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Psychiatric Mental Health Nursing
BT Basavanthappa
CHAPTER 1:
Concepts of Psychiatric Mental Health Nursing
INTRODUCTION
CRITERIA OF POSITIVE MENTAL HEALTH
Positive Attitude Towards Self
Growth, Development and Self-actualisation
Integration
Autonomy
Perception of Reality
Environmental Mastery
CHARACTERISTICS OF MENTALLY HEALTHY PEOPLE
Psychosocial Resilience
Freedoms
Hardiness
Androgyny
Balance in Life
COMPONENTS OF MENTAL HEALTH AND MENTAL ILLNESS
Mental Health
Mental Illness
CHARACTERISTICS OF ‘NORMAL’ AND ‘ABNORMAL’
Characteristics of Normalcy
Sociability
Balance and Fulfillment of Needs
Health, Security and Balance
Characteristics of Abnormalcy
An Approach to Criteria of Abnormalcy
FACTORS INFLUENCING ON MENTAL ILLNESS
Personal Factors
Age, Growth and Development
Genetics and Biology
Physical Health and Health Practice
Response to Drugs
Self-efficacy
Hardiness
Resilience and Resourcefulness
Spirituality
Interpersonal Factors
Sense of Belonging
Social Networks and Social Support
Family Support
Cultural Factors
CONCEPTS OF MENTAL HEALTH PROMOTION
Health Promotion
Mental Health Promotion
PREVENTION OF MENTAL ILLNESS
Primary Prevention
Secondary Prevention
Tertiary Prevention
PRIMARY MENTAL HEALTH CARE AND NURSE
CONCEPTS OF STRESS AND MENTAL MECHANISMS
Stress: Mechanisms and Responses
Alarm Reaction (First Phase)
Stage of Resistance (Second Phase)
Stage of Exhaustion (Third Phase)
USE OF DEFENSE MECHANISMS IN NURSING
Compartmentalisation
Compensation
Condensation
Conversion
Denial
Displacement
Dislocation
Fantasy
Identification
Fixation
Intellectualisation
Introjection
Isolation
Projection
Rationalisation
Reaction Formation
Regression
Repression
Resistance
Sublimation
Substitution
Suppression
Symbolisation
Undoing
CHAPTER 2:
Evolution of Psychiatric Mental Health Nursing
IMPORTANT EVENTS RELATED TO PSYCHIATRIC MENTAL HEALTH
DEVELOPMENT OF PSYCHIATRY
HUMANITARIAN TREATMENT OF INSANE AND MENTALLY ILL
Mesmerism as a Remedy for Mental Illness
Hypnotism as a Remedy for Mental Illness
Contribution of the Nancy School
Charcot's Paris School
VIEWS OF MENTAL HEALTH IN INDIA
PRESENT SCENE OF MENTAL HEALTH
GLOBAL ACTION PROGRAMME ON MENTAL HEALTH
Mental Health Policies
Health and Human Rights
Revision of Hospital Medical Code
NATIONAL MENTAL HEALTH PROGRAMME
Emergence of Nursing in Psychiatric Mental Health Care
NURSING
Mental Health Nursing
Psychiatric Nursing
Concept of Psychiatric Mental Health Nursing
Principles of Psychiatric Mental Health Nursing
FUNCTIONS OF PSYCHIATRIC MENTAL HEALTH NURSES
Basic Level Functions
Advanced Level Functions
Nurses’ Reactions with Psychiatric Clients
Clients’ Views of Mental Health Care
Stress Among Psychiatric Mental Nurses
Use of Nursing Models
TASK OF PSYCHIATRIC MENTAL HEALTH NURSING PRACTICE
Levels of Prevention in Psychiatric Mental Health
Primary Prevention
Secondary Prevention
Tertiary Prevention
Continuum of Care in Psychiatric Nursing
Competent Caring in Psychiatric Nursing
Level of Performance in Psychiatric Nursing
Laws
Qualifications
Practice Setting
Personal Initiative
Networking
Clinical Outcome Indicators
CHAPTER 3:
Theoretical Foundations of Psychiatric Mental Health Nursing
INTRODUCTION TO THEORY AND ITS FRAMEWORK
Theory and Nursing Practice
Values of Theories for Nursing
THEORIES OF HUMAN BEHAVIOUR
Ivan Patrovich Pavlov (Conditioned Response Theory or Learning by Conditioning)
JB Watson (Behaviourism)
Explanation of Behaviour
Sensation and Perception
Memory Images
Feeling and Emotion
Learning
Thinking
Environmentalism
Edwin Guthrie (Theory of Continuity in Learning)
Clark Hull (Systemic Behaviour Theory)
Robert Gagne (Information Processing Theory)
Neal Miller and John Dollard
E Thorndike (SR Bond Theory or Connectivism or Trial and Error Learning)
Law of Readiness
Law of Exercise
Law of Effect
Subordinate Laws Mentioned by Thorndike
BF Skinner (Operant Conditioning Theory)
William Glaser (Reality Therapy)
