Exam #1 Flashcards
MH history
- MH and MI are defined by the times and the culture
MH Historial Concepts
- benhamin rush: father of american psychiatry, encourages kindness, exercise, socialization, purging, physical restrains, extreme temperatures
- dorteha dix: believed that mental illness was curable; give humn and therapeutic care; her system grew but the population grew faster
- linda richards: first american psych nurse
- current psychiatric nursing edu: basic nursing school requirement, emphasis on nurse-client realtionship and therapeutic communication; includes somatic thearpies (shock) and psychopharmacology
hildegard peplau
- mid level theorist
- interpersonal relationships nursing theory
continuum of mental health and mental illness
- MH and MI are not an either/or proposition
- most people are not at either end of the spectrum but between
- what constitutes MH and MI also changes with time and cultures
mental health
- 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
- able to recognize own potential; cope with normal stress; work productively; make contribution to community
mental illness
- maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, behaviors that are incongruent with the local and cultural norms and interfere with the individual’s social, occupational, or physical functioning
World Health Organization WHO
- health = mental, physical, and social well-being, no merelt the absence of disease or infirmity
- mental health = state of well-being in which each individual is able to realize his or her own potential, cope with normal stresse of life, work productively and fruitfully, and make a contributon to the community
US dept of health and human services
- mental health = rational thinking, communication skills, emotional growth, learning, resilience and self esteem
psychiatry’s definition
- evolves over time and subject to culture
- clinically significant behavior or psychological syndrome
- can involve behavior, mood, or thinking disorders or any combination of these
traits of mental health
- think rationally
- communicate appropriately
- leaern
- grow emotionally
- be resilient
- have health self esteem
- effective at work
- happiness
- control of behavior
- in haromy with self and environment
- doesnt impair reasoning, social, etc.
mental illness
- disorders with definable diagnosis
- significant dysfunction in mental functioning related to: development, biological, physiological disturbances
- culturally deinted
resilience
- ability and capacity to secure resources needed to support well-being
- characterized by: optimism, sense of mastery, competence
- essential to recovery
- resilient children have an adult to turn to
- pulling together after a disaster
- adapting to tragedy, trauma, severe stress
- recognize feelings, deal with them and then use them to grow
- resilience factor test
diathesis-stress model
- most commonly accepted model today
- diathesis: biological predispostion - genetics
- stress: environmental stress or trauma
- combo of genetic vulnerability and negative enviro stressors
social influences on mental health care
- consumer/recovery movement: 1980s
- national alliance on mental illness NAMI 1979: advocate for mentally ill
- decade of the brain: 1990s-2000s, human genome project
- surgeon general: 1) without mental health you are not healthy 2) yes, there is effective treatment for MI
- human genome project: strengthened bio and genetic explanations for MI
epidemiology
- definition: quantitative study of the distribution of mental disorders in human
- incidence: number of new cases in a healthy population within a given period of time
- prevalance: number of cases, new and existing, in a given population during a specific period of time, regardless of when they were first diagnosed
- co-morbid condition: more than one psychiatric condition at a time
- 1/5 have diagnosible mental illness
primary, secondary and tertiary care
**Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur. Examples include:
legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to mandate safe and healthy practices (e.g. use of seatbelts and bike helmets)
education about healthy and safe habits (e.g. eating well, exercising regularly, not smoking)
immunization against infectious diseases.
**Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. This is done by detecting and treating disease or injury as soon as possible to halt or slow its progress, encouraging personal strategies to prevent reinjury or recurrence, and implementing programs to return people to their original health and function to prevent long-term problems. Examples include:
regular exams and screening tests to detect disease in its earliest stages (e.g. mammograms to detect breast cancer)
daily, low-dose aspirins and/or diet and exercise programs to prevent further heart attacks or strokes
suitably modified work so injured or ill workers can return safely to their jobs.
**Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects. This is done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic diseases, permanent impairments) in order to improve as much as possible their ability to function, their quality of life and their life expectancy. Examples include:
cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes, arthritis, depression, etc.)
support groups that allow members to share strategies for living well
vocational rehabilitation programs to retrain workers for new jobs when they have recovered as much as possible.
epidemiology of mental disorders
- study distribution of mental disorders: identify highrisk groups and people
- lead to etiology of mental disorder
- use information to: improve clinical practice, plan public health policies
clinical epidemiology
- groups treated for specific mental disorders studies for: natural histry of illness, diagnostic screening tests, interventions
- once they are in for medical treatment
- results used to describe frequency of: mental disorders, symptoms appearing together
DSM-5
- diagnostic and statistical manual of mental disorders, 5th edition
- official medical guidelines of the american psychiatric association for diagnosing psychiatric disorders
- diagnostic criteria with s/s
ICD-9-CM
- international classification of diseases
- clinical descriptions of mental and behavior disorders: 2 broad classifications, subclassifications
psychiatric mental health nurses
- employ purposeful use of self
- use nursing, psychosocial, neurobiological theories and research
- work with people throught the life span
- employed in a variety of settings
NANDA 1
- north american nursing diagnosis assocaition internation
- describes nursing diagnosis as a clinical judgement about individual, family, or community responsess to actual or potential health problems and life processes
future challenges and roles for MH nursing
- aging population: dementia
- increasing cultrual diversity
- expanding technology
- patient advocacy: familities, communities, pts
- legislative involvement: decreasing length of stay for inpatient stay to 72 hours
concepts of the nurse-patient relationship
- basis of all psychiatric nursing treatment approaches
- to establish that the nurse is: safe, confidential, reliable, consistent
- relationshio with clear boundaries
- caregiver and care receiver
- contribute to illness, prevention, healing, growth
- each views the other as a unique human being
therapeutic use of self
- use personality consciously and in full awareness
- attempt to establish relatedness
- structure nursing interventions
- self-awareness
- self-understanding
- philosophical beliefs in life, birth, death, illness
therapeutic relationship goals and functions
- facilitate communication of distressing thoughts and feelings
- assist patient with problem solving
- help patient examine self-defeating behaviors and test alternatives
- promote self care and independence
