Hope and mental health nursing


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First Presentation with group and Mr Derek, our tutor.

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Hope and mental health nursing

  1. 1. Hope and Mental Health Nursing by: Derek Hayes, Ang Geok Ping, Mohd Helmi Fadrin Abu Bakar, Mohd Jofri Aldrin Hj Suhaini & Karmayunika Khamsiah Hj Mohd Kassim
  2. 2. Introduction <ul><li>Hope is a central part of our life. </li></ul><ul><li>It is a protective factor in human existence </li></ul><ul><li>It is that which enables those, with many medical and life problems to acquire a better quality of life whether or not recovery is complete . </li></ul>
  3. 3. <ul><li>“ The other side of hope is hopelessness ” </li></ul><ul><li>It is said that ‘long-lasting’ hopelessness threatens human well-being and health (Kylma et al 2001) that can cause emotional and physiological disturbance (Abramson et al 1989). </li></ul>
  4. 4. <ul><li>“ Where there’s hope, there is life ” (Jenkins 1996) </li></ul><ul><li>Hope is not static but dynamic. </li></ul><ul><li>This give a strong signal to mental health nurses to try to measure hope, and assess the factors influencing hope or hopelessness in clients. </li></ul>
  5. 5. <ul><li>Hope plays an important role in health (Morgante 2000). </li></ul><ul><li>Hope may not only build a patient’s self-esteem and sense of well-being, it may have an additive effect on medical treatment. </li></ul><ul><li>Inspiring hope could be an effective complementary treatment. </li></ul>
  6. 6. <ul><li>If hope is life saving and full of healing power then… </li></ul><ul><li>“ It must be important in nursing ” </li></ul><ul><li>One of the ‘primary acts’ of a mental health nurse is to “ inspire hope ” (Cutliffe & Grant 2001) </li></ul>
  7. 7. Definition <ul><li>‘ Hope is a perception that something desired may happen’ (Snyder 1994:535) </li></ul><ul><li>However Levinson et al (1999) believe, there is no absolute standard by which hope is defined </li></ul>
  8. 8. <ul><li>Hope is best characterized as a belief that the person’s wished for aim can be met – naturally striving towards achieving those aims. </li></ul><ul><li>Any setbacks are seen as temporary obstacles that can be over come. </li></ul><ul><li>(Snyder 1994) </li></ul>
  9. 9. Definition of… <ul><li>Nursing </li></ul><ul><li>“ Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well... Nursing includes the promotion of health & safe environment, prevention of illness, and care of the ill, disable and dying people. Advocacy, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing role”. </li></ul><ul><li>(ICN, 2002) </li></ul>
  10. 10. Definition of… <ul><li>Mental health nursing </li></ul><ul><li>“ Psychiatric-mental health nursing is the diagnosis and treatment of human responses to actual or potential mental health problems. Psychiatric-mental health nursing is a specialised area of nursing practice, employing the wide range of explanatory theories of, and research on human behaviour as its science, and purposeful use of self as an art”. </li></ul><ul><li>(ANA 2000:10) </li></ul>
  11. 11. Spiritual and religious dimensions of hope <ul><li>Hope is innate in all religion </li></ul><ul><li>Hope is based on the need to worship one infinite, almighty, good, forgiving unseen power. </li></ul><ul><li>It is that which is related to God, hence… </li></ul><ul><li>“ Hope is therefore related to faith ” </li></ul><ul><li>(Carpenito 1995) </li></ul>
  12. 12. <ul><li>Faith </li></ul><ul><li>“ A confident assurance that what we hope for is going to happen…things we cannot yet see ” </li></ul><ul><li>The evidence of ‘things we cannot yet see’ may not be acceptable to some in relation to evidence based health care, which needs scientific meta-analysis-of well organized random controlled trials. </li></ul>
  13. 13. <ul><li>Hope is present in many people…who believe in higher power or powers. With faith it brings meaning and purpose to a person’s life. </li></ul><ul><li>(Carpenito 1995) </li></ul><ul><li>Faith then helps us out of everyday problems…in the hope of achieving something better in the future. </li></ul>
  14. 14. “ A strong sense of hope can therefore be of central importance in helping patients to heal and gain mastery of their life once more ”
  15. 15. Hope in Islam <ul><li>Islam teaches and encourages the need to work and pray towards something wished for. </li></ul><ul><li>Followers need to pray and have faith that prayers will be answered </li></ul><ul><li>Hope in Islam is more influenced and determined by how strong one’s faith is in God’s doing and will. </li></ul><ul><li>Hope is more driven by the religion than anything else. </li></ul>
  16. 16. What about those not professing faith? <ul><li>For those not professing faith, their spiritual needs may be still be based on hope. </li></ul><ul><li>The answer may be found in Maslow’s ‘pyramid of needs’. </li></ul><ul><li>It may not mention anything about hope but it may indirectly imply hope in order to achieve the experience of self-actualization . </li></ul>