Behaviouristic Theoretical Perspectives
Sigmund Freud (Psycho-analytic Theory)
Freud's Views on Psychosexual Development
Freud's Psychoanalytic Theory Perspectives
Erik Erikson (Epigenetic Theory of Personality Development)
Erikson's Psychosocial Development Perspective
Harry Stack Sullivan (Interpersonal Theory of Psychiatry)
Sullivan Biological Principles
Sullivan Developmental Stages
Sullivan's Interpersonal Theory and its Perspective
General System Theory
General System Theory's Perspective
Natural Systems Theory
Theoretical Concepts
Bandura (Social Learning Theory)
Piaget (Theory of Cognitive Development)
Kurt Lewin (Gestalt Field Psychology)
Cognitive Field Theory of Learning
Fritz Perls (Gestalt Therapy)
Lawrence Kohlberg (Theory of Moral Development) (Table 3.4)
Abraham Maslow (Theories of Motivation and Hierarchy of Needs)
Existential Philosophy
The Existential-phenomenological Perspective
Current Ecological Theories about Human Development and Behaviour
Social Causation versus Social Selection
Community Factors that Affect Behaviour
Nursing Theories
Peplau's Theory
Helen Erickson, Evelyn Tomlin and Mary Ann Swain
Orem's Theory
Roger's Theory
Roy's Theory
Betty Neuman
Rosemarie Rizzo Parse
Margaret Newman
Jean Watson
Madeleine Leininger
Anne Boykin and Savina Schoenhofer
CHAPTER 4:
Psychobiological Foundation of Psychiatric Mental Health Nursing
INTRODUCTION
NERVOUS SYSTEM
The Central Nervous System (CNS)
Cerebrum
Frontal Lobes
The Parietal Lobes
The Temporal Lobes
The Occipital Lobes
Diencephalon
Limbic System
Mesencephalon
Pons
Medulla
Brainstem
Autonomic Nervous System
Neurotransmitters
Membrane Receptors
Receptor Subtypes
Neuropeptides and Intracellular Modification of Synaptic Signals
NEUROENDOCRINOLOGY
Pituitary Gland
The Posterior Pituitary (Neurohypophysis)
The Anterior Pituitary (Adenohypophysis)
Circadian Rhythms
The Role of Circadian Rhythms in Psychopathology
Neurochemical Influences
PSYCHOIMMUNOLOGY
Normal Immune Response
Genetics of Behaviour
Genetics Influence on Mental Illness
Chromosomes and Genes
Genetic Linkage
Chromosome Mapping
DNA Sequencing
Genetics and DNA
Genetic Factors in Depression and Mania
Genetic Factors in Schizophrenia
Genetic Factors in Dementia
Genetic Factors in Personality, Conduct and Character Disorders
PSYCHOPHYSIOLOGICAL EFFECTS OF ENVIRONMENT
Toxic Substances
Illness and Injury
Seasonal Affective Disorder
BIOLOGICAL IMPLICATIONS FOR NURSING
CHAPTER 5:
The Therapeutic Nurse-Client Relationship and Communication
VIEWS ON RELATIONSHIP
Helping Relationship/Nurse as Helper
The Client as Petitioner
CHARACTERISTICS OF THERAPEUTIC RELATIONSHIP
Nurse-Client Relationship
Phases of Therapeutic Relationship
Orientation Phase
Identification Phase
Exploitation Phase
Resolution Phase
Changing Roles of the Nurses Throughout Relationship
COMMUNICATION AND ITS SIGNIFICANCE IN NURSING
Purpose and Types of Communication
Verbal Communication
Meta Communication
Interpretation and Perception
Self-Concept and Interpersonal Relationships
Communication in Relationships between Nurse and Client
Communication and the Phenomenon of Anxiety
Communication Strategies of Client Care
Therapeutic Communication Techniques
Therapeutic Communication Interventions
Listening
Observation
Self-disclosure
Cultural Sensitivity
Communication Techniques
Using Broad Openings
Reflecting Feelings
Confronting Feelings
Reflecting Content
Clarifying Content
Confronting Content
Directing
Giving Information
Questioning
Interviewing
Selected Application of Therapeutic Communication
Intervening in Crisis Stabilization
Intervening in Psychotic Communication
Therapeutic Dialogue: Responding to Psychotic Communication
COMMUNICATION STRATEGIES THAT REFLECT NONCARING FOR CLIENTS
Outcomes of Helping Relationships
CHAPTER 6:
Basic Aspects of Psychiatric Mental Health Nursing
SOCIOCULTURAL ASPECT
Nature of Culture and its Need
Cultural Sensitivity
Communication
Space
Social Organization
Time
Environmental Control
