Saint Francis of Assisi College • ROLE PLAY

School of Nursing o A situation in which participants enact

a role

CONCEPTS IN PSYCHIATRIC NURSING

COMMON BEHAVIORAL SIGNS AND SYMPTOMS

Disturbance in perception:
A. MENTAL HEALTH – Normal/ Maintain
B. MENTAL ILL HEALTH – Illness 1. ILLUSION

BOTH A SCIENCE AND ART - Misperception of an actual external stimuli

Interpersonal process whereby the professional nurse - (+) stimuli (-) wrong interpretation
practitioner through the therapeutic use of self, assist an
2. HALLUCINATION
individual family, group, or community to promote mental
health, to prevent mental illness and suffering, to - False sensory perception in the absence of
participate in the treatment and rehabilitation of the external stimuli
mental health if necessary to find meaning in this
experience. - (-) stimuli, False perception

Main tool of the Nurse - Visual – seeing

• Therapeutic use of self - Tactile – feeling that there are some insects
crawling on the skin
Core of Psychiatric Nursing
DISTURBANCES IN THINKING
• Interpersonal process
1. NEOLOGISM
Clientele: – Pathologic coining of words
2. CIRCUMSTANTIALITY
• Community, Family and individuals
– Over inclusion of details incoherent mixture
• Both mentally healthy and mentally ill
of words and phrases
Use of Self 3. WORD SALAD
– Incoherent mixture of words and phrases
• Therapeutic use of self – positive use of 4. VERBGERATION
oneself in the process of therapy - Incoherent mixture of words or phrases
• It requires self-awareness. 5. PERSEVERATION
• Basic principles – Persistence of a response to previous
• Basis: Joharis Window questions
6. ECHOLALIA
– Pathological repetition of words
METHODS USED TO INCREASE SELF-AWARENESS
7. FLIGHT OF IDEAS
• INTROSPECTION – Shifting from one topic from one to the next
o Viewing one’s self as honestly as in a somewhat related
possible 8. LOOSENESS OF ASSOCIATION
• DISCUSSION - Shifting of a topic from one subject to
o Learning about oneself through another in a completely unrelated way
association with others. 9. DELUSION
• ENLARGING ONE’S EXPERIENCE: – False belief which is inconsistent with one’s
o Engage in a particular activity and knowledge and culture
noting one’s reaction to it.
 DISTURBANCES OF AFFECT 5. DÉJÀ VU

1.INAPPROPRIATE AFFECT - Feeling of having been to a place which one has not
yet visited
- Disharmony between the stimuli and the emotional
reaction 6. JAMAIS VU

2. BLUNTED AFFECT - Feeling of having been to a place which one has

visited before
- Severe reduction in emotional reaction

3. FLAT AFFECT
COMMON PROBLEMS AFFECTING NPR
- Absence or near absence of emotional reaction
1. TRANSFERENCE
4. APATHY AFFECT
- The development of an emotional attitude of the
- Dulled emotional tone patient either positive or negative towards the
nurse.
5. AMBIVALENCE
2. RESISTANCE
- Presence of two opposing feelings
- Development of ambivalent feelings towards self-
6. DEPRESONALIZATION exploration.
- Feeling of strangeness towards one’s self 3. COUNTER TRANSFERENCE
7. DEREALIZATION - As experienced by the nurse
– Feeling of strangeness toward the environment

DISTURBANCES IN MOTOR ACTIVITY CHARACTERISTICS OF A PSYCHIATRIC NURSE

1. ECHOPRAXIA 1. EMPATHY
- The pathological imitation of posture/action of - The ability to see beyond outward behaviour and
others sense accurately another person’s inner experience.
2. WAXY FLEXIBILITY 2. GENUINENESS/CONGRUENCE
- Maintaining the desired position for long periods of - ability to use therapeutic tools appropriately.
time without discomfort
3. UNEMOTIONAL POSITIVE REGARD

