mental health

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Slide 1: 

RAJESH KUMAR INTRODUCTION TO PSYCHIATRIC NURSING

Slide 2: 

Mental Health ??????? MENTAL ILLNESS

Seven Signs of Mental Health : 

Seven Signs of Mental Health Happiness Control over behavior Appraisal of reality Effectiveness in work Healthy self-concept Satisfying relationships (give and receive love) Effective coping strategies

Traits of Mental Health : 

Traits of Mental Health Ability to Deal with conflicting emotions Live without undue fear, guilt, or anxiety Take responsibility for one's own actions Think clearly Negotiate each developmental task

Slide 5: 

Prevalence of Psychiatric Disorders USA The Department of Health and Human Services and the National Institute of Mental Health (2004) provide the following statistics: 57.7 million Americans have a mental illness. That is 26.2 per cent of Americans 18 or older. Four of the ten leading causes of disability include: major depression, bipolar disorder, schizophrenia and obsessive compulsive disorder. The economic burden of mental illness in the USA, exceeds $ 170 billion.

Slide 6: 

National Institute of Mental Health 2002 USA Statistics Affective Disorders- 9.5 pre-cent. 18.8 million Suicide- 29,350 people committed suicide Schizophrenia- 1.1 percent, 2.2 million Anxiety disorders- 13.3 percent, 19.1 million Eating disorders- 2- 5 percent of population ADHD- 4.1 percent of youth ages 9 to 17 Substance abuse- 11.3 percent of the population

Slide 7: 

Theories of Mental Illness PSYCHOBIOLOGICAL PSYCHOLOGICAL

PSYCHOBIOLOGICAL : 

PSYCHOBIOLOGICAL Genetic Other Biological Influences The Role of the Environment

PSYCHOBIOLOGICAL Overview of the Brain : 

PSYCHOBIOLOGICAL Overview of the Brain Forebrain Cerebrum Frontal lobe- Voluntary movement, language, executive function Parietal lobe- Sensory impulses, tactile sensations Temporal lobe- Memory, emotions, taste, smell, auditory Occipital lobe- Vision, visual perception Diencephalons Thalamus- Pathway of motor & sensory impulses Hypothalamus- Regulates hormonal functioning Limbic system- Modulates emotions

PSYCHOBIOLOGICAL Overview of the Brain (cont.) : 

PSYCHOBIOLOGICAL Overview of the Brain (cont.) MIDBRAIN Mesencephalon- Processes visual & auditory information HINDBRAIN Pons- Visceral & somatic motor control Medulla- Autonomic functioning of major organs Cerebellum- Modulates movement

PSYCHOBIOLOGICAL NEURON : 

PSYCHOBIOLOGICAL NEURON CONDUCTION OF ELECTRICAL IMPULSES NEUROTRANSMITTERS RECEPTORS

PSYCHOBIOLOGICAL NEUROTRANSMITTER : 

PSYCHOBIOLOGICAL NEUROTRANSMITTER CHEMICAL MESSANGERS RELEASED AT PRESYNAPTIC NEURON DIFFUSES ACROSS SYNAPSE TO POST SYNAPSE ATTACHES TO SPECIALIZED RECEPTORS INHIBITS OR STIMULATES RELEASED AND THEN DESTROYED OR TAKEN BACK FOR RECYCLING

PSYCHOBIOLOGICALNeurotransmitter/ Receptor/ Disorder : 

Dopamine DA Schizophrenia, Mania Parkinson’s, Depression Norepinephrine NE Mania Depression Serotonin 5-HT Anxiety Depression Gamma-amino- GABA Reduction of buturic acid anxiety Anxiety Acetyl-Choline Ach Depression Alzheimer’s PSYCHOBIOLOGICALNeurotransmitter/ Receptor/ Disorder

PSYCHOLOGICAL : 

PSYCHOLOGICAL Freud's Psychoanalytic Theory Conscious, preconscious, unconscious Id, ego, superego Defense mechanisms and Anxiety Theories of personality

PSYCHOLOGICALPSYCHOANALYTICAL “EGO FUNCTIONS” : 

PSYCHOLOGICALPSYCHOANALYTICAL “EGO FUNCTIONS” REALITY TESTING SENSE OF REALITY JUDGEMENT IMPULSE CONTROL THOUGHT PROCESS ARISE DEFENSIVE FUNCTIONING OBJECT RELATIONS AUTONOMOUS FUNCTIONING STIMULOUS BARRIER MASTERY COMPETENCE SYNTHETIC INTEGRATIVE FUNCTIONING EGO SELF ESTEEM

PSYCHOLOGICAL : 

PSYCHOLOGICAL Freud “Psychosexual Stages of Development” Oral (0-18mos Anal (18mos-3yrs) Phallic (3-6yrs.) Latency (6-12yrs) Genital (13-20yrs)

PSYCHOLOGICAL : 

PSYCHOLOGICAL ERIKSON “Psychosocial Stages of Development” Trust vs Mistrust Autonomy vs Shame and Doubt Initiative vs Guilt

PSYCHOLOGICAL : 

PSYCHOLOGICAL ERIKSON (cont) Industry vs Inferiority Identity vs Role Confusion Intimacy vs Isolation

PSYCHOLOGICAL : 

PSYCHOLOGICAL ERIKSON (cont) Generativity vs Stagnation Ego Integrity vs Despair

Maslow’s Hierarchy of Needs : 

Maslow’s Hierarchy of Needs 6. Self-Transcendent Needs 5. Self- Actualization Needs 4. Esteem Needs 3. Love and Belonging Needs 2. Safety Needs 1. Physiological Needs Emphasis on human potential and client’s strengths Establishes what is most important in sequences of nursing actions “ Sets Priorities” Varcarolis p. 20-21

Psychiatric Mental Health Nursing and the Nursing Process : 

Psychiatric Mental Health Nursing and the Nursing Process 1. Assessment 2. Nursing Diagnosis 6. Evaluation 3. Outcome Identification 4. Planning 5. Implementation

Factors Affecting Mental Health and Nursing Assessment : 

Factors Affecting Mental Health and Nursing Assessment Support systems Family influences Developmental events Cultural beliefs and values Health practices Negative influences

PSYCHIATRIC ASSESSMENT : 

PSYCHIATRIC ASSESSMENT Construct database Mental status examination (MSE) Psychosocial assessment Physical examination History taking Interviews Standardized rating scales Verifying the data

DIAGNOSIS OF PSYCHIATRIC ILLNESS : 

DIAGNOSIS OF PSYCHIATRIC ILLNESS Medical- DSM-IV-TV (Diagnostic and Statistical Classification of Mental Disorders) Nursing- NANDA (North American Nursing Diagnosis Association)

DSM-IV-TR : 

DSM-IV-TR Mental disorders are considered a manifestation of a Behavioral Psychological Biological dysfunction of the individual

DSM- IV- TR MULTI-AXIAL CLASSIFICATION : 

DSM- IV- TR MULTI-AXIAL CLASSIFICATION Axis I- All major psychiatric disorders Axis II- Personality disorders; Mental retardation Axis III- Current medical conditions that are relevant to the mental disorder Axis IV- Psychosocial and environmental problems Axis V- Global Assessment of Function (GAF)

Therapeutic Approaches : 

Therapeutic Approaches Psychoanalysis Short term psychotherapy Cognitive Therapy Behavior Therapy Modeling Operant Conditioning Systemic desensitization Aversion Therapy Milieu Therapy Individual, group and family therapy

CULTURAL BIASES : 

CULTURAL BIASES Consider cultural differences that influence health Be accepting of changing families Be open, consider differences in order to provide sensitive, competent care

GOALS and Interventions ofPsychiatric Care Directed to… : 

GOALS and Interventions ofPsychiatric Care Directed to… Anxiety + Reality testing + Self esteem = Level of functioning and manage disease process