Schizophrenia as a kind of disease that affects the brain - Essay Example

? Case Study al affiliation Case Study Schizophrenia is a kind of disease that affects the brain. The disease is chronic and has been indicated to cause adverse effects on the brain. Research indicates that almost one percent of every American suffers from the disease. Though the disease affects both affects both men and women at the same rate, it seems to be more rampant in men than women, and it appears earlier in men than women. Patients who suffer from the disease seem to have several symptoms such hearing internal voices, at times they believe that people are reading their mind. These symptoms leave the patients withdrawn, because they fear that people want to harm them from time to time (Videbect, 2007). Scientists are on the move to conduct research on how the disease can be treated, and creating new medications that can be applied to treat the ailment. This disease is prevalent in almost all parts of the world and the major systems cause a high degree of disability in the mind. When treatment is conducted and the medicine used as prescribed, it is possible to control the disease and cure it (Borras, et al, 2007).Though there are some people within the community who follow the prescriptions, they fail to get treatment; thus, continue suffering. The side effects of this treatment are troublesome and can even cause discontinuation among the patients (Brown & Susser, 2008). This paper will discuss the evidence based practice of strategies used to treat the disease. In the past treatment strategies developed for treatment and therapy of Schizophrenic disorders, have revealed to clearly reduce the care, clinical and social morbidity and improve the competence of the mind of individual suffering from the disease. Some reviews of the clinical trials prose have fulfilled that every individual with Schizophrenic disorders ought to be provided a blend of an optimal dose of antipsychotics, methods to educate themselves and methods of handling patients more proficiently. Lastly, assertive home-based management to help stop and get to the bottom of major communal needs and crises, including the several of symptoms experience by the individual has been beneficial. Several clinical trials conducted have revealed that every patient should be given the combination of a dose of antipsychotics, strategies that can be used to edify the patient and their care givers on how to cope with the environmental stress and cognitive behavior so as to, reduce the disease symptoms, and to provide home based management to resolve the social needs of the patients. Apart from less evidence based treatment, some medical service providers have used surgeries to control patients in a way that is linked with the best results. An organization knows an optimal treatment project was developed to use evidence based approach to treating Schizophrenia disorders. Promoting the safety of the client and others Since the client is potentially harmful to herself and others, safety should be regarded as the highest priority. Based on the initial assessment performed in the clinic, the client looked paranoid and seemed to be threatened by her new environment. At this moment, it is important that the therapist approach the client in a less threatening manner. Furthermore, the therapist should also be careful not to sound authoritarian as it may increase the client’s stress levels. Space is a vital component to be considered especially in the early phase of interventions (Videbect, 2007). With the status of the client, preemptive measures should include securing a physician’s order for administering medication to control potentially injurious behaviors. Moreover, the therapist should continue to observe signs of escalating aggression such as pacing, kicking, and yelling. A quiet and less stimulating environment may be helpful in calming the client. However, seclusion and other forms of restraints may also be needed in heightened situations. The importance of Promoting the safety of the client and others Schizophrenia disorders affect the brain of most of the patients making them at times react violently to an extent, of fighting with the care givers. It is important, therefore, to provide the care givers an environment that is safe to work, in that it can be used to deal with patients. Clinical trials have used this method in controlling and treating their patients in the health centers. This is done by looking for evidence of aggregation that is likely to occur during treatment periods. Evaluation of this intervention is concurrent and does not end until the client demonstrates full recovery. The therapist should be careful in deciding whether the client has fully achieved a mental status at a functional level. Research has suggested that the clients’ reports of feeling a sense of wellbeing are never an assurance that the risk for self injury has subsided when promotion of safety is provided (Videbect, 2007). Management of medications and side effects Valenstein, et al (2011) indicates that yet another important aspect regarding the establishment and maintenance of safety for the client is the careful monitoring of the adverse effects of medications. Potent psychotropic drugs may affect the organ function, especially the liver and kidneys, of clients on prolonged therapy. BUN and liver enzymes monitoring should be part of the treatment regimen to ensure that the client maintains a safe level of the medication. Other minor side effects like frequent urination, constipation, dry mouth, and photosensitivity may affect the client’s adherence to prescribed therapy. Most patients initiating antipsychotic medications tend to terminate the regimen within the first few months of treatment (Olfson, et al, 2007). Studies have shown that failure to follow the prescribed medications for mental health conditions is the most common cause of relapse of psychotic symptoms and subsequent hospital readmission (Videbect, 2007). With proper adherence to the prescribed therapy, the client is expected to attain a functional recovery and lead a normal life. Actually, the client’s adherence to the prescribed