Tiêu đề NCM 117 LEC PRELIMS ✅

NCM 117 LEC PRELIMS by TONS and MADS OUTLINE I. Concepts of Mental Health and Mental Illness A. State of Mental Health and Mental Illness in the Country and the World 1. Mental Health Care Delivery System in the Philippines and the Importance and Impact in the Community B. Psychobiological Bases of Behavior Neuroscience: Biology and Behavior 1. Neuroanatomy and Neurophysiology: Neurons, Central Nervous System, Memory, Repetition, Learning Neurotransmitters 2. Concepts and Patterns of Human Behavior a) Family Dynamics b) Patterns of Behavior c) Concepts of Human Behavior (1) Needs (2) Frustrations and Conflict (3) Anxiety, Anxiety Responses (4) Patterns of Adaptation (5) Concepts of Mental Health and Mental Illness Crisis 3. Global and Regional Perspectives on Mental Health a) National Mental Health Program b) Mental Health Gap Action Program Overview C. Therapeutic Models and its Relevance to Nursing Practice 1. Psychoanalytic Model: Sigmund Freud a) Personality Processes b) Levels of Consciousness c) Defense Mechanism 2. Developmental Model: Erik Erikson a) Eight Stages of Development 3. Interpersonal Model a) Harry Stack Sullivan: Interpersonal Psychotherapy Model (IPT) b) Hildegarde Peplau: Interpersonal Relationship in Nursing Practice 4. Cognitive Model a) Jean Piaget: Cognitive Stage of Development b) Aaron Beck: Cognitive Therapy (CT) c) Albert Ellis: Rational Emotive Therapy (RET) 5. Stress Models a) Selye’s Stress Adaptation Syndrome b) Lazarus’ Interactional Model D. Understanding Stress 1. Acute and Long-Term Effects of Stress Physical Responses Psychological Responses 2. General Adaptation Syndrome (GAS) 3. Psychoneuroimmunological Mode 4. Measuring Stress and Coping Styles E. Diagnosis – DSM IV / V F. Psychopathology, Etiology and Psychodynamics 1. Disturbances in Thought Content / Processes: Schizophrenia and other Psychosis 2. Anxiety Disorders 3. Mood Disorders 4. Personality Disorders 5. Cognitive Disorders 6. Eating Disorders 7. Sexual Disorders 8. Substance-related Disorders 9. Disorders in Childhood and Adolescence 10. Domestic Violence II. The Nursing Process in Psychiatric - Mental Health Care A. Assessment 1. Subjective Data • Nursing History • Gordon’s Functional Health Patterns 2. Objective Data Mental Status Assessment • Psychosocial Assessment • Ethno-Cultural and Spiritual • Assessment • Other Assessment tools • Psychological tests • Intelligence tests • Diagnostic and Laboratory • Examinations B. Nursing Diagnosis 1. NANDA Taxonomy 2. NOC (Nursing Outcomes Classification) - Clinical Pathways C. Planning and Implementation of Care 1. Nurse-Client Communication Principles, Dynamics and Components of Therapeutic Communication a) Factors that Influence Communication: Environment, Physical Limitations, Kinesics b) Modes of Communication Types of Communication - Therapeutic and Non- Therapeutic Techniques of Communication - Challenges in Communication 2. Nurse – Client Relationship a) Principles and Goals of the Therapeutic Nurse – Client Relationship b) Phases of the Nurse Client Relationship c) Client as an important Member of the Health Care Team d) Stages of Development of a Therapeutic Relationship (1) Phase 1. Orientation (2) Phase 2. Working Stage (3) Phase 3. Termination Stage 3. Mental Health Gap Action Program (mhGAP) a) Acute Stress (ACU) b) Grief (GRI) c) Moderate-Severe Depressive Disorder (DEP) d) Post-Traumatic Stress Disorder (PTSD) e) Psychosis (PSY) f) Epilepsy / Seizures (EPI) g) Intellectual Disability (ID) h) Harmful Use of Alcohol i) Drugs (SUD) j) Suicide (SUI) 4. Treatment Modalities a) Somatic Therapies (1) Electroconvulsive