Biological Variations
Cultural Sensitivity in Nursing
Beliefs about Mental Illness and Care
Normal Versus Abnormal Behaviour
Interpersonal Interaction and Culture
Verbal and Nonverbal Communication
Eye Contact
Proxemics
Touch
Silence
Social Behaviour
Time Orientation
Diet and Food Habits
ETHICAL ASPECTS
Ethical Theories
Ethical Principles
Autonomy
Beneficence
Fidelity
Justice
Nonmalefficence
Veracity
Ethical Dilemmas in Mental Health
Ethical Decision-making
Legal Aspects
Civil Law
Tort
Contract
Criminal Law
Types of Laws
Statutory Law
Common Law
Client's Bill of Rights
Client's Rights
Legal Issues in Hospitalization and Inpatient Treatment
Legal Issues Related to Care in the Community
Bill of Rights for Psychiatric Clients
Legal Issues in Psychiatric/Mental Health Nursing
Commitment Issues
Voluntary Admissions
Involuntary Commitment
Emergency Commitments
The Mentally Ill Person in Need of Treatment
Involuntary Outpatient Commitment
The Gravely Disabled Client
Nursing Liability
Malpractice and Negligence
Failure to Prevent Dangerous Client Behaviour
Sexual Involvement with Clients
Breaching Confidentiality
Failure to Honour Individual Rights
Control of Violent or Self-Destructive Behaviours
Types of Lawsuits that Occur in Psychiatric Nursing
Avoiding Liability
CHAPTER 7:
Nursing Process Applications in Psychiatric Mental Health Nursing
INTRODUCTION
Nursing's Scientific Methodology
Nature of the Nursing Process
Definition of Nursing Process
Systematic
Dynamic
Interpersonal
Flexible
Theoretically Based
Goal Oriented
Universally Applicable
Steps of Nursing Process
1. Assessment
Health History
Screening and Psychological Testing
Projective Tests
Personality Inventories
Intelligence Tests
Family Assessment
Mental Status Examination
Interview
Stages of Interview
Introductory Phase
Working Phase
Termination Phase
Conducting the Interview
Skills of the Nurse-Interviewer
Client Expectations of the Interviewer
Sources of Motivation
Restraining Forces
Mental Status Examination
2. Nursing Diagnosis
Medical Diagnoses As Etiologies
NANDA Nursing Diagnoses: Taxonomy II
Exchanging
Communicating
Relating
Valuing
Moving
Perceiving
Knowing
Feeling
Assigning Nursing Diagnoses to Client Behaviours
Behaviours
NANDA Nursing Diagnoses
Nursing Diagnoses in Psychiatric—Mental Health Nursing
Possible Related Nursing Diagnoses
Schizophrenia
Mood Disorders
Personality Disorders
Childhood and Adolescent Disorders
Eating Disorders
Anxiety Disorders
Dementia and Delirium Disorders
3. Planning
Goals and Objectives
Integrating the Client Perspective: Collaborative Care
Prioritizing Needs for Change
Formulating Client Outcomes (Objectives)
Delineating the Nursing Approaches
Defining Deadlines and Discharge Plans
Long Term and Short Term Goals (Table 7.1)
Nursing Intervention Plan
Determining the Significance of the Present Situation
Calling Up the Assessment Data and Care Plan
Setting Priorities
Selecting the Appropriate Intervention Strategy
The Role of the Nurse-Client Relationship
Intervention and the Supervision Process
Nursing Care Plan
Problem, Reason, Objective, Nursing Intervention Evaluation (PRONE)
4. Implementation
5. Evaluation
Evaluation in the Nursing Process
Assessment
Diagnosis
Planning
Implementation
Evaluation
DOCUMENTATION OF THE NURSING PROCESS
Problem-Oriented Recording
Focus Charting
The Pie Method
CHAPTER 8:
The Therapeutic Use of Self Concept
INTRODUCTION
Physical Self or Body Image
Personal Identity
Self-Esteem
THEORIES OF SELF AND GROWTH DEVELOPMENT
Erikson's Theory
Levinson's Theory
Piaget's Theory
Other “Ages and Stages” Theories
Life Event Theories
Variability Theories
IMPACT OF SOCIALIZATION IN SELF
Socialisation
Affiliation
The Dependency Condition
The Reference Group
Dependence and the Internalisation of Values
Impulse Control
Delay of Gratification
Identification Process
Development of Self
Components of Self
Self-Concept
Extant Self
Desired Self
Presenting Self
Self-Concept Development
Symbolic Interactionism
