GROUP THERAPY

Group psychotherapy is a treatment in which carefully selected people who are emotionally
ill meet in a group guided by a trained therapist, and help one another effect personality
change.

SELECTION

 Homogeneous group
 Adolescents and patients with personality disorders
 Families and couples where the system need change.

CONTRAINDICATION

 Antisocial patients
 Actively suicidal or severely depressed patients
 Patients who are delusional and who may incorporate the group into their delusional
system.

GROUP SIZE

Optimal size for group therapy is 8-10 members.

FREQUENCY AND LENGTH OF SESSIONS

Most group psychotherapist conduct group sessions once a week; each sessions may last
for 45 minutes to 1 hour.

APPROACHES TO GROUP THERAPY

 The therapists role is primarily that of a facilitator; he should provide a safe,

comfortable atmosphere for self -disclosure.
 Focus on ‘here and now’
 Use any transference situations to develop insight into their problems.
 Protect members from verbal abuse or from scapegoating.
 Whenever appropriate, provide positive reinforcement, this gives ego support and
encourages future growth
 Handle circumstantial patients, hallucinating and delusional patients in manner that
protects the self-esteem of individual and also sets limits on the behaviour so as to
protect other group members.
 Develop ability to recognize when a group member is “fragile”; he should be
approached in a gentle, supportive and non-threating manner.
 Use silence effectively to encourage introspection and facilitate insight
 Laughter and moderate amount of joking can act as a safety and at times can contribute
to group cohesiveness
 Role playing may help a member develop insight into the ways in which he relates to
others.
 THERAPEUTIC FACTORS INVOLVED IN GROUP THERAPY

These involve sharing experiences, support to and from group members, socialization,
imitation and interpersonal learning.

SHARING EXPERIENCE

This helps patients to realize that they are not isolated and that others also have similar
experiences and problem. Hearing from other patients that they have shared experience is
often more convincing and helpful than reassurance from the therapist.

SUPPORT TO AND FROM GROUP MEMBERS:

Receiving help from other group members can be supportive to the person helped. The
sharing action of being mutually supportive is an aspect of the group cohesiveness that can
provide a sense of belonging for patients who feel isolated in their everyday lives.

SOCIALIZATION

It is acquisition of social skills within a group through comments that members provide
about one another’s deficiencies in social skill. This process can be helped by trying out new
ways of interacting within the safety of the group.

IMITATION:

It is learning from observing and adopting the behaviours of the group members. If the
group is run well, patients imitate the adaptive behaviours of other group members.

INTERPERSONAL LEARNING

It refers to learning about difficulties in relationships by examining the interaction of

individuals with other members of the group.

SOME THECHNIQUIES USEFUL IN GROUP THERAPY

 Reflecting or rewarding comments of group therapy

 Asking for group reaction to one members statement
 Asking for individual reaction to one members statement
 Pointing out any shared feelings within the group
 Summarizing various points at the end of session.
In conclusion, one may say that group therapy plays a major role in the
rehabilitation of the mentally ill individual. Group therapy gives an opportunity for
immediate feedback from patient’s peer and a chance for both patient and therapist to
observe the patients psychological, emotional and behavioural response towards a
variety of people. Thus, it helps the patient to master communication and interpersonal
skills, problem-solving, decision making and assertive skills, thus enabling him to re-
enter the society’s mainstream with a greater degree of confidence.
 PLAY THERAPY

Play is a natural mode of growth and development in children. Through play a child learns to
express his emotions and it serves as a tool in the development of a child.

CURATIVE FUNCTIONS

 It releases tension and pent-up emotions

 It allows compensation for loss and failures
 It improves emotional growth through his relationship with other children
 It provides an opportunity to the child to act out his fantasies and conflicts, to get rid of
aggression and to learn positive qualities from other children.

DIAGNOSTIC FUNCTIONS

 Play therapy gives the therapist a chance to explore family relationships of the child and
discover what difficulties are contributing to child’s problems
 Play therapy allows studying hidden aspects of the child’s personality
 It is possible to obtain a good idea of the intelligence level of the child.
 Through play inter-sibling relationships can be adequately studied.

TYPES OF PLAY THERAPY

INDIVIDUAL VS GROUP PLAY THERAPY : In individual therapy, the child is allowed to play by
himself and the therapists attention is focused on this one child alone. In group play therapy,
other children are involved.

FREE PLAY VS CONTROLLED PLAY THERAPY : In free play, the child is given freedom in
deciding with what toys he wants to play. In controlled play therapy, the child is introduced
into a scene where the situation or setting is already established.

STRUCTURED VS UNSTRUCTURED PLAY THERAPY : Structured play involves organizing the

situation in such a way so as to obtain more information. In unstructured play therapy no
situation is set and no plans are followed.

DIRECTIVE VS NON-DIRECTIVE PLAY THERAPY : In directive play therapy, the therapist totally
sets the directions, whereas in non-directive play therapy , the child receives no directions.
Play therapy is generally conducted in a playroom .The playroom should be suitably stocked
with adequate play material, depending upon the problems of the child.

MUSIC THERAPY

Music therapy is the functional application of music towards the attainment of specific therapeutic
goals.
ADVANTAGES

 Facilitates emotional expressions.

 Improves cognitive skills like learning, listening and attention span
 Social interaction is stimulated.

RECREATIONAL THERAPY
Recreation is a form of activity therapy used in most psychiatric settings. It is a planned
therapeutic activity that enables people with limitations to engage in recreational
experiences.

AIMS
 To encourage social interaction
 To decrease withdrawal tendencies
 To promote socially acceptable behaviour
 To develop skills, talents and abilities
 To increase physical confidence and a feeling of self-worth

POINTS TO BE KEPT IN MIND

 Provide a non-threatening and non-demanding environment
 Provide activities that are relaxing and without rigid guidelines and time-frames
 Provide activities that are enjoyable and self-satisfying.

TYPES OF RECREATIONAL ACTIVITIES

MOTOR FORMS: these can be further divided into fundamental and accessory; among the
fundamental forms are such games as hockey and football, while the accessory forms are
exemplified by play activity and dancing.

SENSORY FORMS: These can be either visual, e.g. looking at motion pictures, play ,etc. or auditory
such as listening to a concert.

INTELLECTUAL FORMS: These include reading, debating and so on.

SUGGESTED RECREATIONAL ACTIVITIES FOR PSYCHIATRIC DISORDERS

ANXIETY DISORDER : Aerobic activities like walking, jogging ,etc.

DEPRESSIVE DISORDER : Non-competitive sports, which provide outlet for anger, like jogging,
walking, running etc.

MANIC DISORDER : One-to-one basis individual games like shuttle badminton, ball badminton, etc

SCHIZOPHRENIA ( PARANOID) : Activities requiring concentration like chess, puzzles

SCHIZOPHRENIA ( CATATONIC ) : Social activities to give patient contact with reality like dancing,
athletics.

DEMENTIA : Concrete, repetitious crafts and projects that breed familiarization and comfort.

Childhood and adolescents disorder : It is better to work with the child on a one-to-one basis and
give him a feeling of importance. Employ activities such as playing, story telling and painting.
Adolescents fare better in groups; provide gross motor activities like sports and games to use up
excess energy.

MENTAL RETARDATION : Activities should be according to the patients level of functioning such as
walking, dancing, swimming, ball playing, etc.

OCCUPATIONAL THERAPY

Occupational therapy is the application of goal-oriented, purposeful activity in the assessment and
treatment of individuals with psychological, physical or developmental disabilities.