regimen may be facilitated by the therapist in various ways. A pill box with directions of days and hours may help the client remember the schedule independently. The therapist should teach the client to increase fluid intake so as to alleviate constipation, apply sunscreen lotion to prevent sunburns, and consume candy to prevent dry mouth. Importance of Management of medications and side effects Medication side effects are very important to be observed among the patients some of the side effects can easily make the patients stop medication and hence fail to get treatment. Some of the therapy sessions can easily lead to long term side effects such has kidney and lung problems. Evaluation of the effectiveness of the interventions is reflected on the client’s perception of the situation. When the client appropriately reports adherence to medications and the side effects are effectively managed, then the interventions are considered efficient (Olfson, et al, 2007). Otherwise, the therapist may need to consider other factors including cognitive and psychosocial readiness that may have affected the situation. Most of the health institutions manage medications and the side effects occurring as a result of therapeutic sessions. They control the patients making them not to withdraw from treatment. Importance of managing medication and side effects For effective maintenance of medication and side effects, a patient encounters there is the need of conducting a medical follow-up activity. Conducting a medical follow-up is an important activity during the rehabilitation process. Follow-up activities have two most important purposes. Foremost, to check therapeutic observances and second, to regulate the curative level of medications. Research shows that constantly staying with no medication, individuals with Schizophrenia deteriorate at a degree of 60% to 70% in the first years of identification. Stuart & Sundeen (1995) affirm that for individuals who are devoted to their medicine course of therapy, the deterioration percentage is roughly 40%. Hospitalizations, primarily in the form of emergency intervention, are significant in favor of the therapy program. Clients, families, and caregivers are obliged to boast with a series of prepared facts and retrieve to an urgent situation wards, itinerant emergency units, in-patient or sporadically, in times of severe degeneration, as well as long term hospital stay. Awareness that these options are accessible may reduce nervousness and build their application less essential. Establishing a therapeutic relationship Establishing trust between the client and the therapist is vital in the success of the therapeutic interventions. In this case, the client demonstrated only 5 to 10 minutes of initial contact. This client data imply that establishing contact time may take longer. In fact, research suggests that the therapist’s kinesthetic movements like eye contact, posture, and facial expressions are important factors in establishing genuine trust and communication. The therapist provides explanations that are clear, direct, and easy to understand. In one study, it may be appropriate to address the client by name to maintain reality orientation (Videbect, 2007). Alternatively, the psychotherapist should take consideration of the client’s response through the use of touch. Since the client presented paranoid delusions, it may not be appropriate to exaggerate touch. Genuine concern may be shown in other ways such as consistency by the therapist and other members of the mental health team. Meanwhile, the issue of counter transference should be considered. The gradual and progressive attachment of the therapist to the client may result in counter transference. In this case, the therapist may relate to the client’s experience and eventually develop a personally biased judgment of the situation. Hence, self- awareness should be the fundamental intervention to be used by the therapist to prevent counter transference. Sometimes, it may be possible that the therapist would feel a certain degree of frustration when the client fails to follow the therapeutic regimen, or does not show any sign of progress, or even worse. It is also important that the therapist should not take responsibility for the success or failure of treatment efforts or view the client’s status as a personal success or failure. Importance of establishing therapeutic relationships Psychiatric therapy is a most important composition in the rehabilitation program. A schizophrenia patient could be introduced to his or her psychotherapist to talk about numerous topics ranging from treatment, professional issues, investments, family relations and worthiness of life. Keltner (2006) states that the final ambition of psychotherapeutic supervision is to aid the client turn out to be stronger than the symptoms in them. A lot of schizophrenic patients could go for treatment for five years while under pressure without a person to assist them obtain their strengths. Schizophrenics react unsurpassed to psychiatric therapy that is helpful and focuses on their strengths of coping with tough situations. This therapy also deals with analytical skills offering assertion, lasting concern, expectation, and obligation of individuals. Evaluation of this particular intervention should include the analysis of the therapeutic relationship as perceived by the client. While it is possible that the client portrays submissiveness to the interventions presented by the therapist, the relationship should be assessed thoroughly to ensure that it is therapeutic and promote growth. Coping with alterations in thought process The alterations in the thought process are the major features of clients with schizophrenia (Klingberg, et al 2009). With paranoid type schizophrenia, the delusions may be exaggerated and have a common theme of persecution and irrational suspicion thus, helping the client with delusions and hallucinations remain a fundamental element of management. The therapist should avoid reinforcing or openly arguing with the client’s delusions. Instead, it is the therapist’s responsibility to keep the client connected with reality. When the effects of antipsychotic