Developmental Tasks
Self-Concept Stability
Locus of Control
Factors Affecting Self-Concept
Evaluation of Self Concept
A Healthy Personality
The Interview and Health History
Components of the Interview
Social Identity
Personal Identity
Physical Self
Self Esteem
Threats to Self Concept
Formal Assessment Tools
Twenty Statements Test
Locus/Control Scales
Rosenberg's Self-Esteem Scale
Rosenberg's Self-Esteem Scale
The Piers-Harris Self-Concept Scale
Self-Concept Assessment
CHAPTER 9:
Therapeutic Intervention
INTRODUCTION TO PSYCHOTHERAPY
Major Approaches to Psychotherapy
Insight-oriented Therapy
Psychoanalysis
Psychodynamic Therapy
Interpersonal Therapy
Task-oriented Therapy
Common Thought Distortions Address in Cognitive Behavioural Therapy
Experience-oriented Therapy
Client-centred Therapy (Founded by Carl Rogers)
PSYCHOTHERAPY AND CULTURAL SENSITIVITY
Levels of Psychotherapy
Supportive Therapy
Re-educative Therapy
Reconstructive Therapy
Psychotherapy Concepts
Insight
Repression
Free Association
Resistance
Reworking
Transference
Counter Transference
Ambivalence
Ambiguity
Object Constancy
Acting In
Acting Out
Interpretation
Working Through
Translating
PSYCHOTHERAPY IN NURSING PRACTICE
Different Kinds of Therapies
Nursing Theory Role in Therapies
INDIVIDUAL PSYCHOTHERAPY
Stages of Psychotherapy
Introductory Stage
Working Stage
Working Through Stage
THERAPEUTIC GROUP AND GROUP THERAPY
Definitions of Groups
Properties of the Group
Group Structure
Cohesiveness
Functions of a Group
Types of Groups
Task Groups
Teaching Groups
Supportive/Therapeutic Groups
Self-help Groups
Physical Conditions that Influence Group Dynamics
Seating
Size
Membership
Member Roles
Curative Factors in Therapeutic Groups
Phases of Group Development
Phase I, Initial or Orientation Phase
Phase II, Middle or Working Phase
Phase III, Final or Termination Phase
Leadership Styles of Group
Autocratic
Democratic
Laissez-Faire
Approaches to Therapy Groups
Psychoanalytic Approach
Interpersonal Approach
Existential Approach
Cognitive Behavioural Approach
Psychodrama
Approach to Supportive Groups
Socialisation Groups
Recreation Groups
Educational Groups
Reality Orientation Groups
Reminiscence Groups
Self-help Groups
Group Therapy in Practice
Purposes of Group Theory
Advantages and Disadvantages
Therapeutic Factors of Group Therapy
Instillation of Hope
Universality
Imparting of Information
Altruism
Corrective Recapitulation of the Primary Family Group
Development of Socialising Techniques
Imitative Behaviour
Interpersonal Learning
Group Cohesiveness
Catharsis
Existential Factors
The Role of the Nurse in Group Therapy
Types of Therapy Groups and Nurse
Psychoanalytic Group
Transitional Analysis
Rational-motive Therapy
Rogerian Group Therapy
Gestalt Therapy
Interpersonal Group Therapy
Psychodrama Groups
Bion Method
Marathon Groups
Encounter Groups
T Groups
Community Support Group
Nursing Student Groups
Group Communication and Nursing Intervention
Latent and Manifest Communication
Levels of Communication in Groups
Therapeutic Dialogue: A Group Case
FAMILY AND FAMILY THERAPY
Definitions of Family
Approaches to Family Nursing
Family as Context
Family as Client
Family as a System
Family as Component of Society
Family Theories
Family Developmental Theory
Differentiation
Nursing Interpretation Based on Bowen's Theory
Structural Family Theory
Nursing Interpretations Based on Structural Family Theory
Communication Theory
Nursing Interpretation Based on Communication Theory
Family Functioning
Elements of Family Assessment
Communication
Self-concept Reinforcement
Family Member's Expectation
Handling Differences
Family Interactional Patterns
Family Climate
Therapeutic Modalities with Families
Bowen's Model
The Structural Model
The Strategic Model
THERAPEUTIC COMMUNITY AND MILIEU THERAPY
Goals
Conditions that Promote a Therapeutic Community
Characteristics of a Therapeutic Milieu
Individualised Treatment Plans
Self-governance
Progressive Levels of Responsibility