GOAL

The main goal is to be enable the patient to achieve a healthy balance of occupations through the
development of skills that will allow him to function at a level satisfactory to himself and others.

SETTINGS

Occupational therapy is provided to children, adolescents, adults and elderly patients. These
programs are offered in psychiatric hospitals, nursing homes, community mental health centres,

Day care centres, halfway homes and de-addiction centres.

ADVANTAGES

 Helps to develop social skills and provide an outlet for self-expression

 Strengthen ego defence
 Develops a more realistic view of the self in relation to others.

POINTS TO BE KEPT IN MIND

 The patient should be involved as much as possible in selecting the activity

 Select and activity that interests or has the potential to interest him
 The activity should utilize the patient’s strengths and abilities
 The activity should be of short duration to foster a feeling of accomplishment
 If possible, the selected activity should provide some new experience for the patient.

PROCESS OF INTERVENTION

It consists of six stages:

 1. Initial evaluation of what patient can do and cannot do in a variety of situation over a period
of time.
2. Development of immediate and long-term goals by the patient and therapists together.
Goals should be concrete and measurable so that it is easy to see when they have been
attained.
3. Development of therapy plan with planned intervention.
4. Implementation of the plan and monitoring the progress. The plan is followed until the first
evaluation. If found satisfactory it is continued and altered ,if not.
5. Review meetings with patient and all the staff involved in treatment.
6. Setting further goals when immediate goals have been achieved; modifying the treatment
program as relevant.

TYPES OF ACTIVITIES

DIVERSIONAL ACTIVITIES : These activities are used to divert ones thoughts from life stresses or to fill
time. For example, organized games.

THERAPEUTIC ACTIVITIES : These activities are used to attain a specific care plan or goal. For
example, basket making, carpentry, etc.

SUGGESTED OCCUPATIONAL ACTIVITIES FOR PSYCHIATRIC DISORDERS

Anxiety disorder: simple concrete task with no more than 3 to 4 steps that can be learnt quickly. For
example, kitchen task, washing , sweeping , mopping ,mowing lawn and weeding gardens.

Depressive disorder: simple concrete task which are achievable; it is important for the patient to
experience success. Provide positive reinforcement after each achievement. For example, crafts,
mowing lawn , weeding gardens.

MANIC DISORDER: Non-competitive activities that allow the use of energy and expression of
feelings. Activities should be limited and changed frequently. Patient needs to work in an area from
distractions For example racking grass, sweeping etc.

SCHIZOPHRENIA ( PARANOID): non-competitive and solitary, meaningful task that require some
degree of concentration.so, that less time is available to focus on delusions .For example puzzles,
scrabble, etc.

SCHIZOPHRENIA ( CATATONIC) : simple concrete task in which patient is actively involved. Patient
needs continuous supervision and at first works best on a one-to- one basis For example metal work,
moulding work etc

ANTISOCIAL PERSONALITY : Activities that enhance self-esteem and are expressive and creative but
not too complicated. Patient needs supervision to make sure each task is completed for example,
leather work, painting etc.

DEMENTIA: Group activities to increase feeling of belonging and self-worth. Provide those activities
which promote familiar individual hobbies. Activities need to be structured, requiring little time
completion and not much concentration. Explain and demonstrate each task than have patient
repeat the demonstration . For example cover making, packing goods etc.
SUBSTANCE ABUSE : Group activities in which patient uses his talents. For example involving patient
in planning social activities, encouraging interaction with others, and etc.

CHILDHOOD AND ADOLESCENT DISORDER :

CHILDREN : playing, story telling, painting, poetry, music, etc.

ADOLESCENTS: creative activities such as a leather work ,drawing, painting.

MENTAL RETARDATION : Repetitive work assignments are ideal; provide positive reinforcement after
each achievement. For example cover making, candle making, packaging goods, etc.

PSYCHO THERAPY

Psycho therapy has been referred to as a systematic treatment primarily employing verbal
communication as the means of treatment aimed at relieving the patients symptoms and helping
him to understand and modify his conduct so as to lead a well adjusted life.

PSYCHOANALYTIC THEORY

Psychoanalysis was first developed by Sigmund Freud at the end of the 19 th century. The most
important indication for psychoanalytical therapy is the presence of long standing mental conflicts,
which may be unconscious but produce symptoms. In psychoanalysis, the focus is on the cause of
the problem, which is buried somewhere in the unconsciousness. The therapist tries to take the
patient in to the past in an effort to determine where the problem began. The aim of the therapy is
to repressed material to conscious awareness so that the patient can work towards a healthy
resoluti
 ELECTRO CONVULSIVE THERAPY

Electroconvulsive therapy (CT) is a type of somatic treatment, first introduced byBini and Cerletti in
April 1938. From 1980 onwards ECT is being considered as a unique psychiatric treatment.

Electroconvulsive therapy is the artificial induction of a grandmal seizure

through the application of electrical current to the brain.The stimulus is applied through electrodes
that are placed either bilaterally in the fronto -temporal region, or unilaterally on the non-dominant
side (right side of head in a right-handed individual).

Parameters of Electrical Current Applied

Standard dose according to American Psychiatric Association, 1978

Voltage - 70-120 volts

Duration -0.7-1.5 seconds.

Type of Seizure Produced

1. Grandmal seizure-tonic phase lasting for 10-15 seconds

2. Clonic phase lasting for 30-60 seconds

MECHANISM OF ACTION

The exact mechanism of action is not known.one hypothesis states that ECT possibly affects the
catecholamine pathways between diencephalon and limbic system also involving the
hypothalamus. Types of ECT

TYPES OF ECT

Direct ECT: In this, ECT is given in the absence of anesthesia and muscular relaxation. This is
not a commonly used method now.

Modified ECT: Here ECT is modified by drug induced muscular relaxation and general
anesthesia.

Frequency and Total Number of ECT

Frequency: Three times per week or as indicated.

Total number: 6 to 10; up to 25 may be

preferred as indicated.

Application of Electrodes

Bilateral ECT: Each electrode is placed 2.5-4

cm (1-1% inch) above the midpoint, on a line joining the tragus of the ear and the lateral
canthus of the eye.

Unilateral ECT : Electrodes are placed only on one side of head, usually non-dominant side (right
side of head in a right-handed individual)

Unilateral ECT is safer, with much fewer side effects, particularly those of memory impairment.

INDICATION
Major depression: With suicidal risk; stupor; p0or intake of food and fluids; melancholia with
psychotic features; unsatisfactory response to drugs or where drugs are contraindicated or
have serious side effects.

Severe catatonia (functional): With

Stupor; poor intake of food and fluIds

Severe psychosis
With risk of suicide, homicide or danger of physical assault; depressive features; unsatisfactory
response to drug therapy, or when drugs are contraindicated or have
serious side effects.
Organic mental disorders:
Organic mood disorders
- Organic psychosis

Other indications: ECT is preferred to antidepressant therapy in some cases, such as for patients
with cardiac disease; when tricyclics are contraindicated because of the potential for
dysarrythmias and congestive heart failure; and for pregnant women, in whom antidepressants
place the fetus at risk for congenital defects.

CONTRAINDICATION
1. Absolute :-
Raised ICP (intracranial pressure)

2. Relative

- Cerebral aneurysm

- Cerebral hemorrhage

- Brain tumor

- Acute myocardial infarction

- congestive heart failure
- pneumonia
- retinal detacthment

Complications of ECT
Life-threatening complications of ECT are rare. ECT does not cause any brain damage.Fractures
can sometimes occur in elderly patients with osteoporosis. In patients with a history of heart
disease, dysrhythmias and respiratory arrest may occur.

