vii Preface In general, outcome measurement has focused on a health gain or health maintenance score, or an over- all wellbeing result. However, because quality of life is difficult to define and even more difficult to measure - particularly with physically and mentally vulnerable people - outcomes from nursing in con- tinuing care are not easily articulated. The focus of the nursing assessment tool is therefore on increas- ing quality of life, rather than perceiving health gain simply as increased longevity. Assessment is considered to be the first step in the process of individualized nursing care. It provides information that is critical to the development of a plan of action that enhances personal health status. It also decreases the potential for, or the severity of, chronic conditions and helps the individual to gain control over their health through self-care. One of the great challenges in medicine is to deliver effective therapies tailored to each patient based