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PSYCHIATRIC NURSING Concept of Mental Health and illness

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PSYCHIATRIC NURSING Concept of Mental Health and illness Dr. Naiema Gaber Elsayed Depersonalization feeling of strangeness from one s self Common. – PowerPoint PPT presentation

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Title: PSYCHIATRIC NURSING Concept of Mental Health and illness


1
PSYCHIATRIC NURSINGConcept of Mental Health and
illness
  • Dr. Naiema Gaber Elsayed

2
Lecture objectives
  • Define Mental Health
  • Define Mental Illness and Identify the
    Population at Risk
  • Define Psychiatric Nursing
  • Determine the Nurses Role in Psychiatric Nursing
  • Identify the Common terminology used in
    psychiatric and mental therapy

3
What is Mental Health?
  • World Health Organization
  • "Mental health is a state of well-being where a
    person can realize his or her abilites to cope
    with normal stresses of life and work
    productively.

4
Mental Health/Illness Continuum
  • Stress
  • Mental Health Mental Illness
  • ADAPTIVE MALADAPTIVE
  • Healthy Neurosis Psychosis
  • Reality Oriented Denies Reality
  • Positive self-concept
  • Emotional stable

5
FUNDAMENTAL CONCEPTS
  • MENTAL HEALTH
  • Is a state of emotional, psychological, and
    social wellness evidenced by
  • Satisfying interpersonal relationships
  • Effective behavior and coping
  • Positive self-concept
  • Emotional stability
  • Self-awareness

6
Who has mental health?
  • We all fall short to some extent.
  • Therefore, advocates of mental health believe
    that a broad range of mental health services
    should be available to general population, not
    just seriously mentally ill.
  • They believe that prevention and education, as
    well as treatment, are important.

7
Mental Illness
  • A mental disorder or condition manifested by
    disorganization and impairment of functions that
    arises from various causes such as psychological,
    neurobiological and genetic factors.

8
What is mental illness?
  • Is it a disease, like diabetes or smallpox?
  • Is it a form of deviant behaviorlike being
    disobedient, choosing to dress differently.
  • It is manifested by disorganization and
    impairment of functions that arises from various
    causes such as psychological, neurobiological and
    genetic factors

9
What causes mental illness?
  • Psychological such as early development,
    cognitive styles, personal identity)
  • Biological as Genetics, Neurochemisty, Viral
    causation
  • Sociological environmental/social causation
    as Poor living conditions and dangerous
    neighborhoods

10
  • Factors Affecting Mental Health
  • Mastering the Environment
  • Reality orientation
  • Stress Management
  • Maximizing Ones Potential
  • Autonomy and Independence
  • Tolerating Ones Uncertainties
  • Self-esteem
  • MRS MATS

11
The Classification of Mental
IllnessThe Neuroses usually the patient
retains insight and orientation they experience
deep distress and may commit suicide as
depressionThe Psychoses(the patient is
disorientated, deluded, and lacking in insight)
e.g. Schizophrenia, puerperal psychosis The
DementiasProgressive deterioration with loss of
recent memory and deterioration of a normal
personality,They may be primary or more commonly
secondary to another condition e.g. alcohol,
stroke
12
Etiology mental illness
Drug Abuse Alcohol,Heroin etc
Inheritance-Genetics/Intra-uterine environment
Schizophrenia,Huntingtons
Upbringing Mothering,education,parenting
Neurological diseases MS,Brain tumour
Trauma/head injury
Biochemistry/metabolic Porphyria,Diabetes
Infections-HIV,Syphilis,CJD
Vascular-CVA
Nutrition/PCM
13
Classification of Mental Illnesses
  • The Diagnostic and Statistical Manual of Mental
    Disorders, 4th Edition, Text Revision
    (DSM-IV-TR).
  • Diagnostic criteria are listed for each of the
    psychiatric disorders.
  • A multiaxial system- people are evaluated from
    multiple aspects or points of function.

14
DSM-IV-TR Multiaxial Evaluation System
  • Axis I - Clinical disorders and other conditions
    that may be a focus of clinical attention
  • Axis II - Personality disorders and mental
    retardation
  • Axis III - General medical conditions
  • Axis IV - Psychosocial and environmental problems
  • Axis V - The measurement of an individuals
    psychological, social, and occupational
    functioning on the GAF Scale

15
Population at Risk for Mental Illness
  1. Familiar or genetic predisposition to mental
    illness
  2. Poor access to health care
  3. Misusing substance
  4. Undergoing lifestyle changes
  5. Victims of violence
  6. Elderly poor

16
  • Community Mental Health Services

17
Treatment and Care
Hospital Care
Community Care
18
Preventive NetworksChurch, Family, Home,
Friends, Work
19
Psychiatric Nursing
  • Psychiatric nursing or mental health nursing is
    the specialty of nursing that cares for people of
    all ages with mental illness or mental distress.
  • An interpersonal process that promotes and
    maintains behavior that contributes to integrated
    functioning