Side Effects of ECT

 Memory impairment
 Drowsiness, confusion and restlessness
 Poor concentration, anxiety
 Headache, weakness/fatigue, backache,
 muscle aches
 Dryness of mouth, palpitations, nausea,
 vomiting
 Unsteady gait
 Tongue bite and incontinence.

ECT Team

Psychiatrist, anesthesiologist , trained nurses and aides should be involved in the administration
of ECT
Treatment Facilities
There should be a suite of three rooms:

1. Apleasant, comfortable waiting room (pre-ECT room)

2. ECT room, which should be equipped with ECT machine and accessories, an anesthetic
appliance, suction apparatus, face masks oxygen .cylinders with adjustable flow valve
Curved tongue depressors, mouth gag resuscitation apparatus and emergency
drugs. There should be immediate access to a defibrillator
3. A well-equipped recovery room

ROLE OF NURSE

Pre-treatment Evaluation

 Detailed medical and psychiatric history including history of allergies

 Assessment of patients' and families , side effects , therapeutic effects and risks associated
with ECT.
 An informed consent should be taken Allay any unfounded fears and anxieties regarding
the procedure
 Assess baseline vital signs
 Patient should be on empty stomach for 4-6 hours prior to ECT
 Withhold night doses of drugs which increase seizure threshold like
diazepam,barbiturates and anticonvulsants
 Withhold oral medications in the morning
  Head shampooing in the morning since oil causes impedance of passage of electricity to
brain
 Any jewellery, prosthesis, dentures, contact lens, metallic objects and tight clothing
should be removed from the patient's body
 Empty bladder and bowel just before ECT
 Administration of 0.6 mg atropine IM or SC 30 minutes before ECT, or IV just before ECT

Intra-procedure Care

 place the patient comfortably on the ECT table in supine position

 Stay with the patient to allay anxiety and fear
 Assist in administering the anesthetic agent (thiopental sodium 3-5 mg/kg body weight)
and muscle relaxant (1 mg/kg body weight of succynylcholine)
 Since the muscle relaxant paralyzes all muscles including respiratory muscles, patent
airway should be ensured and ventilatory support should be started
 Mouth gag should be inserted to prevent possible tongue bite
 The place of electrode placement should be cleaned with normal saline or 25%
bicarbonate solution or a conducting gel applied.
 record the findings and medicines given in the patients chart.

Post-procedure Care

 Monitor vital signs

 Continue oxygenation till spontaneous respiration starts
 Assess for post-ictal confusion and restlessness
 Take safety precautions to prevent injury (side-lying position and suctioning to prevent
aspiration of secretions, use of side rails to prevent falls)
 If there is severe post-ictal confusion and restlessness, IV diazepam may be
 administered
 Reorient the patient after recovery and stay with him until fully oriented
 Document any findings as relevant in the patient's record.
 PROCESS RECORDING -1
1. IDENTIFICATION DATA
Name : Mr Rahul Patel
Age :50 years old
Sex: Male
Religion: Hindu
Marital status: Married
Occupation: Business man
Language known: Gujarati Hindi and English
Ward: male psychiatric ward
Address: Surat
Date of admission: 26 /09/2022
Income : 50,000/- year
Diagnosis: Mania

INFORMANTS
 Primary informants :- wife
 Secondary informants :- patients mother
 Name of informants :- Gita ben
 Relationship with patients : wife
 Length of stay with patients : 10 years
PRESENTING COMPLAINTS OF PATIENT
ACC TO PATIENT :
Sometimes patient have many ideas in his mind
Patient get easily anger.
Patient have suddenly irritation
ACC TO INFORMANTS
Feeling very happy or over joyed
Feeling of self important
Talking very quickly
HISTORY OF PRESENT ILLNESS : my patient Mr Rahul 50 years old
admitted in hospital in surat for the second time with the complaints of
decreased sleep, feeling very happy , hallucination.

AIMS AND OBJECTIVES OF INTERVIEWS

Patients point of view:-
 To help the patient to conceptualize his problem
 To help the patient to communicate
 To help the patient to do different activities
 To help the patient to develop insight
 To help the patient to change his attitude.
Students point of view:-
 To gain the patients confidence
 To establish rapport of patient
 To known about patients illness and understandings
 To give skills in taking interviews
 To give skills to in taking interviews
 To develop the understandings.
SUMMARIZATION
Mr. Rahul patel was co-operative during the interviews and not
maintained eye to eye contact during the interview process . His recent
memory was impaired pattern was oriented to time but not orient to
place and person.
 PROCESS RECORDING -2
1. IDENTIFICATION DATA
Name : Mr Mayur parmar
Age : 40 years old
Sex: Male
Religion: Hindu
Marital status: Married
Occupation: Teacher
Language known: Gujarati Hindi and English
Ward: male psychiatric ward
Address: nanpura Surat
Date of admission: 20 /09/2022
Diagnosis: Bipolar disorder
INFORMANTS
• Primary informants :- wife
• Secondary informants :- patients father
• Name of informants :- Vinita ben
• Relationship with patients : wife
• Length of stay with patients : 9 years
PRESENTING COMPLAINTS OF PATIENT
ACC TO PATIENT :
Sometimes patient have many ideas in his mind
Patient get easily anger.
Patient have suddenly irritability
 ACC TO INFORMANTS
Mood swings
HISTORY OF PRESENT ILLNESS : my patient Mr Mayur 40 years old
admitted in Global hospital for the first time with the complaints of
decreased sleep, hallucination.

AIMS AND OBJECTIVES OF INTERVIEWS

Patients point of view:-
• enable him to interact with others
• advice him to relief tension and anxiety by talking to others
Give health education on hypertension to reduce
restlessness.
STUDENTS POINT OF VIEW
 To establish rapport and build trust relationship.
 Establish therapeutic relationship
 To decrease anxiety and agitation
 To relief tension
 Promote communication
 Promote rest and sleep
 Provide emotional support.

SUMMARIZATION
Client is interested in conversation with little difficulty and to be blunt mood
in group activities I could established rapport with him.
 PROCESS RECORDING 3

IDENTIFICATION DATA
Name: Gustavbhai R. Solanki
Age: - 27 years
Sex: male
Religion: Hindu
status: unmarried
Education: - 10th pass
Occupation: R.T.O Agent
Income: 20,000 / month
Religion: Hindu
Reg No:291097
Ward: Psychiatric ward
date of Admission: 23/11/2022
Language known: Gujarati,
Diagnosis: Substance use disorder (Alcohol & Gunja) (ALCOHOL WITHRAWAL)
Admission time : 11:45 AM
Process recording
-> Summary of patient problem:
My patient Name is Gustavbhui has problem of substance use disorder.
Patient Many time use alcohol or ganja.
-> place of interaction
Male Psychiatric ward
-> Description of the environment.:
The surrounding environment is good and patient feel good in this
environment and patient room is well ventilated.
-> Reason for selecting the patient :-
I select the patient for the depth knowledge regarding substance use
disorder and nursing care to the patient. Selected also for done process
recording.