A Variety of Meaningful Activities
Links with the Client's Family and Significant Others
Links with the Community
Effective Interaction among Mental Health Team Members
Humanistic Mental Health Team Members
Facilitating Therapeutic Milieu
Components of a Therapeutic Milieu
Responsibilities in Managing and Coordinating the Therapeutic Milieu
Direct Client Care
Indirect Client Care
Physical and Safety Care
Medication Administration and Education
Psychosocial Care
Mental Health Education
Health Education
CHAPTER 10:
Crisis Theory and Crisis Intervention
INTRODUCTION
Meaning of Crisis
Characteristics of Crisis
Phases in the Development of a Crisis
TYPES OF CRISIS
Maturational Crisis
Situational Crisis
Cultural Crisis
A Community Crisis
NURSING THEORY AND CRISIS
Adaptation Theories
Equilibrium (Adaptive)
Arousal
Impoverishment
Caring Theories
Cultural Care Theory
Crisis Intervention
The Role of The Nurse in Phases of Crisis Intervention
Phase 1. Assessment
Phase 2. Planning of Therapeutic Intervention
Phase 3. Intervention
Phase 4. Evaluation of Crisis: Resolution and Anticipatory Planning
Disaster Nursing
Nursing Process and Crisis
Assessment
Nursing Diagnosis
Planning
Nursing/Interventions
Crisis Intervention as Mental Health Prevention
Evaluation
CHAPTER 11:
Anxiety Disorders
INTRODUCTION
Characteristics of Anxiety
LEVELS OF ANXIETY
Mild Anxiety
Moderate Anxiety
Panic Anxiety
ANXIETY AS A RESPONSE TO STRESS
Anxiety and Defense Mechanisms
Epidemiology of Anxiety Disorders
THEORIES OF ANXIETY
Psychodynamic Theory
Learning Theory
Biochemical Theory
Genetic Theory
CLASSIFICATION OF ANXIETY DISORDERS
Panic Disorders
Aetiology
Clinical Features
Nursing Management
Nursing Diagnosis
Planning
Implementation
Evaluation
Generalised Anxiety Disorder
Aetiology
Treatment
Nursing Management
Nursing Diagnosis
Planning
Implementation
Evaluation
Phobic Disorders
Aetiology
Classification of Phobias
Nursing Management
Differentiation Between Different Phobias
Treatments
Nursing Diagnosis
Planning
Implementation
Evaluation
Obsessive-compulsive Disorder (OCD)
Aetiology of OCD
Clinical Features
Treatment
Nursing Management
Nursing Diagnosis
Planning
Post-traumatic Stress Disorder
Clinical Features
Aetiology
Nursing Management
Nursing Diagnosis
Planning
Implementation
Evaluation
Related Disorders
Anxiety Disorders Due to Medical Condition
Aetiology
Treatment
Substance Induced Anxiety Disorder
Treatment Modalities
CHAPTER 12:
Sleep Disorders
INTRODUCTION
AETIOLOGY
PHYSIOLOGY OF SLEEP
Circadian Rhythms
Sleep Regulation
Stages of Sleep
Stage 1. NREM
Stage 2. NREM
Stage 3. NREM
Stage 4. NREM
REM Sleep
Sleep Cycle
Functions of Sleep
Dreams
NORMAL SLEEP PATTERNS
Neonates
Infants
Toddlers
Preschoolers
School-age Children
Adolescents
Young Adults
Middle Adults
Older Adults
FACTORS AFFECTING SLEEP
Physical Illness
Drugs and Substances
Lifestyle
Sleep Patterns
Emotional Stress
Environment
Exercise and Fatigue
Caloric Intake
CLASSIFICATION OF SLEEP DISORDERS
Insomnia
Hypersomnia
Sleep Apnoea
Sleep Deprivation
Physiological Symptoms
Psychological Symptoms
Narcolepsy
Parasomnias
Nightmare Disorder
Sleep Terror Disorder
Sleepwalking
Circadian Rhythm Sleep Disorders
Shift Work Type
Jet Lag Type
Delayed Sleep Phase Type
Other Sleep Disorders
TREATMENT OF SLEEP DISORDERS
Primary Insomnia
Relaxation Therapy
Biofeedback
Pharmacotherapy
Hypersomnolence
Parasomnias
Sleep-wake Schedule Disturbances
NURSING MANAGEMENT OF SLEEP DISORDERS
Assessment
Sources for Sleep Assessment
Sleep History
Description of Sleeping Problems
Normal Sleep Pattern
Physical Illness
Current Life Events
Emotional and Mental Status
Bedtime Rituals
Bedtime Environment
Sleep-wake Log
Behaviours of Sleep Deprivation
Nursing Diagnosis
Planning
Implementation
Environmental Controls
Controlling Physiological Disturbances
Client Teaching
Evaluation
CHAPTER 13:
Somatoform Disorders
INTRODUCTION
Classification
Pain Disorder
Aetiology
Nursing Diagnosis
Somatization Disorder
Aetiology