20
What do psychiatric nurses do?
  • Ensure safety and security
  • Care for biophysical needs
  • ADLs
  • Nutrition, exercise
  • Medication management
  • Assist in creating a healthy social world
  • increase self-awareness by
  • Discussion,
  • Experience
  • Role play

21
Nursing Approach/Model
  • Components
  • Nurse-Client Interactive Relationship
    mutuality, collaboration, and problem-solving
    tools communication and nurse-client
    relationship
  • Environmental Management provide therapeutic
    environment by serving as advocates and role
    models, by offering social support and by
    engaging clients in collaborative problem-solving
    of here-and-now problems of daily living
  • Nursing Process

22
Common terminology used in psychiatric and mental
therapy
23
Dynamics of Human Behavior
  • Behavior the way an individual reacts to a
    certain stimulus
  • Conflict situation arising from the presence of
    two opposing drives
  • Need - organismic condition that requires a
    certain activity
  • Stress life events in which a demanding
    situation taxes a persons resources as coping
    mechanisms
  • Adaptation process of interacting with the
    environment to maintain homeostatic equilibrium
  • Maladaptation ineffective coping

24
Dynamics of Human Behavior cont.
  • Personality integration of systems and habits
    representing an individuals characteristic and
    adjustment to his environment expressed through
    behavior

25
Personality
  • Each human being is unique
  • We all have different personalities
  • My personality reflects genetic inheritance and
    Environment

26
3 divisions of the mind
  • Conscious focused on awareness
  • Subconscious recalled at will
  • Unconscious never recalled / largest part
  • Learning change in behavior through insight ,
    relearning and remotivation

27
Behavior
The Parent
SUPER-EGO
EGO
The Adult
ID
The Child
28
The Subconscious Mind
The Conscious
The Subconscious
29
Common Behavioral Signs and Symptoms
  • Disturbances in perception
  • Illusion Misinterpretation of an actual
    external stimuli
  • Hallucinations False sensory perception in the
    absence of external stimuli

30
  • Disturbances in thinking and speech
  • Word salad incoherent mixture of words and
    phrases with no logical sequence.
  • Verbigeration meaningless repetition of words
    and phrases.
  • Perseveration persistence of a response to a
    previous question.
  • Echolalia pathological repetition of words of
    others
  • Aphasia speech difficulty and disturbance
  • Expressive , receptive or global

31
  • Flight of ideas- shifting of one topic from one
    subject to another in a somewhat related way.
  • Looseness of association-incoherent ,illogical
    flow of thoughts (unrelated way)
  • Clang association sound of word gives direction
    to the flow of thought.
  • Delusion persistent false belief,rigidly held
  • Delusions of grandeur- special /important in a
    way
  • Persecutory-threatened

32
  • Magical thinking primitive thought process
    thoughts alone can change events.
  • Autistic thinking regressive thought
    process-subjective interpretations not validated
    with objective reality

33
  • Disturbances of affect (imotion)
  • Inappropriate disharmony between the stimuli
    and the emotional reaction.
  • Blunted affect severe reduction in emotional
    reaction.
  • Flat affect absence or near absence of
    emotional reaction.
  • Apathy dulled emotional tone.

34
  • Depersonalization feeling of strangeness
  • from ones self Common.
  • Derealization feeling of strangeness towards
    environment.
  • Agnosia lack of sensory stimuli integration
  • examples of affect are sadness, fear, joy, and
    anger.

35
  • Disturbances in motor activity
  • Echopraxia imitation of posture of others
  • Waxy flexibility maintaining position for a
    long period of time
  • Ataxia loss of balance
  • Akathesia extreme restlessness
  • Dystonia- uncoordinated spastic movements of the
    body
  • Tardive dyskenisia involuntary twitching or
    muscle movements
  • Apraxia involuntary un-purposeful movements

36
  • Disturbances in memory
  • Confabulation filling of memory gaps
  • Amnesia memory loss (inability to recall past
    events)
  • Retrograde-distant past
  • Anterograde immediate past
  • Anomia lack of memory of items

37
summary
  • MENTAL HEALTH is balance in a persons internal
    life and adaptation to reality
  • MENTAL ILLNESS is a state of imbalance
    characterized by a disturbance in a persons
    thoughts, feelings and behavior
  • Familiar, genetic predisposition, Poverty
  • and abuses are major risk factors

38
  • Psychiatric nursing interpersonal process
    whereby the professional nurse practitioner
    assist clients to achieve psychosocial well being
    through the therapeutic use of self(art) and
    nursing theories (science).
  • Core of psych nursing interpersonal process
    human to human relationship(both for
  • mentally healthy and ill

39
  • Community Mental Health Services

1- curative services as hospital and community
care. 2- preventive services as Church, Family,
Home, Friends, Work.
40
Feedback questions
41
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