  17. 17. Hope and mental health nursing <ul><li>All this brings many questions for the mental health nurse. </li></ul><ul><ul><li>How important is hope in maintaining mental health? </li></ul></ul><ul><ul><li>In what ways does mental illness affect a person’s hope? </li></ul></ul><ul><ul><li>In what ways does a client’s level of hope change during mental illness? </li></ul></ul><ul><ul><li>What is the role of the family in hope? </li></ul></ul><ul><ul><li>How can the nurse measure a patient’s level of hope? </li></ul></ul>
  18. 18. Measuring and inspiring hope <ul><li>“ Nurses play a pivotal role in promoting hope in patients… </li></ul><ul><li>Because hope is interwoven with caring” </li></ul><ul><li>(Cutcliffe 1996 cited in collins Citcliffe 2003) </li></ul><ul><li>A nurse needs to demonstrate unconditional acceptance, tolerance and understanding consequently this enters into caring practice and simultaneously inspires hope. (Cutcliffe & Herth 2002a) </li></ul>
  19. 19. <ul><li>Therapeutic interpersonal relationship is the key to patient’s healing process. </li></ul><ul><li>Healing the patient through hope is an important part of nurse-client relationship. </li></ul><ul><li>Like all relationships trust and a sense of value is needed which shows unconditional acceptance and tolerance (Cutcliffe 1995 cited in Cutcliffe & Herth 2002a). </li></ul>
  20. 20. <ul><li>To inspire hope in others, nurses must feel hopeful themselves. </li></ul><ul><li>It can be difficult to feel hopeful, but nurses need to recognize personal sadness and loss and use the support of other health team members (Morgante, 2002) to achieve realistic hope. </li></ul><ul><li>Hope is what helps patient cope in a difficult crisis (DeWit, 1994). </li></ul>
  21. 21. “ Nurses who are motivated can inspire much hope in their patient” “ There can always be hope, even if its direction changes” (DeWit, 1994)
  22. 22. Ways to inspire hope <ul><li>Education of patient and family </li></ul><ul><li>Group therapy </li></ul><ul><li>Humour </li></ul><ul><li>Spiritual </li></ul>
  23. 23. Assessing hope <ul><li>Herth Hope Scale </li></ul><ul><li>Herth Hope Index (HHI) </li></ul><ul><li>Rating </li></ul><ul><li>4-point scale response </li></ul><ul><li>Range: 1 (strongly disagree) to 4 (strongly agree) </li></ul><ul><li>Total: from 12 to 48. </li></ul><ul><ul><li>Higher Score indicate higher level of hope. </li></ul></ul><ul><ul><li>Low scores correlate with depression and low self esteem . </li></ul></ul>
  24. 24. <ul><li>The nurse can ask the patient statements such as: </li></ul><ul><li>‘ I feel I have a positive outlook towards life’ </li></ul><ul><li>‘ I feel all alone’ </li></ul><ul><li>‘ I can see possibilities beyond the present problems’ </li></ul><ul><li>‘ I have faith which gives me comfort’ </li></ul><ul><li>‘ I have a sense of direction’ </li></ul><ul><li>‘ I feel my life has value and worth’ </li></ul>
  25. 25. Suicide <ul><li>Hopelessness is highly correlated with suicide (Aldridge, 1998; Clarke, Beck & Alford, 1999). </li></ul><ul><li>High risk of suicide: Depression & Schizophrenia. </li></ul><ul><li>Schizophrenia: 20 to 50 times higher than the general population to commit suicide. </li></ul><ul><li>Risk of suicide with schizophrenic is associated with feeling of disappointment, frustration, or despair about quality of life (hopelessness). </li></ul>
  26. 26. <ul><li>Nurses need to assess patient who are at risk of suicide. </li></ul><ul><li>Full assessment on the level of hope, thus promote hope in their client. </li></ul>
  27. 27. Effect of Stigma <ul><li>“ Stigma can be more ‘taxing’ than mental illness itself” </li></ul><ul><li>“ Bodily sign designed to expose something unusual or bad about the moral status of the signifier” (Goffman 1968 cited by Bryne 1999). </li></ul><ul><li>Bryne (1999) stated that a person who attends psychiatric services would be mark as ‘different’ . </li></ul>
  28. 28. <ul><li>“ People with mental illness are a danger to others – a feigned or imaginary illness which reflects weakness of character …” </li></ul><ul><li>Psychiatric patients have limited opportunities and are deprived of their dignity and their role in the society. </li></ul><ul><li>Such stigma prevents them from looking for treatment. </li></ul><ul><li>Resulting in failure to seek early treatment and missing out on the support they need. </li></ul>
  29. 29. Reflection <ul><li>This paper has a limited review of literature on hope and mental health nursing. </li></ul><ul><li>It seems evident from the literature that hope is an important factor in the recovery of mental health clients. </li></ul><ul><li>Hope level in client may change over time due to a variety of factors. </li></ul><ul><li>Identified behaviours that inspire hope thus form an important part of the therapeutic relationship. </li></ul>
  30. 30. <ul><li>Level of hope becomes a vital sign of mental health nursing. </li></ul><ul><li>Thus a low level of hope may indicate hopelessness that could lead to suicide. </li></ul><ul><li>Level of hope should be assessed by using the Herth Hope Scale. </li></ul><ul><li>Stigma is devastating on hope, therefore it is up to us to reduce the effects of stigma. </li></ul>
  31. 31. Thank you for your attention Question & Answer session