The Concept of Health, From Definition to Measurement and the Implications of the Reserves-Based Model for Nursing in France.
Camille Joannès, Fanny Crozes, Michelle Kelly-Irving and 2 others
PMID 39422177WHAT IT FOUND
Summing indicators of wear in physical, socioemotional and physiological reserves classified 9377 adults into optimal, medium or impaired health.
Impaired health predicted greater risk of dying or poor self-rated health over 14 years, but the model is not yet ready for routine nursing care.
Key findings
01The reserves-based model summed indicators of deteriorating physical, socioemotional and physiological reserves into one measure with three categories.
02Among 9377 cohort subjects, impaired overall health was associated with greater risk of dying or reporting poor perceived health over 14 years.
03The paper states that clinical thresholds, indicator lists and nurse access to data remain unresolved for nursing practice.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The paper is a conceptual model with a secondary cohort analysis, not a test of nursing care. The health measure was taken in midadulthood, not repeatedly, and transferability to other ages or nursing practice is uncertain. Cognitive reserve was not measured because no indicator was available, which may have reduced precision. The thresholds were based on the statistical distribution in the UK cohort, not on validated clinical cut-offs. The composite measure was validated by comparing population groups, not by showing that it works in individual patient assessment. It is unclear whether nurses can routinely access or collect the indicators needed for the measure.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not treat this as evidence that a reserves-based nursing assessment improves patient outcomes. The cohort analysis only showed that a composite measure predicted later mortality and poor self-rated health. The paper itself states that thresholds, missing indicators and nurse access to data are unresolved for routine nursing care.