OBJECTIVE
-To know the sign and symptoms of the patient
-To know the feeling of patient
- To know the behaviour pattern of patient.
- To assess the memory level of the patient.
NURSES RESPONSE PATIENTS RESPONSE
VERBAL NON VERBAL VERBAL NON VERBAL TECHNIQUE INFERENCE
CONSCIOUSNESS
Hi good morning Maintaining eye contact Hello good morning Maintaining eye contact Questioning Patient in conscious

ORIENTATION
What is time now? Smiling Approximately this is Smiling Questioning Patient is oriented
09:00 AM
Where are you now? Eye to eye contact Sunshine Global Seeing surrounding Questioning Patient is oriented
hospital environment
Who is this? (By Smiling Relative Show relative and Questioning Patient is oriented
showing relative) telling
RECENT MEMORY
What you taken smiling Tea and thepla Looking upward Questioning Recent memory intact
breakfast in morning?
REMOTE MEMORY
What is your birth Eye to eye contact 21/10/1994 thinking Questioning Remote memory intact
date?
INTELLIGENCE
Who is the president of Eye to eye contact Dropadi murmur Smiling Questioning Intelligent intact
india?
ABSTRACT THINKING
What is the meaning of Eye to eye contact It means everything is Questioning Intelligent intact
“ ALL IS WELL” positive
ATTENTION
Tell me the 1 to 10 Maintain eye to eye Forward Maintain eye to eye Questioning Attention is intact
number forward and contact 1.2.3.4.5.6.7.8.9.10 contact and thinking
backward Backward
10.9.8.7.6.5.4.3.2.1
CONCENTRATION
Subtract the 100-3,97- Eye to eye contact Tell that 97,94,91,86 Thinking Questioning Concentration intact
3,94-3,91-3
MEMORY
IMIDIATE MEMORY
Tell the three no. 7,5,8 Eye to eye contact Repeat no 7,5,8 Looking up ward Questionary Immediate memory
(after 5 min.) intact
Tell me similarity Eye to eye contact Both are use for Eye to eye contact Questionary Immediate memory
between car and bike? transportation intact
Tell me disimilarity Eye to eye contact Car is for many people Eye to eye contact Questionary Immediate memory
between car and bike? and bike is only for two intact
person.
JUDGEMENT
What will you do after Eye to eye contact I will go to work at RTO Eye to eye contact Questionary Personal judgment is
discharge? OFFICE intact
What will you do if fire Eye to eye contact I will call the fire Eye to eye contact Questionary Test judgment is
occur at near by home? brigade and police first. intact
INSIGHT
Do you know why are Eye to eye contact I have substance abuse Eye to eye contact Questionary Insight awareness
you admitted here? and aggressive about condition grade
behaviour with others ii
 CONCLUSION
I have done the process recording on substance use disorder
in that I done process recording in that patient is conscious and
oriented , attention is intact, patient intelligence abstract thinking,
judgment is appropriate memory is intact and insight grade II (slight
awareness about condition) and concentration is intact.

HISTORY TAKING 1
NAME: Gaurav bhai R. Solanki
AGE: 27year
SEX: Male
RELIGION: Hindu
MARITAL STATUS: Unmarried
ADDRESS : Kamrej , Surat
EDUCATION: 10th pass
OCCUPATION: R.T.O. agent
INCOME: 20,000/-
RELIGION: Hindu
REG.NO: 291097
WARD: Male psychiatric ward
DATE OF ADMISSION: 23/1/2022
LANGUAGE KNOWN: Gujarati
NATIONALITY: Indian
SOURCE OF INFORMATION: Father
DIAGNOSIS: substance abuse disorder ( alcohol, Ganjaa )
CHIEF COMPLAINT
My patient was admitted in sunshine hospital, Surat. She had a
chief complain of headache, sleep disturbance, sadness of mood,
stress and loss of appetite , tremors.
HISTORY OF PATIENT ILLNESS
My Patient name is Gaurav bhai. he is admitted in the sunshine
hospital in female psychiatric ward. Patient was last well before
1year. Before 1 year the earliest symptoms of illness are seen in
patient like headache, irrelevant talk, sleep disturbance after the
physiological change like loss of sleep, loss of appetite. In My
patient no any suicidal ideation or negative thought.

PAST PSYCHIATRIC AND MEDICAL HISTORY

Past having past psychiatric illness was admitted in sunshine
hospital due to the some condition like headache, sleep
disturbance, irrelevant talk for admitted that time the condition is
multiple psychiatric disorder and convulsion reaction.

HISTORY TAKING 2
NAME: Shirish bhai Ravana
AGE: 60year
SEX: Male
RELIGION: Hindu
MARITAL STATUS: married
ADDRESS: Dindoli, Surat
EDUCATION: 6th pass
OCCUPATION: diamond worker
INCOME: 3000/-
RELIGION: Hindu
REG.NO: 2576
WARD: Male psychiatric ward
DATE OF ADMISSION: 20/1/2022
LANGUAGE KNOWN: Gujarati
NATIONALITY: Indian
DIAGNOSIS: Dementia
SOURCE OF INFORMATION :wife
CHIEF COMPLAINT
My was admitted in sunshine hospital, Surat. She had a chief
complain of headache, sleep disturbance, sadness of mood, anxiety
and loss of appetite.
HISTORY OF PATIENT ILLNES
he is admitted in the sunshine hospital in female psychiatric ward.
Patient was last well before 2year. Before 2 year the earliest
symptoms of illness are seen in patient like headache, irrelevant
talk, sleep disturbance after the physiological change like loss of
sleep, loss of appetite. In My patient no any suicidal ideation or
negative thought. Sometime also have memory loss symptoms.

PAST PSYCHIATRIC AND MEDICAL HISTORY

Past having past psychiatric illness was admitted in sunshine
hospital due to the some condition like headache, sleep
disturbance, irrelevant talk and short term memory loss.

HISTORY TAKING 3
NAME: Bipin bhai J Chauhan
AGE: 40year
SEX: Male
RELIGION: Hindu
MARITAL STATUS: married
ADDRESS : Bhatar, Surat
EDUCATION: 11th pass
OCCUPATION: worker
INCOME: 1500/- month
RELIGION: Hindu
REG.NO: 383014
WARD: Male psychiatric ward
DATE OF ADMISSION: 20/1/2022
LANGUAGE KNOWN: Gujarati
NATIONALITY: Indian
DIAGNOSIS: Bipolar mood disorder
SOURCE OF INFORMATION : mother
CHIEF COMPLAINT
My patient was admitted in sunshine hospital, Surat. She had a
chief complain of headache, sleep disturbance, sadness of mood,
anxiety and loss of appetite.
HISTORY OF PATIENT ILLNESS
he is admitted in the sunshine hospital in female psychiatric ward.
Patient was last well before 3year. Before 3 year the earliest
symptoms of illness are seen in patient like headache, irrelevant
talk, sleep disturbance after the physiological change like loss of
sleep, loss of appetite. In My patient no any suicidal ideation or
negative thought and mood swings .

PAST PSYCHIATRIC AND MEDICAL HISTORY

Past having past psychiatric illness was admitted in sunshine
hospital due to the some condition like headache, sleep
disturbance, irrelevant talk for admitted that time the condition is
multiple psychiatric disorder and BMD

HISTORY TAKING 4
NAME: Dilbahadur Bhikhu bhai
AGE: 22year
SEX: Male
RELIGION: Hindu
MARITAL STATUS: Unmarried
AADRESS : nana Varachha area, Surat
EDUCATION: 2nd standard pass
OCCUPATION: diamond worker
INCOME: 5000/- month
RELIGION: Hindu
REG.NO: 3256
WARD: Male psychiatric ward
DATE OF ADMISSION: 16/12/2022
LANGUAGE KNOWN: Gujarati
NATIONALITY: Indian
DIAGNOSIS: Schizophrenia
SOURCE OF INFORMATION: Father
CHIEF COMPLAINT
My patient was admitted in sunshine hospital, Surat. She had a
chief complain of headache, sleep disturbance, sadness of mood,
anxiety and loss of appetite and some work repeated like
handwashing
HISTORY OF PATIENT ILLNESS
he is admitted in the sunshine hospital in female psychiatric ward.
Patient was last well before 3year. Before 3 year the earliest
symptoms of illness are seen in patient like headache, irrelevant
talk, sleep disturbance after the physiological change like loss of
sleep, loss of appetite. In My patient no any suicidal ideation or
negative thought.

