The difference between subjective and objective data is in the source of the information: Subjective data is what the patients tell the nurse about how they feel, and objective data is what the nurse observes and gathers.
Documenting the patients’ impressions and feelings and rigorous nursing observations enables accurate diagnoses and fosters trust.
Comparing subjective vs. objective data confirms the initial nursing diagnosis or leads to further examination.
What Is Objective Data?
Objective nursing data is information gathered through physical examination, observation, or diagnostic testing. Objective data is measurable and often numerical. For example, nurses’ observations regarding physical findings or patient behaviors, laboratory test results, diagnostic imaging, and vital signs.
Examples of Objective Data in Nursing
Observed data involving the senses of sight, smell, touch, and hearing:
- A fruity smell or an odor similar to nail polish remover on a patient’s breath is often an alert to diabetic ketoacidosis (DKA), a severe complication of diabetes.
- The nurse quickly sees posture, gait, and balance alterations, which can be signs of a neurological disorder, calling for a differential diagnosis.
- Touch or light palpation often identifies an inguinal hernia as the cause of discomfort or pain.
- Hearing or listening for signs of health issues usually involves using a stethoscope to detect abnormal heart, lung, abdominal, or vascular sounds, contributing significantly to accurate assessments.
A physical examination in nursing assessment involves the senses and systematic techniques to understand the patient’s health status and spot any potential issues. Physical examinations involve checking the general appearance, including hygiene, behavior, and signs of distress, pallor, jaundice, or abnormal movements. For more details, check out Nursa’s Guide to Head-to-Toe Nursing Assessments.
Diagnostic testing commonly includes complete blood counts, blood glucose tests, lipid profiles, urine analyses, electrocardiograms, and various screenings.
What Is Subjective Data?
Subjective nursing data encompasses the information and impressions the patient, family member, or caregiver shares spontaneously or in response to questions in the initial nursing assessment interview and subsequent conversations. Subjective data is qualitative and non-numerical. Patients’ comments about discomfort, pain, feelings, experiences, or concerns give the nurse clues to psychological, sociological, or physiological issues.
Example of Subjective Data in Nursing
The most common subjective information is pain, which only the patients themselves can feel and cannot objectively measure. To understand the pain level, the nurse often asks the patient to estimate the severity on a scale of one to 10. Pain is an essential alert signal to health issues.
Signs and Symptoms in Healthcare
In healthcare, signs are what the clinician observes, and symptoms refer to what the patient feels. A rash can be felt by the patient and observed by the nurse, but a rash feeling itchy is a subjective symptom that clinicians cannot observe clinically. The nurse will inspect the color, texture, swelling, and fever that can suggest certain viral infections, such as measles or shingles, and other objective signs of bacterial infection, such as red streaks or pus.
The patient will subjectively detect many symptoms or signs, and the healthcare team will detect others objectively. Here are some examples of signs and symptoms:
- A patient tells the nurse that she has stomach pain—a symptom subjectively perceived by the patient—and the nurse observes abdominal tenderness to palpation in the lower right quadrant. The nurse will record both in the report; additional testing and clinical observation will aid in an accurate diagnosis. Often, nursing notes cover helpful subjective data.
- In another example, a patient reports dull back pain in the lower lumbar area that worsens when he sits at the computer for an extended period. The nurse observes the patient’s posture and range of motion. The straight leg test shows that pain appears at 30 degrees—objective and numerical information. The test validates the patient’s report, suggesting lumbar spine pathology.
Pros and Cons of Subjective vs. Objective Data in Nursing
The table below shows some pros and cons of subjective and objective nursing data regarding understanding, patient care plans, advocacy, communication, cultural considerations, and emotional interference. In many cases, the pros of each are complimentary and can integrate into a more complete assessment, or the pros of one can help overcome the cons of the other.
Objective Data Pros and Cons
Pros
- Understanding: Observations are informed by clinical knowledge and expertise.
- Care plans: Objective nursing data informs an evidence-based diagnosis and care plan based on measurable facts. Such data can offer a baseline to measure and monitor improvement or advances made through treatment.
- Advocacy: By monitoring objective data, nurses detect changes in the patient’s condition and can advocate for necessary nursing or other interventions based on objective evidence, ensuring patient safety and quality care.
- Communication and trust: Gathering subjective data helps establish communication and trust in the nurse-patient relationship, which favors patient compliance and outcomes.
Cons
- Cultural and ethical considerations: Cultural and ethical considerations can leave questions in the minds of practitioners and patients, especially when subjective and objective data do not agree. Nurses must be careful not to dismiss subjective information and to document each type of data carefully, seeking clarification for any questions. Objective data often needs the context of diverse concepts of right and wrong.
