Psych interview Flashcards
(34 cards)
Healthy People 2020 Goal
: Improve mental health through prevention and by ensuring access to appropriate, quality mental health services
Mental Health Defn
:State of successful perf or mental fn, resulting in productive activities, fulfilling reln w/ others, and ability to adapt to change and cope w/ challenges. Essential to personal well-being, fam, and interpersonal reln, and ability to contribute to community or society
Mental Disorders Defn
: Health conditions that are characterized by alterations in thinking, mood, and/or behavior that are associated with distress and/or IMPAIRED FN Contribute to a host of probs that may include disability, pain, or death
Why is Mental Health Imp?
- Mental disorders are among the most common causes of disability, leading cause in U.S and Canada (25% of all yrs of life lost due to disability and premature mortality)
- NIMH, given yr 13 mill american adults have seriously debilitating illness
- Leading cause of diability
- Suicide is 11th leading cause of death in U.S, 30000 deaths/yr
Mental Illness Defn
:Term that refers collectively to all diagnosable mental disorders
Reln btn Mental and Physical Health
- mental health plays major role in people’s ability to maintain good physical health
- illnesses such as depression and anciety, affect people’s ability to participate in health-promoting behaviors
- chronic dx can have serious impact on mental health and decr a person’s ability to participate in tx and recovery
Healthy People Objectives: Suicide (2)
- Reduce suicide rate
- Reduce suicide attempts by adolescents
Healthy People Objectives: Wt (1)
-Reduce proportion of adolescents who engage in disordered eating behaviors in attempt to control wt
Healthy People Objectives: Depression (2)
- Reduce proportion of teens 12-17 who experience major depressive episode
- Reduce proportion of adults >18 who experience major depressive episodes
Healthy People Objectives: Treatment (3)
- Incr proportion of primary care facility provide mental health tx onsite or by paid referral
- -Incr proportion of adults >18 with major depressive episodes who receive tx
- Incr proportion of persons w/ co-occuring substance abuse and mental disorders who receive tx for both disorders
Healthy People Objectives: Screening (1)
-Incr proportion of primary care doc who screen youth 12-18 for depression during office visit
Healthy People Objectives: Homeless (1)
-Incr proportion of homeless adults w/ mental health probs who receive mental health services
DSM-5 Changes
- Elimination, addition , and renaming of sections
- Dx name change
- Change in conceptual approach to a set of dx, defn, criteria for dx, and specifiers of disorder
- No more axes 1-5
Assessment and Interview Process
Purpose: id major probs and key nursing dx
- nurses assist clients to meet their own needs and solve their own problems
- people should be involved in own decision-making
- nurses need to be aware of own biases and issues
Sources of info
Primary: client
Secondary: Records, family, friends
Data Collection v. Assessment
Data Collection: objective data that nurses observe and subjective data that clients report
Assessment: health care providers interpretation and PRIORITIZATION of collected data
MSE elements (8)
- PERSONAL INFO: age, sex, race, marital status, religion, employment, living arrangements
- APPEARANCE: grooming and dress, hygiene, facial expression, pupil dilation or constriction, ht, wt, nutritional status, presence of piercing, tattoos, or scars (in relation to economic and cultural status), appears age
- BEHAVIOR: excessive or reduced body movements, unusual body movement such as repetitive movements, scanning the environment, level of eye contact (cultural differences)
- SPEECH: rate (slow, rapid, normal), volume (loud, soft, normal), disturbances (slurring, mumbling), disorganization
- AFFECTt (what I observe) AND MOOD (subjective): affect (flat, blunted, animated, angry, withdrawn, appropriate to context), mood (sad, labile euphoric)
- THOUGHT: process (disorganized, coherent, flight of ideas, neologisms, thought blocking, content (delusions, obsessions, suicidal ideation)
- PERCEPTUAL DISTURBANCE: hallucinations (auditory=most common, visual, tactile=feeling bugs, olfactory=rotting meat), delusions are based in reality
- COGNITION: orientation, level of consciousness, memory, fund of knowledge, attention, abstraction, insight, judgement
Nursing Process
Assessment: gathering data. Act of gathering, classifying, categorizing, analyzing, documenting info about a client’s health status
Dx: identifying a problem. Analysis of data collected during assessment, leads to dx or id of clinical prob to address
Planning/Outcomes: creating a plan that will achieve outcomes. Id outcomes: realistic, measurable, within time-frame, flow from nursing dx, stated in behavioral statement. Selecting interventions: dependent on nurses’ level of practice, targeted toward helping client achieve outcome, standardized care plans, clinical or critical pathways
Implementation/Intervention: enacting the plan. Occurs when nurses perform planned nursing actions, continuity in carrying out specific interventions is critical to achieving desired outcomes
Evaluation: determining the effectiveness of the plan. Determining the value of each intervention or the attainment of desired outcomes, centers on the changes experienced by clients and the quality or the effectiveness of the nursing care itself
Clinical Interview
- understand clients probs in their lives and help them to learn new skills or alternative ways of ealing with the problems
- need good communication skills and good active listening skills
- right answer is client centered
Beginning the interview (3)
setting: relative privacy, allowing the client to feel secure
-converse in normal tones, maintain eye contact, avoid barriers
Confidentiality: between us and my team
Use an open-ended statement: how is everything going today?
Avoid in the interview (9)
-arguing (present an observation instead) minimizing the client prob. praising (wow that is a big step/change instead), giving false reassurance, interpreting or speculating on dynamics (ex. mom issues, they should come to own concl), probing (info not relevant), joining if a client verbally attacks someone in their lives, criticism of staff member (ct can feel unsafe), selling the client on treatment
Helpful for interview (7)
-speak briefly, say nothing when you don’t know what to say, when in doubt focus on feelings, avoid giving advice, avoid relying on questions, note non-verbal cues, keep focus on client
Response to specific behaviors
- crying
- secrets: no I can never keep secrets
- suicide threats: sounds very serious, I want to do what I can to help
- leaving the interview: we’re here whenever you need, ill be back to check on you
Factors that affect comm (8)
-personal factors, cultural differences, knowledge levels, language use (high v low intensity), environmental factors, verbal communication, nonverbal communication, interaction of verbal and nonverbal communication