PAST PSYCHIATRIC AND MEDICAL HISTORY

Past having past psychiatric illness was admitted in sunshine
hospital due to the some condition like headache, sleep
disturbance, irrelevant talk for admitted that time the condition is
multiple psychiatric disorder and convulsion reaction
 HISTORY TAKING 5
NAME: Bhura bhai
AGE: 50year
SEX: Male
RELIGION: Hindu
MARITAL STATUS: married
ADDRESS : Aamroli, Surat
EDUCATION: 5th standard pass
OCCUPATION: farmer
INCOME: 5000/- month
RELIGION: Hindu
REG.NO: 26546
WARD: Male psychiatric ward
DATE OF ADMISSION: 18/2/2022
LANGUAGE KNOWN: Gujarati
NATIONALITY: Indian
DIAGNOSIS: bipolar mood disorder
SOURCE OF INFORMATION: Family member
CHIEF COMPLAINT
My patient was admitted in sunshine hospital, Surat. She had a
chief complain of headache, sleep disturbance, sadness of mood,
anxiety and loss of appetite.
HISTORY OF PATIENT ILLNESS
he is admitted in the sunshine hospital in female psychiatric ward.
Patient was last well before 2year. Before 2 year the earliest
symptoms of illness are seen in patient like headache, irrelevant
talk, sleep disturbance after the physiological change like loss of
sleep, loss of appetite. In My patient no any suicidal ideation or
negative thought.

PAST PSYCHIATRIC AND MEDICAL HISTORY

Past having past psychiatric illness was admitted in sunshine
hospital due to the some condition like headache, sleep
disturbance, irrelevant talk for admitted that time the condition is
multiple psychiatric disorder and convulsion reaction.

HISTORY TAKING 6
NAME: Vishwa Patel
AGE: 22year
SEX: female
RELIGION: Hindu
MARITAL STATUS: Unmarried
AADRESS :- Vesu area, Surat
EDUCATION: 12th standard pass
OCCUPATION: worker
INCOME: 15000/- month
RELIGION: Hindu
REG.NO: 3451
WARD: female psychiatric ward
DATE OF ADMISSION: 12/5/2022
LANGUAGE KNOWN: Gujarati & Hindi
NATIONALITY: Indian
DIAGNOSIS: bipolar effective disorder
SOURCE OF INFORMATION: mother
CHIEF COMPLAINT
My patient was admitted in sunshine hospital, Surat. She had a
chief complain of headache, sleep disturbance, sadness of mood,
anxiety and loss of appetite.
HISTORY OF PATIENT ILLNESS
She is admitted in the sunshine hospital in female psychiatric ward.
Patient was last well before 3year. Before 3 year the earliest
symptoms of illness are seen in patient like headache, irrelevant
talk, sleep disturbance after the physiological change like loss of
sleep, loss of appetite. In My patient no any suicidal ideation or
negative thought.

PAST PSYCHIATRIC AND MEDICAL HISTORY

Past having past psychiatric illness was admitted in sunshine
hospital due to the some condition like headache, sleep
disturbance, irrelevant talk for admitted that time the condition is
multiple psychiatric disorder and convulsion reaction.

HISTORY TAKING 7
NAME: Aryan Singh
AGE: 10 year
SEX: Male
RELIGION: Sikh
MARITAL STATUS: Unmarried
ADDRESS : Sarthana Surat
EDUCATION: 6th standard
OCCUPATION: Student
INCOME: nil
REG.NO: 3410
WARD: ward
DATE OF ADMISSION: 18/09 /2022
LANGUAGE KNOWN: Gujarati & Hindi , Punjabi
NATIONALITY: INDIAN
DIAGNOSIS: Autism
SOURCE OF INFORMATION : father
CHIEF COMPLAINT
My patient was admitted in sunshine hospital, Surat.he had a chief
complain of headache, sleep disturbance, sadness of mood, anxiety
and loss of appetite.
HISTORY OF PATIENT ILLNESS
he is admitted in the sunshine hospital in female psychiatric ward.
Patient was last well before 1year. Before 1 year the earliest
symptoms of illness are seen in patient like headache, irrelevant
talk, sleep disturbance after the physiological change like loss of
sleep, loss of appetite. In My patient no any suicidal ideation or
negative thought.

PAST PSYCHIATRIC AND MEDICAL HISTORY

Past having past psychiatric illness was admitted in sunshine
hospital due to the some condition like headache, sleep
disturbance, irrelevant talk for admitted that time the condition is
multiple psychiatric disorder and convulsion reaction.

HISTORY TAKING 8
NAME: Arti ben Mahesh bhai Gohil
AGE: 38year
SEX: female
RELIGION: Hindu
MARITAL STATUS: married
ADDRESS : athva lines, police residence, Surat
EDUCATION: 6th pass
OCCUPATION: house wife
INCOME: nil
REG.NO: 319886
WARD: female psychiatric ward
DATE OF ADMISSION: 15/12/2022
LANGUAGE KNOWN: Gujarati
NATIONALITY: Indian
DIAGNOSIS: Major depressive disorder
SOURCE OF INFORMATION: own

INFORMANT DATA
NAME: Kanu bhai
AGE: 45year
SEX: male
RELATIONSHIP WITH PATIENT: husband
LENGTH OF STAY WITH PATIENT: 16year
RELIABILITY OF INFORMATION: reliable
CONCERN WITH THE PATIENT: Good
ADEQUACY & CONSISTENCY OF INFORMATION: Adequate

CHIEF COMPLAINT
My patient Arti ben was admitted in sunshine hospital, Surat. She
had a chief complain of headache, sleep disturbance, sadness of
mood, anxiety and loss of appetite.
HISTORY OF PATIENT ILLNESS
My Patient name is Arti ben Gohil. She is admitted in the sunshine
hospital in female psychiatric ward. Patient was last well before
3year. Before 3 year the earliest symptoms of illness are seen in
patient like headache, irrelevant talk, sleep disturbance after the
physiological change like loss of sleep, loss of appetite. In My
patient no any suicidal ideation or negative thought.