Clinical Features of Somatization Disorder
Nursing Diagnosis
Hypochondriasis
Assessment
Aetiology
Conversion Disorder
Assessment
Aetiology
Nursing Diagnosis
Body Dysmorphic Disorder
Assessment
Aetiology
Nursing Diagnosis
Related Disorders
Aetiology
Treatment of Somatoform Disorders
Client/Family Education
Nursing Diagnosis
CHAPTER 14:
Eating Disorders
INTRODUCTION
AETIOLOGY
Biological Factors
Development Factors
Family Influences
Psychosociocultural Factors
TYPES
Anorexia Nervosa
Clinical Manifestation
Specific Type of Anorexia Nervosa
Treatment of Anorexia Nervosa
Bulimia Nervosa
Clinical Manifestations
Specific Types of Bulimia Nervosa
Treatment of Bulimia Nervosa
Obesity
Clinical Manifestation
Nursing Management of Eating Disorders
Nursing Diagnosis
Intervention for Clients with Eating Disorders
Evaluation
CHAPTER 15:
Schizophrenia
INTRODUCTION
ETIOLOGY
Biological Factors
Physiological Factors
Psychological Factors
Sociocultural Factors
CLINICAL MANIFESTATIONS
Phase I: The Schizoid Personality
Phase II: The Prodromal Phase
Phase III: Schizophrenia
Positive Symptoms
Negative Symptoms
Phase IV: Residual Phase
TYPES OF SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS
Disorganized Schizophrenia
Catatonic Schizophrenia
Paranoid Schizophrenia
Undifferentiated Schizophrenia
Residual Schizophrenia
Schizoaffective Disorder
Brief Psychotic Disorder
Schizophreniform Disorder
Delusional Disorder
Erotomanic Type
Grandose Type
Jealous Type
Persecutory Type
Somatic Type
Shared Psychotic Disorder
Psychotic Disorder due to a General Medical Condition
Substance-Induced Psychotic Disorder
NURSING MANAGEMENT OF SCHIZOPHRENIA
Assessment
Content of Thought
Form of Thought
Perception
Affect
Sense of Self
Volition
Impaired Interpersonal Functioning and Relationship to the External World
Psychomotor Behaviour
Associated Features
Nursing Diagnosis
Planning
Implementation
Evaluation
TREATMENT MODALITIES FOR SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS
Psychological Treatments
Individual Psychotherapy
Group Therapy
Behaviour Therapy
Social Skills Training
Social Treatment
Milieu Therapy
Family Therapy
Organic Treatment
Psychopharmacology
CHAPTER 16:
Mood Disorders
INTRODUCTION
GRIEF AND ITS STAGES
Stages of Grief
Elizabeth Kubler Ross
John Bowlby
George Engel
Length of the Grief Process
Anticipatory Grief
Maladaptive Responses to Loss
Delayed or Inhibited Grief
Exaggerated Grief Response
DEPRESSIVE DISORDER
Aetiology
Biological Theories
Psychosocial Theories
Classification of Depressive Disorders
Criteria for Identifying Depressive Disorders
Diagnostic Criteria for Dysthymic Disorder
Nursing Management of Depressive Disorders
Assessment
Transient Depression
Nursing Diagnosis
Planning
Implementation
Evaluation of Care for the Depressed Client
BIPOLAR DISORDER
Etiology of Bipolar Disorder (Mania)
Biological Theories
Psychosocial Theories
Classification of Bipolar Disorders
Criteria for Identifying Manic Episode
Other Mood Disorders
Mood Disorder due to a General Medical Condition
Nursing Management of Bipolar Disorder (Mania)
Assessment
Nursing Diagnosis
Planning
Implementation
Evaluation of Care for the Manic Client
Treatment Modalities for Mood Disorders
Psychological Treatments
Organic Treatments
Electroconvulsive Therapy for Depression and Mania
CHAPTER 17:
Personality Disorders
INTRODUCTION
DEFINITION OF PERSONALITY
PERSONALITY DISORDER
CLASSIFICATION OF PERSONALITY DISORDERS
Cluster A. Personality Disorder
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Cluster B. Dramatic and Emotional Personality Disorders
Antisocial Personality Disorder
Borderline Personality Disorder (BPD)
Histrionic Personality Disorder
Narcissistic Personality Disorder
Cluster C. Anxiety and Fear Based Personality Disorder
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive Compulsive Personality Disorder
Passive-Aggressive Personality Disorder
Nursing Management of Personality Disorder
Paranoid Personality Disorder (Table 17.1)