- Respect
DISTURBANCES IN MEMORY

1. CONFABULATION
STANDARDS OF PSYCHIATRIC MENTAL HEALTH
- filling in of memory gaps CLINICAL NURSING PRACTICE
2. AMNESIA Ø STANDARD I. Assessment
- Inability to recall past events Ø STANDARD II. Diagnosis
Ø STANDARD III. Outcome Identification
3. ANTEROGRADE AMNESIA Ø STANDARD IV. Planning
- Loss of memory of the immediate past Ø STANDARD V. Implementation
Ø STANDARD Va. Counseling
4. RETROGRADE AMNESIA Ø STANDARD Vb. Milieu Therapy
- Loss of memory of the distant past
SELF-AWARENESS
§ Recognizing your own attitudes, feelings, and
beliefs.
§ Knowing yourself so that this will not affect
nursing care.
§ In this process, one should have time to focus
on his own feelings and values.
RECOMMENDATIONS
§ Look for alternative beliefs
§ Be clinically supervised
§ Communicate with a trusted individual
§ Have a diary
§ memory loss; Filling in the memory gaps with
LEVELS OF INTERVENTIONS IN PSYCH NURSING
1. Primary – Interventions aimed at the
promotion of mental health and lowering the
rate of cases by altering the stressors
2. Secondary – Interventions that limits the
severity of a disorder
2 Components : 1. Case Finding, 2. Prominent
Acting Out
– The active expression of emotions through
actions, not words, that occurs when the client
relieves the feelings, wishes or conflicts that are
operating unconsciously.
Affect
– The emotion or mood an individual show as
response, such as flat affect or inappropriate
affect
Ambivalence
– The simultaneous presence of strong, but
contradictory or opposite, feelings or idea about
something or someone
Anxiety
- Fear or apprehension caused by an unknown or
unrecognized threats
Autism
- A syndrome involving abdominal sensory
perceptions and develops mental ( usually
language and psychosocial issues )
Body image
- One’s perception of one’s body
Catatonic State – immobility
Cohesiveness – Group togetherness
Compulsion – Emotional urge or need to act
Confabulation – A compensatory mechanism for
imaginary stories the teller believes to be true
Confusion – Mental bewilderment from
disorientation
Grief – An emotional response to a recognized
loss
Group therapy – Application of psychotherapy
techniques by a skilled leader to a group of
clients
Hallucinations – False sensory perceptions
including any of the senses
Hostility – Feeling similar to anger but of longer
duration
Ideas of reference – ideas stemming from the
incorrect interpretation of incidents are referring
directly to self
Loose of Association – ideas appear unrelated or
only slightly related
Mania – Elated, excited mood state
Manipulation – Control of another’s behaviors for
one’s own purposes
Neologism – Coined word with special meaning to
the user
Obsession – Repetitive, uncontrollable thought
Paranoid – Suspicion, Mistrust, without a basis in
reality
Phobia – Irrational Fear
Premorbid – Occurring before development o f a
disease
Psychosis – State in which there is impairment in
a person’s ability to recognized reality,
communicate and relate to others appropriately
Secondary Cains – Benefits from being ill, such as
attention
Self esteem – The degree of feeling worthwhile or
valued
Somatic Therapy – Treatment of the emotionally
ill by physiological means

Resistance – Opposition to uncovering Stereotyped Behavior – Persistent repetition of

unconscious maternal speech or motor activity

Role – Pattern of behavior

Crisis – A conflict that control readily, be resolved ANTI PSYCHOTIC DRUGS

by using usual coping mechanisms
MAOIs – Monoamin Oxidase Inhibitor
Defense Mechanisms – Mental strategies used to
SSRIs – Selective Serotonin Septate Inhibitor
help cope with area of conflict

Delirium Tremens – Alcohol withdrawal

syndrome, including restless continuing to
disorientation, hallucinations, and convulsions

Delusions – A fixed false idea

Denial – Unconscious refusal to acknowledge

that which is anxiety provoking

Desenization – Gradual systematic exposure of

the client to fear situation under controlled
conditions

Echolalia – Repetition by one person of what is

said by another person

Echopraxia – A meaningless imitation of

movement

Empathy – Objective and insightful awareness of

another’s feelings

Extrapyramidal Reaction – A reversible side effect

of some psychotropic drugs characterized by
muscle rigidity, restlessness shuffling gait and
blurred vision

Family Therapy – Treatment that involves the

family and explores the relationship among the
members

Fantasy – Day dreams

Flight of Ideas – Rapid shift from an ideas to

another before the first idea has been concluded