PAST PSYCHIATRIC AND MEDICAL HISTORY

Past having past psychiatric illness was admitted in sunshine
hospital due to the some condition like headache, sleep
disturbance, irrelevant talk for admitted that time the condition is
multiple psychiatric disorder and convulsion reaction.
 HISTORY TAKING 9
NAME: Harkaur singh
AGE: 30
SEX: male
RELIGION: Sikh
MARITAL STATUS: married
ADDRESS : Sarshana gam, surat
EDUCATION: Graduated
OCCUPATION: Teacher
INCOME: 20,000/
REG.NO: 1255
WARD: male psychiatric ward
DATE OF ADMISSION: 11/10/2022
LANGUAGE KNOWN: Hindi, Gujarati and English
NATIONALITY: INDIAN
DIAGNOSIS: Psychosis
SOURCE OF INFORMATION: wife

CHIEF COMPLAINT
The patient come to the hospital with chief complaints suspicious
behaviour, aggressiveness, anxiety , fear, anger since 6 months.
PRESENT ILLNESS
The patient have 40min changes episode symptoms like changes in
behaviour & mood swings. Unaware about the situation.
 MENTAL STATUS EXAMINATION 1

GENERAL APPEARANCE & BEHAVIOUR

 BODY BUILD: mild
 GROOMING: Well dressed
 FACIAL EXPRESSION: sad
 ATTITUDE TOWARDS THE EXAMINER: co-operative
 COMPREHENSION: Intact
 GAIT & POSTURE: Normal
 PSYCHOMOTOR ACTIVITY: decreased
 SOCIAL MANNER & NON-VERBAL BEHAVIOUR: normal
 RAPPORT: Good
 HALLUCINATORY BEHAVIOUR: Not present
SPEECH
 RATE & QUANTITY OF SPEECH: moderate & Spontaneous
 TONE OF SPEECH: normal but sometime high pitch of speech
 FLOW & RHYTHM OF SPEECH: Adequate

MOOD & AFFECT

 Subjective mood:
Nurse: How are you feel now?
Patient: I am good
 OBJECTIVE MOOD:
NURSE: patient is looking sad
Inference: appropriate

THOUGHT
 STREAM & FORM OF THOUGHT:
STREAM: Decreased the productivity of thought, no flight of idea,
thought blocking present
Form: loosening of association
CONTENT OF THOUGHT: no any specific phobia present patient
having ideas of hopelessness.

PERCEPTION:
 Hallucination: present
 Illusion: Not present
 Depersonalization: Not present

COGNITION
 CONCIOUSNESS: Conscious
 Orientation:
Time: oriented
Place: oriented
Person: not oriented
ATTENTION
NURSE: Tell forward number 1-10
PATIENT: 1,2,3,4,5,6,7,8,9,10
NURSE: tell backward number 10-1
PATIENT: 10,9,8,7,6,5,4,3,2,1
INFERENCE: Intact

CONCENTRATION

NURSE: tell 100-5

Patient: 95
Nurse: 95-5
Patient: 90
Inference: Intact

MEMORY
 IMMEDIATE MEMORY
NURSE: Tell about no 3,6,5,8
PATIENT: read 3,6,5,8
Inference: intact
 Recent memory
NURSE: what you taken in lunch
PATIENT: dal & rice
Inference: intact
 REMOTE MEMORY
NURSE: do you remember your birth date?
PATIENT: I don’t know
INFERENCE: impaired
INTELLIGENT MEMORY
NURSE: what is a name of our chief minister?
PATIENT: I don’t know
INFERENCE: Impaired

ABSTRACT THINKING
 INTERACTION OF PROVERB
NURSE: tell me meaning of samp tya jamp
PATIENT: I don’t know
INFERENCE: impaired
 SIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell similarity between car & bike
PATIENT: both are use for travelling
INFERENCE: intact
 DISSIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell me dissimilarity between car & bike
PATIENT: car is 4 wheeler & bike is 2 wheeler
INFERENCE: intact

JUDGEMENT
 PERSONAL JUDGEMENT
NURSE: where will you go after discharge?
PATIENT: I go to meet my friend
INFERENCE: intact
  SOCIAL JUDGEMENT
NURSE: how will you celebrate your birthday?
PATIENT: I don’t know
INFERENCE: impaired
 TEST JUDGEMENT
NURSE: if fire will occur what will you do?
PATIENT: I called a fire brigade
INFERENCE: intact

INSIGHT
NURSE: do you know why are you admitted in the hospital?
PATIENT: I have some problem like continue sad mood.
INFERENCE : intact

MENTAL STATUS EXAMINATION 2

GENERAL APPEARANCE & BEHAVIOUR

 BODY BUILD: moderate
 GROOMING: Well dressed
 FACIAL EXPRESSION: confuse
 ATTITUDE TOWARDS THE EXAMINER: co-operative
 COMPREHENSION: Intact
  GAIT & POSTURE: Normal
 PSYCHOMOTOR ACTIVITY: decreased
 SOCIAL MANNER & NON-VERBAL BEHAVIOUR: normal
 RAPPORT: Good
 HALLUCINATORY BEHAVIOUR: Not present
SPEECH
 RATE & QUANTITY OF SPEECH: slow & Spontaneous
 TONE OF SPEECH: normal but sometime low pitch of speech
 FLOW & RHYTHM OF SPEECH: Adequate

MOOD & AFFECT

 Subjective mood:
Nurse: How are you feel now?
Patient: I am good
 OBJECTIVE MOOD:
NURSE: patient is looking happy
Inference: appropriate

THOUGHT
 STREAM & FORM OF THOUGHT:
STREAM: Decreased the productivity of thought, no flight of idea,
thought blocking present
Form: loosening of association
CONTENT OF THOUGHT: no any specific phobia present patient
having ideas of hopelessness.
PERCEPTION:
 Hallucination: Not present
 Illusion: Not present
 Depersonalization: Not present

COGNITION
 CONCIOUSNESS: Conscious
 Orientation:
Time: oriented
Place: oriented
Person: oriented
ATTENTION
NURSE: Tell forward number 1-10
PATIENT: 1,2,3,4,5,6,7,8,9,10
NURSE: tell backward number 10-1
PATIENT: not tell
INFERENCE: Impaired

CONCENTRATION

NURSE: tell 100-5

Patient: 95
Nurse: 95-5
Patient: 92
Inference: Impaired
MEMORY
 IMMEDIATE MEMORY
NURSE: Tell about no 3,6,5,8
PATIENT: read 3,6,5,8
Inference: intact
 Recent memory
NURSE: what you taken in lunch
PATIENT: dal & rice
Inference: intact
 REMOTE MEMORY
NURSE: do you remember your birth date?
PATIENT: I don’t know
INFERENCE: impaired
INTELLIGENT MEMORY
NURSE: what is a name of national bird?
PATIENT: I don’t know
INFERENCE: Impaired

ABSTRACT THINKING
 INTERACTION OF PROVERB
NURSE: meaning of teat for tat
PATIENT: which means that we done with other like they do with
me
INFERENCE: intact
 SIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell similarity between apple & tomato
PATIENT: both are eatable
INFERENCE: intact
 DISSIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell me dissimilarity between apple & tomato
PATIENT: apple is fruit & tomato is vegetable
INFERENCE: intact

JUDGEMENT
 PERSONAL JUDGEMENT
NURSE: where will you go after discharge?
PATIENT: I go to home
INFERENCE: intact
 SOCIAL JUDGEMENT
NURSE: how will you celebrate your child’s birthday?
PATIENT: I don’t know
INFERENCE: impaired
 TEST JUDGEMENT
NURSE: if fire will occur what will you do?
PATIENT: I called a fire brigade
INFERENCE: intact
INSIGHT
NURSE: do you know why are you admitted in the hospital?
PATIENT: I have some problem like continue sad mood.
INFERENCE: intact

MENTAL STATUS EXAMINATION 3

GENERAL APPEARANCE & BEHAVIOUR

 BODY BUILD: moderate
 GROOMING: Well dressed
 FACIAL EXPRESSION: confuse
 ATTITUDE TOWARDS THE EXAMINER: co-operative
 COMPREHENSION: Intact
 GAIT & POSTURE: Normal
 PSYCHOMOTOR ACTIVITY: decreased
 SOCIAL MANNER & NON-VERBAL BEHAVIOUR: normal
 RAPPORT: Good
 HALLUCINATORY BEHAVIOUR: Not present
SPEECH
 RATE & QUANTITY OF SPEECH: slow & Spontaneous
 TONE OF SPEECH: normal but sometime low pitch of speech
 FLOW & RHYTHM OF SPEECH: Adequate
MOOD & AFFECT
 Subjective mood:
Nurse: How are you feel now?
Patient: I am good
 OBJECTIVE MOOD:
NURSE: patient is looking happy
Inference: appropriate

THOUGHT
 STREAM & FORM OF THOUGHT:
STREAM: Decreased the productivity of thought, no flight of idea,
thought blocking present
Form: loosening of association
CONTENT OF THOUGHT: no any specific phobia present patient
having ideas of hopelessness.

