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The objective of this paper is to discuss on how Simon’s on-going health needs will be met after been diagnosed of schizophrenia. At age 20, Simon was diagnosed of schizophrenia due to worsening state of his mental health. The assessment shows a history of symptoms like auditory hallucinations, disorders of perception, thoughts and affect.
Simon initially had poor personal functioning in memory and concentration, bizarre behavior and ideas, social withdrawal, distorted communication and affect, and apathy. Subsequently, it was aggravated to an acute episode with hallucinations, behavioral disturbances (like agitation and distress), and delusions. Presently, Simon habitually neglects his physical health, drinks and eats inconsistently, ignores personal hygiene except reminded by his mother and several others. These symptoms are the required criteria for the diagnosis of schizophrenia according to The Diagnostic and Statistical Manual IV (DSM IV 1994) and ICD -10. Due to the fact that the specific pathogenesis is still unconfirmed, study suggests that the cause of schizophrenia is multifaceted which includes factors such as genetic, neural elements, and environment.
In line with meeting the health needs of schizophrenia patients, a 5 year follow-up study of first-episode among schizophrenia patients conducted by Robinson et al., (1999), reported that interruption in the usage of antipsychotic medication as the major risk factor among the sample. As a result, Emsley et al., (2013) posited that schizophrenia needs incessant treatment by combining antipsychotic drugs with psychosocial therapy to decrease the susceptibility to relapse. Correll (2014) opined that antipsychotic drugs possess significant attraction for dopamine D2 receptors and influences many other neurotransmitter receptors. In addition, Hassan et al., (2013) suggested that combining antipsychotic drugs with psychosocial therapy in treating patients with schizophrenia is a very vital in reducing vulnerability to relapses.
Therefore, meeting the health needs of Simon requires certain decision-making on how to uphold the ongoing treatment he is receiving. Also, switching medications (if necessary) will entail constant discussions in the course of clinical sessions. These would enhance Simon to self-manage Schizophrenia. The aim of this paper is to highlight effective approaches nurses apply as they work hand in hand with schizophrenia patients in their usage of medication in order to meet their health needs.
A biopsychosocial model is usually adopted by psychiatric nurses. This model provides an all-inclusive care for Simon which entails education, fostering self-management, and supernatural aid. However, Simon’s viewpoint about medication decisions is highlighted. Encouraging self-management will give room for discussion and understanding of Simon’s preferences, this will reflect his anticipated degree of self-sufficiency.
Adams, Drake, and Wolford (2007) opined that shared decision-making is a means of helping clients to play a significant part in their treatment by making available handy information and preferences. Therefore, choosing suitable drug and psychosocial therapies based on mutual decision-making is very important in meeting the health needs of clients. Shared decision-making combines concerted approach of interaction with decision-making resources to initiate information on health conditions and evaluate various treatment preferences based on client’s beliefs, traditional values, personal experiences, and choices. Shared decision-making is an approach that gives room for clients and healthcare professionals to come together to evaluate risks and benefits of a specific treatment as part of a treatment design. In essence, it furnishes the clients with vital information for appropriate decisions in agreement with healthcare professionals, so as to make the clients active in their treatment design.
According to Dixon, Holoshitz, and Nossel (2016), there is frequent dropout among clients with schizophrenia receiving treatment. There is usually difficulty in ensuring that clients living with schizophrenia participate in ongoing treatment. Poor participation of these clients may result in deterioration of symptoms, or even re-hospitalization, and as a result not achieving the benefits associated with the treatment. The researchers also asserted that healthcare that is person-centered with shared decision-making, is a vital treatment strategy that maximizes clients’ objectives and life situations. Making use of person-centered care in schizophrenia treatment approaches has good prognosis.
To corroborate the choice of shared decision-making among schizophrenia clients, Curtis et al., (2010) found that a large percentage of their study opts for significant participation in decisions made concerning their mental health treatment. Park et al., (2014) reported that 85% of the clients chose to be given an array of treatment decisions and to request for their viewpoint on the various treatment decisions at their disposal. Most African American participants favored shared decision-making. Cuevas and Penate (2014) conducted a study among 900 patients with schizophrenia, most of the patients reported that their healthcare professionals neither bothered about their desired participation in decision-making nor considered their choices. Hamann et al., (2007) opined that many researchers have recommended that shared decision-making is very effective for clients with schizophrenia. However, at times healthcare professionals may consider that clients are not in suitable position to make effective contribution due to impaired mental capacity.
Psychosocial treatment such as assertive community treatment (ACT), family psycho-education, illness self-management, social skills training, and supported employment have been highlighted to be effective with patients with mental illness. For instance, ACT that is also known as case management is a comprehensive treatment strategy that is exclusively adopted among patients with chronic symptoms and psychosocial interventions like patients with antecedents of homelessness or refusal to continue with treatment being administered. This approach also entails regular interaction in order to make available comprehensive medical and psychosocial interventions. It also enhances the healthcare providers to obtain direct information from their clients instead of relying on third party reports. Illness self-management approach helps clients to develop or improve on their skills to handle different aspects of schizophrenia. It aids clients’ health seeking behaviors, minimizes severity of symptoms, and eventually reduces healthcare expenses over a period of time.
Kurtz and Richardson (2012) asserted that social skills training (SST) focuses on social-cognitive inadequacies in areas like appreciating social stimuli (gesture, body language etc.) and facial expression recognition. The effect of SST may go beyond enhancing social skills. The researchers in their study found that SST enhances functional results among patients with schizophrenia. Lecomte et al., (2014) opined that supported employment also aids functional results. According to these researchers, supported employment in suggested for clients with mental illness willing to work and stay employed. Supported employment assists clients to hunt for employment and getting it. It makes available continuous assistance to remain employed. Nonetheless, several clients under support employment plan could only hold on to a job for few months.
Among various psychosocial interventions for schizophrenia, family intervention is the most widely researched intervention. Family-based treatment plan happens to be one of the most vital innovations in the management of schizophrenia in the recent years. A meta-analysis conducted by Pharaoh et al., (2010) revealed that family intervention approaches lessened the rate of relapse and susceptibility to re-hospitalization. It also enhances adherence to treatment and fine tuning social functioning. Family interventions also reduce symptoms, lessen the burden of caregivers, boost coping skills of caregivers and reduce cost.
According to Deegan (2005), non-compliance with psychiatric drugs takes place when pills hinder recovery objectives or personal medicine. Personal medicine is regarded as non-pharmaceutical exercises aimed at making life more meaningful and purposeful, boosting self-esteem, reducing symptoms, and guard against unpalatable consequences like being hospitalized. This approach does not focus on pathogenesis; it lays emphasis on the clients and variables that enhance health and well-being. Samples of personal medicine are engaging in valued social tasks, assisting others, work out, spending time with friends and family, sexual intercourse, fishing, improving food intake, being with “ordinary” individuals, being distant from everyone else, being in nature, chatting on the telephone, taking an auto ride, a three day weekend work, pushing to accomplish, gathering dolls, getting exposed to sunlight. Personal medicine has been accounted for to reduce nervousness, perplexity, and other troubling side effects. Customers found the term approved their experience and recognized that recuperation requires trust, guts, creative energy, and versatility among different characteristics and demeanors. Individual drug isn’t routinely answered to clinicians nor requested by them.
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