Schizoid Personality Disorder
Schizotypal Personality Disorder
Antisocial Personality Disorder
Borderline Personality Disorder (BPD)
Historionic Personality Disorder
Narassistic Personality Disorder
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder
Passive-Aggressive Personality Disorder
CHAPTER 18:
Substance Abuse Related Disorders
INTRODUCTION
CLASSIFICATION SUBSTANCE-ABUSE RELATED DISORDERS
Substance Use Disorders
Substance Abuse
Substance Dependence
Substance-Induced Disorders
SUBSTANCES USED AND ABUSED BY HUMANS
Alcohol Abuse and Dependence
Phases of Alcoholism
Effects of Alcohol on the Body
Types of Alcoholism
Personality Characteristics of an Alcoholic
Nursing Management of Alcoholics
Alcoholic Addiction
Alcoholic Anonymous (AA)
Sedative, Hypnotic or Anxiolytic Abuse and Dependence
Effects of Sedative Hypnotics on the Body
Intoxication, Withdrawal and Detoxificants
Stimulants (Amphetamines, Cocaine, Others) Abuse and Dependence
Use and Abuse
Effects of Stimulants
Intoxication
Withdrawal
Inhalant Abuse and Dependence
Use/Abuse
Effects of Inhalants on the Body
Opioid Abuse and Dependence
Use/Abuse
Effects of Opioids on the Body
Hallucinogen Abuse and Dependence
Use/Abuse
Effects of Hallucinogens on the Body
Hallucinogen Intoxication
Cannabis Abuse and Dependence
Use/Abuse
Effects of Cannabinoids on the Body
Cannabis Intoxication
Nursing Management
CHAPTER 19:
Psychophysiological Disorders
INTRODUCTION
CLASSIFICATION
Asthma
Signs and Symptoms
Aetiology
Management
Coronary Heart Disease
Signs and Symptoms
Aetiology
Management
Peptic Ulcer
Signs and Symptoms
Aetiology
Management
Cancer
Signs and Symptoms
Aetiology
Management
Essential Hypertension
Signs and Symptoms
Aetiology
Management
Migraine Headache
Signs and Symptoms
Aetiology
Management
Rheumatoid Arthritis
Signs and Symptoms
Aetiology
Management
Ulcerative Colitis
Signs and Symptoms
Aetiology
Management
NURSING MANAGEMENT
Nursing Diagnosis
Planning
Implementation
Evaluation
CHAPTER 20:
Cognitive Disorders
INTRODUCTION
CLASSIFICATION OF COGNITIVE DISORDERS
Delirium
Aetiology
Nursing Interventions for Delerium
Dementia
Stages of Dementia
Aetiology
Nursing Intervention for Dementia
Amnestic Disorder
Aetiology
Nursing Management of Cognitive Disorders
MEDICAL TREATMENT MODALITIES
Delirium
Dementia
Cognitive Impairment
Agitation, Aggression, Hallucinations, Thought Disturbances and Wandering
Depression
Anxiety
Sleep Disturbances
CHAPTER 21:
Dissociative Disorders
INTRODUCTION
Dissociative Amnesia
Aetiology
Nursing Diagnosis
Implementation
Evaluation
Dissociative Fugue
Aetiology
Nursing Diagnosis
Implementation
Evaluation
Dissociative Identity Disorder
Aetiology
Nursing Diagnoses
Planning
Implementation
Evaluation
Depersonalisation Disorder
Aetiology
Nursing Diagnoses
Planning
Implementation
Evaluation
TREATMENT MODALITIES
Dissociative Amnesia
Dissociative Fugue
Dissociative Identity Disorder
Depersonalisation Disorder
Client/Family Education Related to Dissociation Disorders
Nature of the Illness
Management of the Illness
Support Services
CHAPTER 22:
Sexual and Gender Identity Disorders
INTRODUCTION
DEFINITIONS OF SEXUALITY
DEVELOPMENT OF HUMAN SEXUALITY
Birth Through Age 12
Adolescence
Adulthood
Marital Sex
Extramarital Sex
Sex and the Single Person
The “Middle” Years – 40 to 65
SEX ROLE (GENDER ROLE)
SEXUAL RESPONSE PATTERN
Forms of Sexual Stimulation
Sexual Response Cycle
Excitement Phase
Plateau Phase
Orgasmic Phase
Resolution Phase
CAUSES FOR SEXUAL DISORDERS
TYPES OF SEXUAL DISORDERS
Paraphilias
Types of Paraphilias
Aetiology
Treatment Modalities for Paraphillias
Sexual Dysfunctions
The Sexual Response Cycle
Phase I. Desire
Phase II. Excitement
Phase III. Orgasm
Phase IV. Resolution
Types of Sexual Dysfunction
Sexual Desire Disorders
Orgasmic Disorders
Sexual Pain Disorders
Sexual Dysfunction Due to a General Medical Condition and Substance-Induced Sexual Dysfunction
Aetiology
Predisposing Factors in Sexual Dysfunctions
Nursing Management of Sexual Disorders