PERCEPTION:
 Hallucination: Not present
 Illusion: Not present
 Depersonalization: Not present

COGNITION
 CONCIOUSNESS: Conscious
 Orientation:
Time: oriented
Place: oriented
Person: oriented
ATTENTION
NURSE: Tell forward number 1-10
PATIENT: 1,2,3,4,5,6,7,8,9,10
NURSE: tell backward number 10-1
PATIENT: not tell
INFERENCE: Impaired

CONCENTRATION

NURSE: tell 100-5

Patient: 95
Nurse: 95-5
Patient: 92
Inference: Impaired

MEMORY
 IMMEDIATE MEMORY
NURSE: Tell about no 3,6,5,8
PATIENT: read 3,6,5,8
Inference: intact
 Recent memory
NURSE: what you taken in lunch
PATIENT: dal & rice
Inference: intact
 REMOTE MEMORY
NURSE: do you remember your birth date?
PATIENT: I don’t know
INFERENCE: impaired
INTELLIGENT MEMORY
NURSE: what is a name of national animal?
PATIENT: I don’t know
INFERENCE: Impaired

ABSTRACT THINKING
 INTERACTION OF PROVERB
NURSE: meaning of teat for tat
PATIENT: which means that we done with other like they do with
me
INFERENCE: intact
 SIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell similarity between mango & tomato
PATIENT: both are eatable
INFERENCE: intact
 DISSIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell me dissimilarity between mango & tomato
PATIENT: mango is fruit & tomato is vegetable
INFERENCE: intact

JUDGEMENT
 PERSONAL JUDGEMENT
NURSE: where will you go after discharge?
PATIENT: I go to home
INFERENCE: intact
 SOCIAL JUDGEMENT
NURSE: how will you celebrate your child’s birthday?
PATIENT: I don’t know
INFERENCE: impaired
 TEST JUDGEMENT
NURSE: if fire will occur what will you do?
PATIENT: I called a fire brigade
INFERENCE: intact

INSIGHT
NURSE: do you know why are you admitted in the hospital?
PATIENT: I have some problem like continue sad mood.
INFERENCE : intact

MENTAL STATUS EXAMINATION 4

GENERAL APPEARANCE & BEHAVIOUR
 BODY BUILD: moderate
 GROOMING: Well dressed
 FACIAL EXPRESSION: confuse
 ATTITUDE TOWARDS THE EXAMINER: co-operative
 COMPREHENSION: Intact
 GAIT & POSTURE: Normal
 PSYCHOMOTOR ACTIVITY: decreased
 SOCIAL MANNER & NON-VERBAL BEHAVIOUR: normal
 RAPPORT: Good
 HALLUCINATORY BEHAVIOUR: Not present
SPEECH
 RATE & QUANTITY OF SPEECH: slow & Spontaneous
 TONE OF SPEECH: normal but sometime low pitch of speech
 FLOW & RHYTHM OF SPEECH: Adequate

MOOD & AFFECT

 Subjective mood:
Nurse: How are you feel now?
Patient: I am good
 OBJECTIVE MOOD:
NURSE: patient is looking happy
Inference: appropriate

THOUGHT
 STREAM & FORM OF THOUGHT:
STREAM: Decreased the productivity of thought, no flight of idea,
thought blocking present
Form: loosening of association
CONTENT OF THOUGHT: no any specific phobia present patient
having ideas of hopelessness.

PERCEPTION:
 Hallucination: Not present
 Illusion: Not present
 Depersonalization: Not present

COGNITION
 CONCIOUSNESS: Conscious
 Orientation:
Time: oriented
Place: oriented
Person: oriented
ATTENTION
NURSE: Tell forward number 1-10
PATIENT: 1,2,3,4,5,6,7,8,9,10
NURSE: tell backward number 10-1
PATIENT: not tell
INFERENCE: Impaired

CONCENTRATION

NURSE: tell 100-5

Patient: 95
Nurse: 95-5
Patient: 92
Inference: Impaired

MEMORY
 IMMEDIATE MEMORY
NURSE: Tell about no 3,6,5,8
PATIENT: read 3,6,5,8
Inference: intact
 Recent memory
NURSE: what you taken in lunch
PATIENT: dal & rice
Inference: intact
 REMOTE MEMORY
NURSE: do you remember your birth date?
PATIENT: I don’t know
INFERENCE: impaired
INTELLIGENT MEMORY
NURSE: what is a name of national bird?
PATIENT: I don’t know
INFERENCE: Impaired

ABSTRACT THINKING
 INTERACTION OF PROVERB
NURSE: meaning of teat for tat
PATIENT: which means that we done with other like they do with
me
INFERENCE: intact
 SIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell similarity between pineapple & potato
PATIENT: both are eatable
INFERENCE: intact
 DISSIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell me dissimilarity between pineapple & potato
PATIENT: pineapple is fruit & potato is vegetable
INFERENCE: intact

JUDGEMENT
 PERSONAL JUDGEMENT
NURSE: where will you go after discharge?
PATIENT: I go to home
INFERENCE: intact
 SOCIAL JUDGEMENT
NURSE: how will you celebrate your birthday?
PATIENT: I celebrated my birthday
INFERENCE: intact
 TEST JUDGEMENT
NURSE: if someone bully the girl will occur what will you do?
PATIENT: I called a police
INFERENCE: intact

INSIGHT
NURSE: do you know why are you admitted in the hospital?
PATIENT: I have some problem like continue sad mood.
INFERENCE : intact

MENTAL STATUS EXAMINATION 5

GENERAL APPEARANCE & BEHAVIOUR
 BODY BUILD: moderate
 GROOMING: Well dressed
 FACIAL EXPRESSION: confuse
 ATTITUDE TOWARDS THE EXAMINER: co-operative
 COMPREHENSION: Intact
 GAIT & POSTURE: Normal
 PSYCHOMOTOR ACTIVITY: decreased
 SOCIAL MANNER & NON-VERBAL BEHAVIOUR: normal
 RAPPORT: Good
 HALLUCINATORY BEHAVIOUR: Not present
SPEECH
 RATE & QUANTITY OF SPEECH: slow & Spontaneous
 TONE OF SPEECH: normal but sometime low pitch of speech
 FLOW & RHYTHM OF SPEECH: Adequate

MOOD & AFFECT

 Subjective mood:
Nurse: How are you feel now?
Patient: I am good
 OBJECTIVE MOOD:
NURSE: patient is looking happy
Inference: appropriate

THOUGHT
 STREAM & FORM OF THOUGHT:
STREAM: Decreased the productivity of thought, no flight of idea,
thought blocking present
Form: loosening of association
CONTENT OF THOUGHT: no any specific phobia present patient
having ideas of hopelessness.

