Quality and Inter-rater Reliability

Inter-rater Reliability Case Studies

Case Study 1: Mental Health Problem

Scenario:
First time 20 year old mom presented with a flat affect during pregnancy. She did not want, discuss, or seek medical care for mental health concerns during her pregnancy. One week postpartum, mom described suicidal ideation "I feel like taking my sleeping pills all at once". During this visit one week postpartum, she responds very briefly to questions and lacks eye contact. When PHN discussed symptoms of depression, mom says "I do not know what you are talking about." Mom does not have interest in her baby or parenting. She did not want to talk to her doctor about suicidal ideation.

Correct KBS Ratings:
K = 1, B = 1, S = 1

Case Study 2: Mental Health Problem

Scenario:
Same mom as above. The public health nurse assisted her to seek care through the ER. She began to take medications. Counseling was recommended once a week and group counseling three times a week. She chose to attend counseling in lieu of hospital admission. She is attending counseling sessions once or twice per week, and states "I had no idea how depressed I really was". One month later, she is taking her medications with reminders from family but sometimes lapses. She is now makes eye contact with PHN. She verbalizes baby's needs, but interacts inconsistently with baby, with little attachment observed.

Correct KBS Ratings:
K = 3, B = 3, S = 3