Nursing Interventions for Schizophrenia

nursing Interventions for SchizophreniaSchizophrenia is a severe mental illness in which individuals loose the ability to sort between reality and imagination, characterized by disturbances to their thoughts, behavior and feelings. About 1% of the population is predicted to suffer from dementia praecox at some point in their life (www.rethink.org), with experience of psychotic episodes such as those of schizophrenia ranging in their duration of a single crisis, to the chronic experience of schizophrenia over a life time. During episodes of schizophrenia, patients forget experience a range of what is know as positive and negative symptoms associated with the condition.Positive symptoms include delusions and hallucinations and droll or irrational behavior ( a great deal as a result of the hallucinations and delusions). Delusions can be defined as strange thoughts or beliefs which atomic enactment 18 non founded in reality, some examples include delusions of grandeur (such as a ccept cardinalself to be the next messiah) and delusions of persecution (as in being secretly watched / fol scummyed by the police or secret service). Hallucinations ar when you see (visual) hear (auditory) or smell (olfactory) things that others cannot. One of the most well known symptoms of schizophrenia is that of sense of hearing voices. People whitethorn overly experience thought disturbances such as thought jumping (going from one line of thought to another in rapid succession) poor concentration and attention abilities (www.mind.org.uk).Negative symptoms ar those which in some way take away from the individual such as anhedonia (not getting diversion out of activities which were previously pleasurable) and social withdrawal from social situations and a lack of interest in personalized hygiene (such as not washing or changing clothes). Treatment of individuals with schizophrenia can be in infirmary (forced through section or voluntarily in some cases) and in associat ion settings, and should involve a mixture of pharmacological treatment (typical and atypical antipsychotic medicinal drugs) and psychological therapies such as cognitive behavioral therapy (CBT) in order to manage current symptoms, and in preventing and minimizing future relapse and crises.breast feeding of individuals with a severe mental illness such as schizophrenia indoors a connection setting (e.g. after discharge from hospital or when patients not under section and do not want to go to hospital) go forth be conducted by a community psychiatric nurse (CPN) who allow often be working indoors a community mental health team (CMHT) from a c ar programme approach. The parting of the CPN has diversified over recent years, and is now often nominated within the CMHT to act as the individuals key worker (i.e. who the patient will have most contact with in the CMHT). CPNs can be seen to be snarled in patient c atomic number 18 interventions in a add together of capacities.The m ost predominant (and traditional) intervention role of the CPN may be seen in the medicinal drug management of battalion with schizophrenia. Typical (haloperidol) and atypical (aripiprazole, olanzapine etc) antipsychotic medication part now mean that around 70% of patients will experience some degree of relief to their psychotic symptoms (McCann, 2001). However relief is most often not absolute and the majority of patients will experience some form of side effects. In typical (older multiplication do drugss) this is often in terms of extrapyramidal symptoms (EPS) such as movement disorders like Tardive Dyskinsia, and although newer atypical drugs ar renowned for less EPS, side effects can include weight gain, sexual dysfunction and sedation. CPNs are therefore an important contact with the patient in ensuring that they are taking their medication correctly, and in identifying patients who may be experiencing high levels of side effects who as a result are at a high risk of disc ontinuing their medications.By identifying such individuals, relapse can be minimized by component the patient to engage with clinical services to investigate other medication options of which there are a good number. Switching is a term used by professionals to define this process and it is not crotchety for patients to have to switch between medications a number of times, before finding the most appropriate drug / combination. Dosage required is likewise a very individual factor, and therefore an important aspect of medication management is to check to signs that dosage is high enough to enable clinical relief, alone also low enough to minimize side effects. CPNs are thus often in a position to fill in if their patients are not on high enough dosages.The way in which medication is administered will also differ between patients some may be able to take their drugs orally, save a number of patients with schizophrenia are on a form of drug administration called depots. These ar e long-lasting injections of the antipsychotic, and are often used for patients who suffer severe episodes and those who have a history of non-compliance in taking their medication (Jackson-Koku, 2001). CPNs may also act in helping people come to terms with the fact that they are suffering from an illness, as denial is common in those mental illnesses such as schizophrenia (Fung Fry, 1999), often referred to as lacking insight into illness, and so discuss the need for taking their medications. Providing medication related teaching is therefore an important part of the medication interventions that nurses are involved with, and will often include discussions around side effects, recognizing early signs of illness and other concerns the person may have.Nurses are however becoming progressively involved in psycho-educational (Fung Fry, 1999) and psychological therapy (McCann, 2001) based interventions in their patient care within community settings for sufferers and their families . such(prenominal) approaches have in the literature, been described as aiming at increasing social functioning, decreasing distress, and reduction hospital admission rates (Tarrier Birchwood, 1995) These educational interventions are so targeted on helping to reduce distress in more drug-resistant cases, to help both sufferers and their family (Leff et al, 2001) deal with the illness and learn the signs of relapse and symptom return, and as mentioned above, in increasing medication compliance through better understanding and information.(McCann, 2001) Psychological therapies such as CBT and cognitive therapy (CT) have found recognized success in treating many mental illnesses including schizophrenia including when used within community settings (Morrison et al, 2004), as are aimed at helping people deal emotionally with their illness and its associated distress, but also to help on a practical level through promoting relapse prevention strategies and reducing social disability ( Fowler, Garety Kuipers, 1995) Coping techniques and strategies can also be discussed when CPNs become aware and gain cognition into what particular symptoms are causing people most distress. One example of this could be distraction techniques discussed with those who are having problems with auditory hallucinations one method that is known for helping many people with this is to listen to music.CPNs often also play an important counseling role to those they support (royal college of psychiatrists,1997). Acting as key workers for people with schizophrenia gives many CPNs the opportunity to get to know the person, and so are in a position to use the discussions they have with their patients in an intervention capacity. Counseling may help in anxiety and distress reduction, but also will provide invaluable insight for the CPN into what the person is going through, how much they understand and whether they are doing well or becoming ill. All this information will play a crucial role in the assessment capacity that the CPN also performs within the care programme.CPNs are thus seen to be involved in many aspects of peoples outpatient care in community settings. Especially involved in medication, information and more recently psychosocial and psychological interventions, nurses looking after people with schizophrenia within the community are profound to the patients care programme, and act as an invaluable access into mental health services (McCann Clark, 2003) for community patients.