Assessment of Mood and Affect (Nursing)

00:00 So now we've looked at their appearance.

00:03 We've judged the way they can walk and we've assessed it, and we've written it down.

00:09 And we have looked at the way they can speak to us, and we have written it down.

00:16 And now we're going to get to their mood.

00:19 We have to ask them about their mood.

00:24 Their mood is what they feel.

00:27 And so we're going to ask them, how do you feel? And they might say, "I feel fine. Everything is okay." I'm not having any ups. I'm not having any downs.

00:39 It's kind of boring. But it's okay. I'm getting used to boring.

00:42 That's called euthymic.

00:46 It's a mood that is neither up nor down.

00:49 If we think about there being a, an upper level and a lower level, there are somewhere in between here, which is the normal level.

01:00 We can say, "I hate the word normal." But it is the level where they are neither up in the ozones, neither are they down in the basement.

01:12 It's okay.

01:13 You can ask them, how are you feeling? Have you been feeling really happy or elated recently? Have you been feeling low or depressed, or out of sorts recently? I usually say in the last two weeks.

01:30 It makes it easier for someone to answer.

01:33 In the last two weeks, have you had any real spurts of elation? Or in the last two weeks, has there been any time where you've been so sad that you really haven't wanted to do anything? Different from mood is an affect.

01:50 Affect we can observe.

01:53 We see how a person is feeling. We can see if they're happy.

01:58 Usually, if you're happy, you're smiling.

02:05 Is there affect appropriate? So what do we mean by appropriate? Well, if they tell us, "I have had the worst two weeks of my life.

02:17 It's just been terrible. Everybody I know is sick.

02:24 My dog died.

02:26 My cat is now having to have a surgery because the articular joints are now getting old.

02:34 It's just been the worst two weeks of my life.

02:38 Well, that is not congruent. That is not appropriate.

02:41 They're smiling at me and telling me how terrible everything is.

02:47 Is it fluctuating? Are we noticing this labile affect? Where at one moment they are, "This is so much fun." And the next day going, "I can't believe that was a terrible moment.

03:02 But it's okay, because I'm over it now.

03:05 That is rapidly fluctuating affect.

03:08 And we would write down labile affect.

03:12 Or how about, nothing? "Yes, my cat. My cats really sick.

03:24 It's been a terrible two weeks.

03:29 I can't remember what it's ever been worse.

03:34 No variability. No movement at all.

03:38 We have to say that is a flat affect.

03:42 And of course me doing it, I'm doing it for two seconds.

03:47 When you are interviewing a patient with a flat affect, it's an amazing thing because you must be looking at this with curiosity, not with judgment with curiosity.

03:59 And notice how long and how devoid of affect this person is.

04:07 Does this person have a range of affects while you're talking to them? Are they able to demonstrate joy? Are they able to demonstrate appropriate sadness? Every one of these things needs to be documented.