Transcript of "Historical and theoretical concepts rf order 1"
Mental Health Nursing
Historical Beliefs Demonology requiring exorcism, beating, torture Middle Ages associated mental illness with witchery Asylums emerged in the 1800s – institutionalized Evolution of Nursing Linda Richards – First psychiatric nurse Est’b psychiatric hospitals and schools of nursing (asylums) Contemporary Approach Mid 1900s – shift to community care, psychiatric nursing added to nursing curricula National Mental Health Act – post WWII
American Psychiatric Association A state of being that is relative rather than absolute Shown by productive activities, fulfilling relationships, ability to adapt to change and cope with adversity Lisa Robinson (Psychiatric Nursing Expert) Dynamic state in which thought, feeling, and behavior is age appropriate and congruent with local and cultural norms
American Psychiatric Association A clinically significant behavioral or psychological pattern, associated with distress, disability, or risk of suffering Not an expected cultural response to an event Townsend Maladaptive responses to s tre s s o rs , AEB thoughts, feelings, behaviors that are not congruent with c ulture and interferes with functioning
Members of the community define norms Relatives typically determine “normalcy”and define when state has changed Class and Education Lower - high incidence; low recognition Higher - high recognition and self labeling Gender Women are more likely to recognize symptoms of MI and seek treatment
Stressor Any factor that causes emotional or physical tension; may be a responsible factor in certain illnesses Stress Response - General Adaptation Syndrome Alarm-Resistance-Exhaustion (review N101 lecture) Adaptation – responses preserve integrity and equilibrium Maladaption – responses that result in disruption
Primary Secondary The person asks The person assesses themselves is this event: their skills, resources, ▪ Irrelevant – the and knowledge to deal outcome is with the situation insignificant Determines coping ▪ Benign-positive - the strategies available outcome is Considers options pleasurable ▪ Stressful – the outcome is harmful, threatening, challenging
Predisposing Factors Genetic influences: temperament, family history of mental illness, personality Past Experiences: learned patterns of coping due to past experiences Existing Conditions: Current health status, developmental maturity, financial and educational resources, support system
The use of coping strategies in response to stress Adaptive or Maladaptive Specific Strategies Awareness - recognition Relaxation/Meditation Communication – talking it out; support systems Problem Solving – view situation objectively, analyze, act, evaluate Alternative Resources ▪ Pets/ music/ dance/ art/ exercise
Anxiety Vague apprehension associated with feelings of uncertainty Levels of anxiety ▪ Mild – tension, prepares for action/response ▪ Moderate –heightened tension; cognition impaired and individual needs assistance ▪ Severe – Difficulty functioning even simple tasks ▪ Panic – terror, desperate, out of touch with reality
Defense Mechanisms Protective devices used to alleviate anxiety ▪ Compensation – covering up a weakness by emphasizing something more desirable ▪ Denial – refusal to acknowledge ▪ Displacement – transfer of feelings from target to another ▪ Identification – increase self worth by acquiring attributes of a positive role model ▪ Intellectualization – avoid emotions by focusing on analysis ▪ Introjection – integration of others values into self ▪ Isolation – separating the event and emotion
Defense Mechanisms con’t ▪ Projection – attributing unacceptable self-feelings to another ▪ Rationalization – making excuses ▪ Reaction – avoids thoughts, feelings by expressing opposite ▪ Repression – blocking unpleasant feelings ▪ Sublimation – direct impulses into constructive activities ▪ Suppression – avoiding unpleasant thoughts, feelings ▪ Undoing – symbolically cancels out an unpleasant experience
Dia g no s tic a nd Sta tis tic a l M nua l o f M nta l a e Dis o rd e rs – Fo urth Ed itio n – Te x t Re v is io n This is a tool provides guidelines and diagnostics criteria for mental illness It is a multi-axial system Axis 1: All psychiatric disorders except personality d/o and MR Axis 2: Personality disorders and MR Axis 3: Medical conditions Axis 4: Environmental issues or psychosocial problems that may impede treatment Axis 5: Global Functioning Scale – Townsend, page 26
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