- Emotional Interference: Fear and anxiety can impact vital signs, although the nurse may be able to detect strong emotions and find a way to calm the patient.
Subjective Data Pros and Cons
Pros
- Understanding: Insight into the patient’s feelings, background, attitudes, and perspective provides nurses with helpful context.
- Care plans: Knowledge of the patient's preferences and priorities strengthens patient-centered care, enabling clinicians to tailor care plans to individual patient needs.
- Advocacy: Nurses can use subjective data to get to know their patients and learn about their needs, values, and beliefs. Clinicians defend patient autonomy, respecting cultural, religious, and personal convictions.
- Communication and trust: Among healthcare team members, objective data provides a common language, accuracy, and information for evidence-based decisions, efficient hand-offs, and nurse charting.
Cons
- Cultural and ethical considerations: Subjective data may be less reliable in some cases due to perceptions or memories influenced by emotional or cultural factors. Language barriers and cultural or social biases may also limit the information provided.
- Emotional Interference: Fear or anxiety may lead the patient to deny some symptoms.
Understanding the differences between subjective and objective data in nursing offers nurses a broader perspective and ensures that nurses use the correct type of information to guide decision-making.
More Examples of Subjective and Objective Data in Nursing
The following are examples of subjective data patients may share:
- Pain
- Nausea
- Tiredness
- Dizziness
- Levels of anxiety, depression, and stress
- Weight loss or gain
These are examples of types of subjective data family members or caregivers provide:
- Mood
- Behavior
- Physical appearance
The following are examples of objective data nurses gather:
- Weight as shown by the scale and in medical history
- Height
- Body mass index (BMI)
- Vital signs
- Tremors
- Skin color
- Edema
- Rashes
- Laboratory results from blood tests, urine analysis, or imaging studies
How Do Subjective and Objective Data Determine Outcomes?
In general, nurses find three typical combinations of subjective and objective nursing data:
- The two often align and confirm a common conclusion, with the objective data specifying the condition, perhaps alerting to an emergency intervention.
- The subjective data poses health issues, but the initial objective data does not confirm a health problem. However, given the subjective symptoms, the clinician explores further, leading to a diagnosis and effective care planning.
- Appreciating subjective data in nursing enhances compliance with the care plan, which nurses observe and monitor using objective measures.
In all cases, serious consideration increases diagnostic accuracy, compliance, and understanding on behalf of the patient and the healthcare team, all leading to improved patient outcomes. The following scenarios further illustrate how subjective and objective data in nursing complement each other.
Diagnosis Example 1
Subjective Report
Sharp, stabbing pain in the lower abdomen, rated at eight on a one to 10 scale and getting worse
Objective Findings
Tenderness in the right lower quadrant, elevated white blood cell count (WBC), localized inflammation, and an abnormal CT scan
Conclusions
Both the subjective and objective information strongly suggest acute appendicitis.
Diagnosis Example 2
Subjective Report
Unexplained weight gain, fatigue, and hair loss.
Objective Findings
Initial data:
- Vital signs in the normal range
- Dry skin but no visible or palpable abnormalities
- No swelling
- No significant abnormalities in lab tests
Further testing:
- Elevated thyroid stimulating hormone (TSH) levels
- Goiter revealed by a thyroid ultrasound
Conclusions
Subjective information prompts further investigation, informing a diagnosis of hypothyroidism.
Diagnosis Example 3
Subjective Report
Dry mouth, thirst, and a concern about high blood sugar.
Objective Findings
Weight and vital signs within a healthy range and 122 mg/dL fasting blood sugar.
Conclusions
With a diagnosis of type 2 diabetes, the care plan emphasizes a diabetes-friendly meal plan and glucose monitoring.
Why Are Objective and Subjective Data Important?
Objective data is factual and not open for interpretation or vulnerable to bias. Overall, objective data does not change depending on the observer or the context. Any trained observer should obtain the same objective data. On the other hand, pain is an essential piece of subjective data and has even been called the fifth vital sign.
The Bottom Line: Which Is More Important?
While objective data is critical to reliable and conclusive assessment, patients’ subjective reports often give the first alert to health problems and provide precious information regarding the patient’s lifestyle and beliefs, thus facilitating patient compliance. Using both subjective and objective data helps the healthcare team create a robust and effective care plan based on a precise nursing diagnosis. Learn more about nursing care plans in this ultimate guide.
Sources:
