COMMUNICATE TO PARTICULAR GROUP PATIENT

WHO ARE:
“ANXIETY”

BY:

MARIA IRIANI PERADA ARAN 9103017009

EKA PERANDUWINATA 9103016012
BOY SAKTI PARNINGOTAAN SIBARANI 9103017020
MARIA DEYS NATALIS OKTAVIAN 9103017021
DAHLIA 9103017030
MARIA ANITA FARNEUBUN 9103017034

FAKULTAS KEPERAWATAN
UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA
2018
 PART I

INTRODUCTION

Anxiety is a normal reaction to stress and can be beneficial in some situations. It can
alert us to dangers and help us prepare and pay attention. Anxiety disorders differ from normal
feelings of nervousness or anxiousness, and involve excessive fear or anxiety. Anxiety
disorders are the most common of mental disorders and affect nearly 30 percent of adults at
some point in their lives.But anxiety disorders are treatable and a number of effective
treatments are available. Treatment helps most people lead normal productive lives.

Women are more likely than men to experience anxiety disorders.Anxiety refers to
anticipation of a future concern and is more associated with muscle tension and avoidance
behavior.Fear is an emotional response to an immediate threat and is more associated with a
fight or flight reaction – either staying to fight or leaving to escape danger.Anxiety disorders
can cause people into try to avoid situations that trigger or worsen their symptoms. Job
performance, school work and personal relationships can be affected. In general, for a person
to be diagnosed with an anxiety disorder, the fear or anxiety must:Be out of proportion to the
situation or age inappropriate, hinder your ability to function normally. There are several types
of anxiety disorders, including generalized anxiety disorder, panic disorder, specific phobias,
agoraphobia, social anxiety disorder and separation anxiety disorder.

Patient communication is an integral part of clinical practice. A perfect communication

creates consensus cooperation, continuity, courage of conviction, commitment and credibility.
A lack of communication leads to confusion, chaos, contradiction, conflict and crisis of
confidence. A communication gap results in mistrust and misunderstanding. The ability to
communicate effectively and sensitively is central to all medical activities and to those working
in all specialties. Communication is imparting, conveying or exchanging ideas/ knowledge.
The ability to communicate well with the patients to build up a trusting relationship within
which curing, relieving and comforting can take place is a great challenge. Communication is
not an addition; it is at the heart of patient care. The purpose of communication is to reassure
the patient, solve their problems, form and maintain relationship so that we can alleviate
distress by conveying our feeling. Thus satisfying patient with care they receive.
Problem Formulation
1. What is the definition of anxiety?
2. What are anxiety disorders?
3. What are the types of anxiety?
4. How to do a good communication with patients who are anxiety?

Purpose
1. To explain the definition of anxiety
2. To explain about anxiety disorder
3. To explain about the types of anxiety
4. To explain the good communication with patient who are anxiety
 PART II

DISCUSSION

Anxiety

When you are anxious you feel fearful and tense. In addition you may also have one or
more unpleasant physical symptoms - for example, you might have: a fast heart rate, the
sensation of having a 'thumping heart' (palpitations), a feeling of sickness (nausea), shaking
(tremor), sweating, dry mouth, chest pain, headaches, fast breathing.

The physical symptoms are partly caused by the brain which sends lots of messages
down nerves to various parts of the body when you are anxious. The nerve messages tend to
make the heart, lungs and other parts of the body work faster. In addition, you release stress
hormones, such as adrenaline (epinephrine), into the bloodstream when you are anxious. These
can also act on the heart, muscles and other parts of the body to cause symptoms.

Anxiety is normal in stressful situations and can even be helpful. For example, most
people will be anxious when threatened by an aggressive person, or before an important race.
The burst of adrenaline (epinephrine) and nerve impulses which we have in response to
stressful situations can encourage a 'fight or flight' response. Anxiety is abnormal if it: is out
of proportion to the stressful situation; or persists when a stressful situation has gone, or the
stress is minor; or appears for no apparent reason when there is no stressful situation.

Anxiety Disorders

Social anxiety disorder, panic attack and panic disorder, generalised anxiety disorder.
here are various conditions (disorders) where anxiety is a main symptom. You may have an
anxiety disorder if anxiety symptoms interfere with your normal day-to-day activities, or if
worry about developing anxiety symptoms affects your life. About 1 in 20 people have an
anxiety disorder at any one time. The following is a brief overview of the main anxiety
disorders. Some people have features of more than one type of disorder.

Types Of Anxiety

There are common types of reaction disorders:

Acute reaction to stress (sometimes called acute stress reaction)

This sudden reaction - typically due to an unexpected life crisis - features anxiety, low
mood, irritability and other symptoms. It usually settles quickly and sometimes occurs before
the event takes place (this is known as situational anxiety).
 Adjustment Reaction
This is similar to the above but symptoms develop days or weeks after a stressful
situation such as a divorce or house move, as a reaction or adjustment to the problem.
Symptoms are similar to acute reaction to stress but may include depression. The symptoms
tend to improve over a few weeks or so.

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) may follow a severe trauma such as a serious
assault or a life-threatening accident. The main symptoms of PTSD are recurrent flashbacks
about the trauma, avoidance of anything that can trigger thoughts of the trauma, emotional
numbness, pessimism about the future and an increased state of irritability and arousal (for
example, poor sleep, difficulty in concentrating).

Phobic anxiety disorders

A phobia is strong fear or dread of a thing or event. The fear is out of proportion to the
reality of the situation. Coming near to or into contact with the feared situation causes anxiety.
Sometimes even thinking of the feared situation causes anxiety. Therefore, you end up avoiding
the feared situation, which can restrict your life and may cause distress.

Social anxiety disorder

Social anxiety disorder (also known as social phobia) is possibly the most common
phobia. With social anxiety disorder you become very anxious about what other people may
think of you, or how they may judge you. Therefore, you fear meeting people, or 'performing'
in front of other people, especially strangers. You fear that you will act in an embarrassing way
and that other people will think that you are stupid, inadequate, weak, foolish, crazy, etc. You
avoid such situations as much as possible. If you go to the feared situation you become very
anxious and distressed. Discover more about social anxiety disorder.

Agoraphobia

This too is common. Many people think that agoraphobia means a fear of public places and
open spaces. But this is just part of it. If you have agoraphobia you tend to have a number of
fears of various places and situations. So, for example, you may have a fear of:

 Entering shops, crowds and public places.

 Travelling in trains, buses, or planes.

 Being on a bridge or in a lift.

 Being in a cinema, restaurant, etc, where there is no easy exit.

 But they all stem from one underlying fear. That is, a fear of being in a place where help will
not be available, or where you feel it may be difficult to escape to a safe place (usually to your
home). When you are in a feared place you become very anxious and distressed and have an
intense desire to get out. To avoid this anxiety many people with agoraphobia stay inside their
home for most or all of the time.

Other specific phobias

There are many other phobias of a specific thing or situation. For example: Fear of confined
spaces or of being trapped (claustrophobia), fear of certain animals, fear of injections, fear of
being sick (vomiting), fear of being alone, fear of choking. But there are many more.

Other anxiety disordersa

 Panic disorder, generalised anxiety disorder (GAD), mixed anxiety and depressive disorder,
obsessive-compulsive disorder (OCD).

Communication with patients who are anxiety

1. Let your patient be heard

The most important skill to learn when dealing with anxious patients is to listen. Most
people just want to know that you are listening to their concerns. People come into their rooms
all day long talking at them and rarely ask them how they are feeling. Take two minutes,
preferably at the beginning of your shift, to sit down and talk with your patient. Ask an open
ended question like “how are you feeling?” or “is there anything I can do to make you feel
more comfortable?”

2. Explain the What and the Why

Let your patient know everything that you are doing and why you are doing it. Most
people’s fear of the hospital comes from being in an unfamiliar environment and not knowing
what to expect. The majority of patients with anxiety are not frequent fliers. They don’t know
the hospital routine like some of your other patients.
Before you enter the room, make sure you are prepared. Bring in any new medication hand-
outs, understand and be able to explain the rationale behind administering all of them. Prepare
patients on what to expect with any procedures that will be done for that day or the next day.
If you can’t answer all their questions then find someone who can.

3. Don’t tell your patient to relax, show them how

Do not tell someone who is anxious to relax. IT DOESN’T WORK. Instead, ask them
what you can do to help them relax.
Some patients actually have the ability to tell you what they need. If they cannot tell
you, then help them with some relaxation techniques. Give direction “breathe in through your
nose and out through your mouth.” Take some vital signs just to make sure they aren’t anxious
for a medical reason. Dim the lights. Ask their family members to step out for a moment to let
the patient rest. Maybe offer the services of the chaplain, a cup of tea or a warm blanket.

4. Do hourly rounding
 Let the patient or family know that you will be checking in with them or “rounding” on
them every hour just to make sure everything is okay. Explain the plan of care including
medication schedule, repositioning or procedural preparations for the day/night. Introduce the
on-coming nurse during report and reassure the patient that they will be in good hands.

5. Use humor
Make efforts to lighten the mood and be personable. Ask people about their lives; how
many kids/ grandkids they have, where they are from, what brought them to where they are,
how they met their spouse, etc.

6. Prepare yourself for stressful situations

Understand how you feel when a negative emotional response like anxiety or fear is
activated in your body. It can feel like a knot in your stomach, a fast heart rate or tense muscles.
Recognize these feelings and take a couple of deep breaths before your speak or act.
If you get in report that a particular patient or family is anxious, prepare yourself to
“practice your patience.” Use this as an opportunity to train yourself to remain calm in stressful
situations.

7. Be empathetic
Be wary of your own biases or assumptions. Sometimes we have conscious or
unconscious beliefs about how people should or should not behave in certain situations. The
fact of the matter is that unless you have actually been in this situation yourself, you have no
right to judge how someone else should feel or act. Do your best to put yourself in their shoes.

PART III
CONCLUSION

Acknowledging our limitations and being prepared to challenge them occasionally can help us
to understand our patients as well as ourselves. We can learn and practice skills to help us relieve and
cope with unpleasant situations in our day to day practice. Anger and violence are as much a part of
grieving as are acceptance or sadness. To deny or dismiss anger and violence prematurely can delay a
necessary process in healing. People in stressful situations may well behave out of character.

The efficiency and the effectiveness of your interaction with the patient will be enhanced if you
converse with concern and create an expression to leave an ever-lasting impression. It is a distinct art
to talk medicine in the language of non-medical man. Patient don’t care what you know but they know
that we care with concern, compassion, courtesy commitment thus bringing credibility in our
relationship. In healing, we should not hurt the patients.

REFERENCES

https://patient.info/health/anxiety

https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety- disorders

https://www.travelnursing.org/7-ways-to-provide-exceptional-patient-care/