medications become apparent with the client, the therapist may start to discuss the delusional ideas and facilitate ways that the client learns to adapt. Furthermore, delusional thinking and ideas of reference may be minimized by some techniques like distraction, positive conversation, and ignoring of delusional ideas. Effective conversations with the client facilitate the therapist’s understanding of the situation. At times, it may also be possible for the therapist to determine certain situations that precipitate the onset of delusions and hallucinations. Current researches in mental health suggest that certain situations promote delusional thinking in mentally disturbed individuals. Rational for Coping with alterations in thought process Specifically, the therapist should consider the client’s command hallucinations and explore its contents as deemed possible. It is possible that the client listens to voices that instruct them to perform self- destructive behaviors. When this happens, the client must be instructed to divert attention to activities that promote and maintain reality orientation like playing cards or listening to the radio. It is important that the client not to feel being ridiculed with the interventions suggested by the therapist. Schizophrenia makes an individual develop mutilation of social skills, loss of ideas, and regular, suspicion. The consequence is repeated and vigorously social evading. Peer relations are significant to ordinary teenager growth. Teenagers with schizophrenia may perhaps require help in humanizing their communal skills and associating with peer groups. Some teenagers getting better from a sharp psychotic incident and hospitalization might be victorious at associating with elderly acquaintances. Others find it easier to communicate to peers who possess some knowledgeable cerebral ill health. Socialization might be helped by sharing in common skills education groups, psychiatric activities, or prearranged communal actions in the society. Evaluation of this intervention involves repeated assessments about the client’s mental status. While it may not be realistic to assume that the client will learn to adapt to the delusions at a short time, the therapist should continuously follow- up the client’s progress patiently. Promoting adequate nutrition and proper hygiene Meeting physiological needs like proper nutrition, proper hygiene, and adequate rest and sleep should be prioritized by the therapist. The client may exhibit lack of energy and concentration to perform these tasks. In fact, the client may still refuse to eat because of false beliefs of being poisoned. In this case, the therapist may need to direct the client consistently to complete bathing and grooming tasks. When the signs of hallucinations and delusions become increasingly evident, it is expected that the client will not have enough sleep. Instructions should not sound compelling; thus, the client’s independence is promoted as much as possible. Rational for promoting nutrition and proper hygiene Even as, scientists make out that appropriate nourishment is vital for the security of a human being with poor health, they fail to be of the same mind that are short of definite vitamins that lead to schizophrenia. Treatments with megavitamin rehabilitation are not established and are over and over again are extremely costly. Some citizens advance while using vitamins; though, this could be appropriate to the medication they are going through, the restorative effect of a prearranged medication, diet, and vitamin rule, or they might be a component of 30% of the patients who get well with no attribute of behavior applied. Good quality nutrition is significant to maintaining the patients of personality suffering from schizophrenia, but cannot independently cure the ailment, or lead to a faultless recovery. Evaluation for this intervention requires a gradual monitoring of the client. Weight measurements may be performed once a week or as necessary to determine the degree of progress. Additionally, the status of rest and sleep should also be monitored. Conclusion General treatment of schizophrenia may be applied to clients with paranoid type, with specific emphasis on safety, nutrition, and establishment of a therapeutic relationship. In this case, the therapist needs to understand the client’s situation before any interventions must take place. The safety of medications can vary widely with each client as substance abuse may be a co- morbid factor (Roncero, et al, 2011). Current researches in mental health indicate differences with religious and cultural aspects of care based on the outcome of therapeutic sessions. Therefore, although clients may have similar symptoms indicating a similar pattern of mental disorder, it is the responsibility of the therapist to explore the circumstances that lead to the diagnosis without being personally involved avoiding counter transference of treatment. This is because the results of treatment are based on individual outcome treatment during therapy sessions. References Borras, et al. (2007). Religious Beliefs in Schizophrenia: Their Relevance for Adherence to Treatment. Schizophrenia Bulletin, 33 (5), pp. 1238– 1246. d oi:10.1093/schbul/sbl070 Klingberg, et al. (2009). Cognitive behavioral treatment of negative symptoms in schizophrenia patients: study design of the TONES study, feasibility and safety of treatment. European Archive of Psychiatry and Clinical Neuroscience, 259 (2), pp. S149–S154. DOI 10.1007/s00406-009-0047-8. Olfson, et al. (2007). Treatment of Schizophrenia With Long-Acting Fluphenazine, Haloperidol, or Risperidone. Schizophrenia Bulletin, 33 (6), pp. 1379–13 87. doi: 10.1093/ sch bu l/sb m033 Roncero, et al. (2011). Protocols of Dual Diagnosis Intervention in Schizophrenia. Addictive Disorders and their Treatment, 10 (3), pp. 131- 154. Valenstein, et al. (2011). Using A Pharmacy- Based Intervention To Improve Antips ychoti c Adher ence Among Patien ts With Serious Mental Illness. Schizophrenia Bulletin, 37 (4), pp. 727- 736. doi: 10.1093/ schbul/sbp121 Videbect, S.L. (2007). Psychiatric mental health nursing. (4th ed). New York: Lippincott Williams and Wilkins. Read More