Mental Health Nursing, day 1 Flashcards
what is Optimal mental health?
individual, group and environmental factors work together effectively: well-being, optimal development & use of mental abilities, achievement of goals, justice & equality
what is Minimal mental health ?
I,G,E factors conflict producing subjective stress, impairment of mental abilities, failure to achieve goals, destructive behaviours; prevalent inequalities
Recovery Model
- Hopefulness, 2. recovery 3. reintegration 4. optimization of functioning in society
Standards of Psychiatric-Mental Health Nursing (summary)
-Provision of competent, professional care through Therapeutic Relationship “Therapeutic Use of Self” -Ongoing, professional, systematic assessments -Evaluation: provision of and monitoring therapeutic interventions -Managing rapidly changing situations -Teaching & Coaching -Ensuring quality health practices – advocacy -Organization, interprofessional practice- partnerships
what is cognitive therapy
Focus: - thoughts/cognitions - correcting cognitive distortions Therapist: active and directive …
Psychodynamic/Psychoanalytic
Focus - internal experience - defense mechanisms - transference and past relationships Therapist more non-directive
interpersonal therapy
Focus: learning more adaptive behaviour Applications: Operant conditioning Modeling Systematic desensitization Aversion therapy Relaxation Assertiveness Therapist: active & directive
PHASES of the Therapeutic Relationship
- Preinteraction 2. Introductory Orientation 3. Working 4. Termination
Pre interaction phase
- Self exploration 2. Self awareness – ONGOING - Professional Role - Own experiences - Biases, stigmatization, stereotyping - Communication style – strengths, weaknesses - Sense of hopefulness or lack of hope - Self analysis (see text)
introductory/orientation phase
- Why now? What brought patient to seek help?
- Situational
- Change in coping
- Change in symptoms
- Crisis - Goal for treatment – what are your goals for care?
- Contract – trust and confidentiality
- Exploring patient’s perspectives
working phase
Termination Phase
•VERY Important – especially at students
•Learning maximized for both parties
•Summarize
–What work was done
–Milestones reached
–Changes forthcoming or achieved
–Separation – expression of feelings
•Boundaries need to be well established to facilitate termination phase - Protection of client
Dorothea Orem
Three foci: (promotes independence)
•Self Care
•Self Care deficit – lacking motivation, knowledge or skill in meeting self-care need
–Nurses help by: Acting or doing for
–Guiding
–Teaching supporting
–Enhancing milieu to meet current or future demands
•Nursing systems - series of actions to meet pt’s self-care needs
General Adaptation Syndrome (GAS)
–Alarm reaction
–Resistance
–Exhaustion
Psychoimmunology: possibilities
- Complex interworking and interdependence between the immune system, endocrine system, nervous system and the environment or emotional stress.
- Consider PANDAS: acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection, leading to OCD.
Levels of intervention
- Crisis: stabilization, inpatient hospitalization 24 hr. mobile unit intervention, telephone access and triage
- Acute: remission, symptom relief, partial
hospitalization, intensive out-pt Rx - Maintenance: recovery, improved functioning,
rehab day treatment, supported independent living - Health Promotion: optimal level wellness, education, social
Crisis, Maintenance, Health Promotion
- Crisis – acute , stabilization & safety
- Acute – goal to work toward recovery and remission
- Maintenance – complete recovery, functioning well in daily life (family, work, study, goal setting and attainment)
- Health Promotion – work toward OPTIMAL level of functioning, quality of life, inspiring and validating experiences
cultural safety
•Recognition of historical context
–Various stressors
–Policy impact upon community / population health
–Status, social, political, psychosocial context
•Recognition of differences in perception, engagement, relationship understanding
– going in to hospital and nurses do FOR you
– feelings of shame or besmirch of family name
– Not engaging in therapy earlier than later
– understanding of mental illness as the brain as a physical entity that is changed rather than choice
Primary, secondary, and tertirary nursing in mental health
…
what is resilience
the personal characteristic that aids people to recognize stressors and decrease negative emotions, deal with them and learn from it
Mental health Recovery
- self directed
- individual and person centered
- empowering
- holistic
- nonlinear
- strengh based
- peer supported
- respect
- resonsibility
- hope
incidence
of new cases in a healthy population in a given time frame
prevelance
total # of cases new and exsisting in a give pop during a time frame
seven domains of mental health
- functional health
- physiological health
- psychological health
- health knowledge and behaviour
- percieved health
- family health
- community health
classes of the psychosocial domain
- psychological well being
- pscychosocial adaption
- self control
- social interaction
nursing interventions
- corrdination of care
- health teaching and maintainance
- milieu therapy
- pharmacological, biological, and integrative therapies
- medication and treatment
- psychotherapy
- consultation
Social determinants of health
- income and social status
- social support networks
- education
- emploment and working conditions
- social environments
- physcial environments
- personal health practices and coping skills
- healthy childhood development
- health services
- biologic and genetic endownment
11 gender
- culture
standards of practice
- provides competent and professional care through the development of a therapuetic relationship
- performs/refines client assessment through diagnostic and monitoring function
- administers and monitors therapeutic interventions
- effectively manages rapidly changing situations
- intervenes through the teaching- coaching function
- montiors and ensures the quality of health care practices
- practices within organizational and work role structure
types of behavioural therapy
- modelling
- operant conditioning
- systemic desensitization
- aversion therapy
- biofeedback
Cognitive Behavioural Therapy (CBT)
- automatic thoughts or cognitive distortions, irrational thoughts/beliefs leading to false assumptions and misinterpretations
- patients are taught to challenge this thinking
* the idea that the way people feel is because of how they see the world