PERCEPTION:
 Hallucination: Not present
 Illusion: Not present
 Depersonalization: Not present

COGNITION
 CONCIOUSNESS: Conscious
 Orientation:
Time: oriented
Place: oriented
Person: oriented
ATTENTION
NURSE: Tell forward number 1-10
PATIENT: 1,2,3,4,5,6,7,8,9,10
NURSE: tell backward number 10-1
PATIENT: not tell
INFERENCE: Impaired

CONCENTRATION
NURSE: tell 100-5
Patient: 95
Nurse: 95-5
Patient: 92
Inference: Impaired

MEMORY
 IMMEDIATE MEMORY
NURSE: Tell about no 3,6,5,8
PATIENT: read 3,6,5,8
Inference: intact
 Recent memory
NURSE: what you taken in lunch
PATIENT: dal & rice
Inference: intact
 REMOTE MEMORY
NURSE: do you remember your birth date?
PATIENT: I don’t know
INFERENCE: impaired
INTELLIGENT MEMORY
NURSE: what is a name of national bird?
PATIENT: I don’t know
INFERENCE: Impaired
ABSTRACT THINKING
 INTERACTION OF PROVERB
NURSE: meaning of teat for tat
PATIENT: which means that we done with other like they do with
me
INFERENCE: intact
 SIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell similarity between parrot and butterfly?
PATIENT: both can fly
INFERENCE: intact
 DISSIMILARITY BETWEEN PAIRED OBJECT
NURSE: tell me dissimilarity between rabbit & parrot?
PATIENT: rabbit is animal & parrot is bird
INFERENCE: intact

JUDGEMENT
 PERSONAL JUDGEMENT
NURSE: where will you go after discharge?
PATIENT: I go to home
INFERENCE: intact
 SOCIAL JUDGEMENT
NURSE: how will you celebrate your anniversary?
PATIENT: I don’t know
INFERENCE: impaired
 TEST JUDGEMENT
NURSE: if fire will occur what will you do?
PATIENT: I called a fire brigade
INFERENCE: intact

INSIGHT
NURSE: do you know why are you admitted in the hospital?
PATIENT: I have some problem like continue sad mood.
INFERENCE : intact

VISIT TO CHARITABLE - OLD AGE HOME,KIM CHAR RASTA,SURAT

We F.Y.M.Sc. Nursing students of OBG Speciality got appointment to visit Charitable Old
Age Home, kim Char Rasta at Surat on 11 th April 2022. We are four students in obstetric and
gynecological nursing Specialty & 3rd year GNM Nursing. We reached there at 10.a.m. We
report to reception office regarding our visit Trustee was present there. He gave warm
welcome to us. He took opportunity to orientate that institute.

OBJECTIVES OF GERIATRIC HOME/HOME AGE HOME CEBTRAL

OBJECTIVE:

After completion of field trip of geriatric home students will be able to acquire knowledge
about geriatric home, its establishment and components and activities performed by geriatric
home.
CONTRIBUTORY OBJECTIVES:

After completion of field trip students will be able to:

1. Explain the concepts of geriatric home.

2. Enumerate the objectives of establishing geriatric home.
3. Know the organization of geriatric home.
4. Describe the health problems/needs of the elderly person.
5. Discuss the principles of geriatric care.
6. Identify the health assessment by multidisciplinary term of elderly person.
7. List the services provided by geriatric home to the elderly person.

VIDHYADEEP COLLEGE OF NURSING,KIM,SURAT

DETAILS OF THE PROGRAMME
SR NO DESCRIPTION
1 PROGRAMME VISIT TO CHARITABE OLD AGE
HOME,KIM CHAR RASTA
2 OBJECTIVES 1. Explain the concepts of geriatric home.
2. Enumerate the objectives of establishing
geriatric home.
3. Know the organization of geriatric home.
4. Describe the health problems/needs of the
elderly person.
5. Discuss the principles of geriatric care.
6. Identify the health assessment by
Multi-disciplinary term of elderly person.
List the services provided by geriatric home
to the elderly person
 3 PROCEDURE/PRACTISE Visit to the old age home to study and acquire
knowledge about geriatric home, its establishment
and components and activities performed by
geriatric home.
4 BENI FICIARIES • Geriatric home clients
• PG and UG students

5 FUNDING Vidhyadeep college

• Transport
• Handmade cards for old people

6 OUTCOME • Learning about the old age home helped students

develop skills and a better attitude toward geriatric
clients
• Helped students to communicate with them and
learn about the importance of Geriatric assessment

7 ACTION TAKEN ON • Implement the objectives in the community

OUTSOME settings
• Plan in a better way how to care for the old age
people in the community

ADMISSSION CRITERIA:
Following criteria are made for admission
1. Person age should be above 60 years
2. Preference should be given to those who are unmarried, having no issues after
marriage.
3. Those are having only daughter and no son
4. Rejection from home when their children go out from country.
5. Those who are having 2-4 sons but no one is ready to keep their parents with them,
and do physical and mental torture, Quarrel for sampati or in any condition both
parents are living and separating them among sons. No love from son.
DAILY ACTIVITIES:
TIME ACTIVITY

7:00 a.m Prayer

8:00 a.m Breakfast — Coffee, tea and some light snakes

 8:30 a.m- 11:00 Performance of daily activity — like cleaning, gardening, ladies
a.m will help in kitchen ect.

11:00 a.m Lunch Break

11:45 -2:45p.m Time for Tea

3.15 p.m Bazaar — They will go for some shopping out of home

4:00 p.m-6 p.m Visiting Time

6:00 p.m Dinner

7:00 p.m Time for recreation- they watch Television

9:00 p.m They go to sleep

OBJECTIVES FOR MAKING OLD AGE HOME

1. No lesson in society like shravan who cared for his blind parents.
2. NJ proper values in family or in society about respect and care of parents, as well as
responsibility of children towards their parents.
3. No proper guidance from parents of girl child at time of marriage about respect and
care of In- laws and their family.
4. Previously marriage partners were selected by parents which gave opportunity for
joint family. But now no parents selection , means single family.
Above all reasons make community to build Old Age Home for rejected, Neglected patents.
 Above all activities are performed by member of Old age Home.
 At Tuesday and Saturday doctor use to come for routine check — up
 There is also a provision of dispensary at institution
 In case of seriously ill person are hospitalized at Surat civil Hospital
 Relatives are informed about hospitalization.
 In case of no relatives than male attendant will remain with male patient and vice a
versa.
 If any person die and no relatives are there., then funeral will be done by CW institution
according to the religion of dead person.
 There is provision of work also for those are capable of doing. e.g - Hath sal by which
Dusters are made and kept for sale. Profit amount will be given to those who made it.
Which give them self- independence feeling till death.
 There is a Cultural Hall which are made to facilitate recreation to all members by
organizing different Programmes, like Drama, Jokes, Mimicry show, Q. Antakshary
programmeect.
 There are also facility for physiotherapy for exercises, which make them CFT) healthy
and active.
 Library facility is also available for reading religious and social books.
 All religious festivals are going to be celebrate here, also celebration of cy, Oct National
Day.
 Different games are going to be played here in Sports Day- like Musical chair,Lemoon
spoon ect.
 Navratri festival is celebrated very nicely.
 Three-Four times in a year all members got opportunity to go out for picnic
 At 2-3 months they are took for outing like watching social movie , Drama, Water park
ect.
Above all facilities, work and activities are looked after by Managing trustee.

At 12.45 p.m. We departed for place. It was very nice experience, which realize us
our responsibility towards our family as well as our society.