Concepts Of Psychiatric Nursing

Front 1

What is Mental Health?

Back 1

The successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms

Front 2

What is Mental Illness?

Back 2

Maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms and interfere with the individual’s social, occupational, or physical functioning

Front 3

Cultural influences that affect how individuals view mental illness include

Back 3

Incomprehensibility and Cultural relativity

Front 4

What is Incomprehensibility

Back 4

the inability of the general population to understand the motivation behind the behavior

Front 5

Cultural relativity

Back 5

the “normality” of behavior determined by culture

Front 6

Culture

Back 6

influences human behavior, interpretation of human behavior, and response to human behavior

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stereotyping

Back 7

must be avoided and all individuals must be appreciated for their uniqueness. Caution must be taken not to assume that all individuals who share a culture or ethnic group are clones

Front 8

Culture

Back 8

describes a particular society’s entire way of living, encompassing shared patterns of beliefs, feelings, and knowledge that guide people’s conduct and are passed from generation to generation

Front 9

Ethnicity

Back 9

relates to people identifying with each other because of a shared heritage

Front 10

How do cultures differ?

Back 10

Communication, Space, Social Organization, Environmental Control, Biological Variation and Time.

Front 11

Communication

Back 11

Has its roots in culture; Is expressed through language, paralanguage, gestures

Front 12

Space

Back 12

The place where communication takes place: Territoriality, Density, Distance

Front 13

Social Organization

Back 13

The groups within which individuals are acculturated, acquiring knowledge and internalizing values

Front 14

Social Organization examples:

Back 14

Families
Religious groups
Ethnic groups

Front 15

Environmental Control

Back 15

The extent to which individuals perceive they have control over their environments;
Cultural beliefs and practices influence how individuals respond to their environment during periods of wellness or illness.

Front 16

Biological Variations

Back 16

Differences among people in various racial groups include:
body, skin color, physiological responses to medication,
electrocardiography patterns, susceptibility to disease,
nutritional preferences and deficiencies

Front 17

Time

Back 17

Some cultures place great importance on values that are measured by time, whereas others are actually scornful of clock time.
Whether individuals perceive time in the present or future orientation influences many aspects of their lives.

Front 18

Spirituality

Back 18

Cannot be seen, Difficult to describe, Means something different to all people, Has been largely ignored in nursing literature

Front 19

Spirituality

Back 19

The human quality that gives meaning and sense of purpose to an individual’s existence.
Spirituality exists within each individual regardless of belief system and serves as a force for interconnectedness between the self and others, the environment, and a higher power.

Front 20

Meaning and Purpose

Back 20

Having a purpose in life gives one a sense of control and the feeling that life is worth living.
Individuals must ultimately determine what is important to them and what gives meaning to their life.
A solid spiritual foundation may help individuals confront life’s challenges

Front 21

Faith or Trust

Back 21

The acceptance of a belief in the absence of physical or empirical evidence.
Faith transcends the appearance of the physical world.

Front 22

Faith or Trust

Back 22

Research suggests that what individuals believe exists can have as powerful an impact as what actually exists.
Faith combined conventional treatment and an optimistic attitude, can be powerful in the healing process.

Front 23

Hope

Back 23

A special kind of positive expectation,
An energizing force, May promote healing, facilitate coping, and enhance quality of life, Provides an incentive to live

Front 24

Love

Back 24

Probably life’s most powerful force and our greatest spiritual need
May be a very important key in the healing process, May have a positive effect on the immune system

Front 25

Love

Back 25

Giving and receiving loves may increase levels of endorphins, Research shows that receiving love early in life may help to resist the effects of a deleterious lifestyle.

Front 26

Forgiveness

Back 26

The ability to release from the mind all the past hurts and failures; all sense of guilt and loss, Forgiveness enables a person to cast off resentment and begin the pathway to healing, Holding on to grievances causes pain, suffering, and conflict
Forgiveness is a gift to oneself, offering freedom and peace of mind.

Front 27

Importance of Nurse’s Understanding of Spiritual Influences

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Nurses must be able to assess the spiritual needs of their clients.
Because of the closeness of their relationship, clients may feel more comfortable revealing intimate details of their lives to nurses than to others.

Front 28

DSM-IV-TR Multiaxial Evaluation System

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AXIS I, AXIS II, AXIS III, AXIS IV and AXIS V

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Axis I

Back 29

Clinical disorders and other conditions that may be a focus of clinical attention

Front 30

Axis II

Back 30

Personality disorders and mental retardation

Front 31

Axis III

Back 31

General medical conditions

Front 32

Axis IV

Back 32

Psychosocial and environmental problems

Front 33

Axis V

Back 33

The measurement of an individual’s psychological, social, and occupational functioning on Global Assessment of Functioning (GAF) Scale

Front 34

Milieu

Back 34

A scientific structuring of the environment to effect behavioral changes and to improve the psychological health and functioning of the individual.

Front 35

Expectations of the Milieu

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Within the therapeutic community setting, the client is expected to learn adaptive coping, interaction, and relationship skills that can be generalized to other aspects of his or her life.

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History

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Milieu therapy blossomed during the 1960s, 1970s, and early 1980s, when psychiatric inpatient treatment provided sufficient time to implement programs of therapy aimed at social rehabilitation.

Front 37

History

Back 37

Strategies have been modified to conform to the current short-term approach to care and to outpatient treatment programs.

Front 38

Basic Assumptions

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The health of each individual is to be realized and encouraged to grow.
Every interaction is an opportunity for therapeutic intervention.
The client owns his or her environment.
Each client owns his or her behavior.

Front 39

Basic Assumptions

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Peer pressure is a useful and powerful tool.
Inappropriate behaviors are dealt with as they occur.
Restrictions and punishment are to be avoided.

Front 40

Conditions Promoting a Therapeutic Community

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Basic physiological needs are fulfilled.
The physical facilities are conducive to achievement of the goals of therapy.
A democratic form of self-government exists.
Responsibilities are assigned according to client capabilities.

Front 41

Conditions Promoting a Therapeutic Community

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A structured program of social and work-related activities is scheduled as part of the treatment program.
Community and family are included in the program of therapy in an effort to facilitate discharge from the hospital.

Front 42

The Program of Therapeutic Community

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The treatment plan is formulated & directed by an interdisciplinary team.
Team members of all disciplines sign the plan and meet regularly to update the plan as needed.

Front 43

The Program of Therapeutic Community

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Disciplines may include psychiatry, psychology, nursing, social work, occupational therapy, recreational therapy, art therapy, music therapy, dietetics, and chaplain’s service

Front 44

Role of the Nurse

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Through use of the nursing process, nurses manage the therapeutic environment on a 24-hour basis.

Front 45

Role of the Nurse

Back 45

Nurses have the responsibility for ensuring that the client’s physiological and psychological needs are met.

Front 46

Nurses are also responsible for

Back 46

Medication administration,
Development of a one-to-one relationship, Setting limits on unacceptable behavior, Client education