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psychiatry (Nursing theory : roy's adaptation ((Physical, Roles &…
psychiatry
Nursing theory : roy's adaptation
Physical
Roles & functions
Self awareness, self image
Interpersonal relationships
whole
The ories and concepts relating to mental health nursing
Psychoanalytical Model
Id Ego Superego
Defense mechanism
Instinct
Psycho sexual development
Acceptance
Do not blame
How to treat
Dream interpretation
Free association
Hypnosis
Psychotherapy
Supportive psychotherapy
Insight psychotherapy
Interpersonal Relationship Model
Humanistic Model
Human being
Worth
acceptance
Cognitive Behaviour Model
Behaviour Model
Model
Learned from experience (current)
re-enforcement
How to change
systematic desensitization
Assertive
positive reinforcement
negative reinforcement
shaping technique
successive approximation
chaining
Motivation
Token economy
Relaxation technique
present
Nursing Theories
Biochemical Imbalance
Epinephrine=>emotion, concentration, anxiety
Nor-epinephrine=>
Serotonin=>sleep, wake up, appetite, emotion
Dopamine=>movement, judgement, awareness
Acetylcholine=>movement, memory
Gamma immunobutyric acid=>brain response,reflection
Electro
Convulsive
Therapy (ECT)
How to treat
Medication
-Tablets / pills &
injection
-Antipsychotic drugs
-Anti-anxiety drugs &Sedative
-Mood stabilizing drugs
-Anticholinergic drugs
MENTAL HEALTH INTERVENTIONS:ROLES OF NURSES
Physical treatment
Medicine
ECT
Restrain
Psychological treatment
Individual psycho therapy
Group psycho therapy
Social treatment
Milieu therapy
Group therapy
Medication
Anti-anxiety drug
Diazepam, Transene, Ativan
Anti-depressant drug
Anti-psychotic drug
Hadol, Haloperidal, Perphenazine,
Resperidal
Mood stabilizing drug
Naco3
Care for patients taking medicine
Oral
5 rights
Check by talking, opening the mouth,watching
Check @ bed, bin, locker, etc
Drink water
Injection
Quickly
Slowly pushing
Care for side effects
Extra pyramidal symptoms
Pseudo parkinsonism
Agitation
Akinesia
dystonia
Drowsiness
Thirsty
Weigh gained
Care for patients having ECT
Before providing ECT
Same to preparation of operation
Sedation and without sedation (Modified and
unmodified ECT)
Providing ECT
Supportive care while convulsing
Oxygen cannular or mask
Mouth protect
After providing ECT
Waking
Prevention of accident
Care for restrain
Tie with cloths without irritation
Not too lose and fixed
Communicate with patient
Feed water and meal
Make some rules for releasing and getting free
Explain about controlling not punisment
Care for seclusion
Keep room clean and safe
Control stimulation
Communicate
Give food and drink
Inform the reasons and time of seclusion
Psychological treatment & care
Individual and group psychotherapy
Supportive psycho therapy
Here and now problem focused
Eclectic approach appropriately
Emphasize in supporting, not in-depthsolving
Listening, understanding, supporting,ventilating
Social treatment and care
Milieu therapy
Keep environment clean and comfortable
Have duties as members
Have recreations and relaxation
Know and learn to stay with others
Accept others, community rules and social
Group therapy
Nurse as a leader, co-leader and member
Inform about the group
Invite patients to participate
Help in personal preparation before
beginning the group
As leader,
Lead the group to meet goals of group
motivate members to participate, share, and
being in group through the session
Open, operate, and close group
As co-leader,
Catch content and connect information emerged
Support leader and group
Help in summarization
Protect the group, control environment may affect
As member
Participate like other members
Being the good member
Being socialized agent
Support other member as a peer member
social
Social norm
Social expectation
Social acceptance
Community mental health care
Existential model
Exist
Independence
Free
responsibility
acceptance
How to change
Rational emotive therapy (RET)
Rational emotive behaviour therapy (REBT)
Logotherapy
Reality Therapy
Gestalt Therapy
Roles of Mental Health Nurse
Intervention
–Medicine
–Injection
–ECT
–Group therapy
–Interaction
–Milieu
Rehabilitation
–Group
–individual
Promotion
Prevention
Intervention
Rehabilitation
Mental health promotion
Risks => groups, issues
–General => age, gender, groups
–Mental health education =>
media, publication, campaign
Education
Resource person
• Surrogate parent
• Technician manager
• Socializing agent
• Counselor
• Teacher
• Leader
Basic level
Counselling
–Milieu therapy
–Promotion of self care activities of daily
living
–Psychological intervention
–Health teaching
–Case management
–Health promotion and health maintenance
Primary prevention
• Secondary prevention
• Tertiary prevention
Advance level
Psychotherapy
–Prescriptive authority for drugs
–Clinical supervision and clinical
consultation
–Consultation liaision
Primary prevention is ways of …
Finding out of new patients with mental illness
and provide care to them early
– Provide care with qualities in order to shorten
duration of hospital staying
• Intervention provided by mental health
professionals
• Eg. Medicine, ECT
Tertiary prevention is ways of…
– Recovery of mental illness
Note: mental illness may not be disappear within
one or more discharges from the hospitals.
Therefore in the mental health field, we tended to
accept that actions after discharging can be care of
recovery.
• Community mental health care
• Eg. Home visit
Secondary prevention is ways of…
– Finding out of new patients with mental illness
and provide care to them early
– Provide care with qualities in order to shorten
duration of hospital staying
• Intervention provided by mental health
professionals
• Eg. Medicine, ECT
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