Editorial.

Our November issue of JRN focuses on some of the methods that nurses use to understand their patients’ and their carers’ needs and circumstances. Increasingly nurses augment their skills of observation and communication by using scales to assess and evaluate a patient’s physical, psychological or spiritual state and the progress or deterioration of their health and wellbeing. Scale development is a complex and time-consuming business, so most practitioners use tools that are already available and thus rely on researchers to develop and validate new tools. These tools are an adjunct to high-quality care and need to be designed and used appropriately. In this issue we explore, through five papers and their related commentaries, a variety of assessment techniques and how they may be used and developed. We bring readers two papers about the use of existing tools. The first investigates people’s self-management of insulin-dependent diabetes (Gharaibeh and Tawalbeh) and the second focuses on quality of life among older people with cancer (Malak et al). Both papers show how researchers and practitioners can successfully use structured measurement techniques to understand patients better and thereby fine-tune care to suit individual needs. However, the compendium of scales available for use in care is understandably not comprehensive, so researchers often find that they need to develop measurement tools to use in their research and later, once validated, in everyday practice. Bilsin and Bal Yılmaz’s paper is an example of scale development focused on taste alterations in children undergoing chemotherapy in Turkey. Having such a scale enables nurses as well as researchers to consistently assess a child’s needs and sensitively modify care. However, sometimes researchers do not understand a ‘problem’ well enough to immediately set about designing a tool to measure it, so their first job is to find out more, either through literature reviews or exploratory studies. In this issue Salem and Ahmad report their literature review on ways to improve communication for mechanically-ventilated patients in Iran and Valizadeh Zare et al discuss the insights they gained from a phenomenological study of coping in people who have had kidney transplants. All of these approaches can be used successfully to build ways to assess, monitor and evaluate patients’ and carers’ needs and thus gain a better understanding of people’s requirements, wishes and expectations. Understanding patients and their carers better is only part of the story since high-quality care requires both understanding and action. Achieving this double act often requires researchers, practitioners and patients – with their carers, to come together to co-produce