Assessment
Nursing Diagnosis
Planning
Implementation
Nature of the Illness
Management of the Disorder
Support Services
Evaluation
Treatment Modalities for Sexual Dysfunctions
Sexual Desire Disorders
Sexual Arousal Disorders
Sexual Pain Disorders
GENDER IDENTITY DISORDER
Aetiology: Predisposing Factors
Biological Influences
Family Dynamics
Psychoanalytical Theory
Nursing Management of Gender Identity Disorders
Assessment
Nursing Diagnosis
Planning
Implementation
Evaluation
VARIATIONS IN SEXUAL ORIENTATION
Homosexuality
Aetiology
Trans-Sexualism
Aetiology
Bisexuality
Aetiology
Sexually Transmitted Diseases
CHAPTER 23:
Psychopharmacology
INTRODUCTION
ROLE OF NURSES IN PSYCHOTROPIC MEDICATION
ANTIANXIETY DRUGS
Indications
Classification (Table 23.1)
Mechanism of Action
Contraindications
Side Effects
Nursing Management during Anxiolytic Medication
Antidepressants
Indications
Classification (Table 23.3)
Mechanism of Action
Contraindications
Side Effects
Nursing Management of Antidepressant Medication
MOOD-STABILISING AGENTS
Antimanic: Lithium Carbonate (Eskalitis, Lithone)
Anticonvulsants
Calcium Channel Blocker
Nursing Management
Antipsychotics
Classification
Mechanism of Action
Contraindications
Nursing Management
Pharmacokinetics
General Guidelines and Dosage
SEDATIVE HYPNOTICS
Mechanism of Action
CNS Stimulants
Mechanism of Action
Nursing Management
ANTIPARKINSON AGENTS
Mechanism of Action
Nursing Management
CHAPTER 24:
Child and Adolescent Disorders
INTRODUCTION
CLASSIFICATION OF CHILD AND ADOLESCENT DISORDERS
Mental Retardation
Aetiology
Assessment of Degree of Mental Retardation
Nursing Diagnosis
Planning
Evaluation
Down's Syndrome
Phenylketonuria
Learning Disorders
Classification
Aetiology
Clinical Features
Management of Learning Disorder
Motor Skill Disorder
Developmental Coordination
Communication Disorder
Pervasive Developmental Disorder
Autistic Disorder
Aetiology
Nursing Management
Nursing Diagnosis
Rett's Disorder
Childhood Disintegrative Disorder
Asperger's Disorder
Attention Deficit and Disruptive Behaviour Disorder
Aetiology
Psychosocial Influences
Clinical Features
Subtypes
Management of ADHD
Nursing Management
Psychopharmacological Intervention
Conduct Disorder
Aetiology
Subtypes
Clinical Features
Treatment
Nursing Management
Oppositional Defiant Disorder
Aetiology
Nursing Management
Feeding and Eating Disorders of Infancy and Early Childhood
PICA (Geophagia)
Rumination Disorder
Feeding Disorder
TIC Disorders
Tourette's Disorder
Aetiology
Nursing Management
Psychopharmacological Intervention
Separation Anxiety Disorder
Anxiety Disorders
Aetiology
Nursing Management
Over Anxious Disorder
Phobias
Somatoform Disorder
Obsessive-Compulsive Disorder
Enuresis (Bed Wetting)
Thumb Sucking and Nail Biting
Teeth Grinding (Bruxism)
School Phobia (School Refusal, School Withdrawal)
Periodic Syndrome
Hysteria (Conversion Reaction or Hysteria)
Types
Sleep Walking (Somnambulis)
Aetiology
Common Presentations
Management
Autism
Aetiology
Clinical Features
Nursing Management
Prognosis
General Principles in the Treatment of Child: Pharmacotherapy
CHAPTER 25:
Community Mental Health Nursing (CMHN)
INTRODUCTION
NEED FOR CMHN
CURRENT AND FUTURE PERSPECTIVES IN MENTAL HEALTH CARE
Model Standards for Implementing National Objectives
Scope of Mental Illness
Severe Mental Disorders
Mental Health Problems
Children and Adolescents
Adults
Older Adults
Low Income, Ethnic and Minority Groups
MODELS FOR COMMUNITY MENTAL HEALTH NURSING
Client-Centred Model
Case Management Model
Description of PACTS
Capitation and Managed-Care Models
The Public Health Model
Primary Prevention
Secondary Prevention
Tertiary Prevention
ROLE OF THE NURSE IN COMMUNITY MENTAL HEALTH
Practitioner
Educator
Coordinator
CONCEPTUAL FRAMEWORKS
LEVELS OF PREVENTION
VULNERABILITY-STRESS MODEL
RELAPSE MANAGEMENT
FUTURE DIRECTIONS
Terminology of Psychiatric/Mental Health Nursing
INDEX
TOC
Index
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