the Problem
The problem is described as
partially modifiable. In the scoring rubric, partial modifiability corresponds to a score of
1 out of a possible
2. The weight for modifiability is
2. Therefore: (1 ÷ 2) × 2 =
1.00.
Criterion 3: Preventive Potential
The nurse rates the preventive potential as
moderate. A moderate preventive potential receives a score of
2 out of a possible
3. The weight for preventive potential is
1. Therefore: (2 ÷ 3) × 1 =
0.67.
Criterion 4: Salience
The family recognizes the father's departure as a problem but states it does not need immediate attention. This reflects a salience score of
1 out of a possible
2 — the family perceives the problem but does not see it as urgent. The weight for salience is
1. Therefore: (1 ÷ 2) × 1 =
0.50.
Total Score
Adding the weighted scores:
0.33 +
1.00 +
0.67 +
0.50 =
2.50. The total is already at two decimal places, so no further rounding is needed.
| Criterion | Score | Highest Possible | Weight | Computation | Weighted Score |
|---|
| Nature | 1 | 3 | 1 | (1 ÷ 3) × 1 | 0.33 |
| Modifiability | 1 | 2 | 2 | (1 ÷ 2) × 2 | 1.00 |
| Preventive potential | 2 | 3 | 1 | (2 ÷ 3) × 1 | 0.67 |
| Salience | 1 | 2 | 1 | (1 ÷ 2) × 1 | 0.50 |
| Total | | | | | 2.50 |
Key point! The weight for each criterion is not arbitrary — it reflects the relative importance of that criterion in determining the priority of a family health problem. Modifiability carries the heaviest weight (
2) because a problem that the nurse and family can change is more actionable than one that is fixed. This is why a partially modifiable problem still contributes a full
1.00 to the total, even though its raw score is only 1 out of 2.
Watch out! Do not confuse
salience with
urgency. A family can recognize a problem (high salience) but still not feel it needs immediate action. In this case, the family acknowledges the father's departure but does not perceive it as requiring prompt intervention, which lowers the salience score to 1 out of 2.
The concept of
family resilience is relevant here. Systematic reviews of family resilience assessment questionnaires emphasize that family functioning and coping capacity are measured within specific adversity domains, such as caregiving burden or major life transitions . The father's departure represents a transitional stressor that will alter the family's caregiving structure — the mother will become the sole caregiver for a child with cerebral palsy and a toddler. Instruments designed to assess family caregiver needs consistently identify anticipatory concerns about role strain and resource adequacy as central dimensions . The scoring of this problem as a foreseeable crisis with moderate preventive potential aligns with the understanding that family-level interventions can be planned before the departure, even though the event itself is not fully preventable.
The moderate preventive potential score (
2 out of
3) reflects that while the father's departure cannot be stopped, the family can prepare for it — arranging additional caregiver support, modifying the home environment for wheelchair access, or connecting with community resources. This is distinct from a problem with high preventive potential, where early intervention could prevent the problem entirely, and from low preventive potential, where little can be done to alter the outcome.