therapy (2) Alternative / Complementary treatments (3) Other therapies Psychotherapies (4) Individual Psychotherapy (5) Group therapy (6) Family therapy (7) Play therapy (8) Gestalt Therapy (9) Client-Centered Therapy b) Behavioral Therapies c) Cognitive Therapies d) Milieu Therapies / Therapeutic Milieu (1) Safety Protocols and Infection Control in the Psychiatric Setting e) Adjunction / Art-Based, Dance / Music Therapies f) Attitude Therapies g) Psychopharmacology (1) Antipsychotics (2) Anti-anxiety of Anxiolytics (3) Antidepressants (4) Lithium and Mood stabilizers h) Basic Intervention for Tobacco Control (1) Introduction to the Drug Nicotine Dependence (2) Smoking Cessation vs Nicotine Dependence (3) Treatment Approach And Holistic Model (a) Physical Well Being (b) Emotional Well Being (c) Mental Well Being (d) Spiritual Well Being i) Complementary and Alternative Therapy j) Nutrition and Dietary Therapy D. Health Education E. Recording and Reporting F. Evaluation of Care III. Standards of Psychiatric - Mental Health Nursing Practice A. Structure Criteria and Standards 1. Qualifications of the Nurse -Personal -Professional 2. Functions of the Nurse 3. Physical Facilities and Equipment B. Process Criteria and Standards C. Outcome Criteria and Standards 1. Progress and Effects of Nursing Care IV. Related Laws in Mental Health A. Philippine Mental Health Law (RA No. 11036) B. Other Laws and Ethical Context of Psychiatric Mental Health Nursing 1. Patients’ Bill of Rights 2. Magna Carta of Women 3. Magna Carta of Disabled Person 4. Magna Carta of Health Workers C. Ethico-Legal Considerations 1. Legal Psychiatric Nursing Issues -Torts (Civil laws) -Commitment issues 2. Independent Interventions that Protect Clients’ Health Care Rights. D. Documentation in Psychiatric Nursing Practice 1. Elements of Documentation in Monitoring and Evaluation 2. Methods of Charting Problem-Oriented Recording (SOAPIE) Focus Charting (DAR) ADPIE or PIE Method Electronic Communication - EHR Process Recording 3. Integrity of Client’s Records and Information 4. Health Information Privacy V. Interdisciplinary Mental Health Team Collaboration A. The Psychiatric-Mental Health Nurse as a Member of the Mental Health Team B. Team Approach in Nursing Care C. Principles and Functions of the PMHN Collaboration with InterAgency, Intra-Agency, Multidisciplinary and Sectoral Teams D. Interpersonal Relationships with Other Members of the Mental Health Team - Referrals - Transport E. Managing Conflicts and Conflict Resolution for Better Working Relationships F. Safety and Security Measures VI. Leadership and Management Roles of the PMHN A. Organizational Structure of a Mental Health Facility 1. Mental Health Team 2. Roles and Functions B. Policies and Procedures B. Physical Set-Up and Resources C. PMHN Roles 1. Coordination of Multidisciplinary Health for Integrated Delivery of Client Services 2. Resource Allocation D. Positive Practice Environment in Psychiatric Nursing Practice. E. Quality Assurance, Continuous Quality Improvement and Risk Management Programs in Psychiatric Nursing Practice. VII. Psychiatric Nurses’ Role as Member of the Research Team VIII. Continuing Professional Development Program A. In-service Training Programs B. Continuing Education Program C. Formal Education D. Self-Directed Learning Initiatives: On-line Learning E. Health Advocacy Programs 1. Positive Mental Health 2. Suicide Prevention 3. Prevention of Substance Abuse 4. Healthy Lifestyle 5. Tobacco-free programs IX. Filipino Culture, Values and Practices in Relation to the Care of Clients with Maladaptive Patterns of Behavior. X. Online Database / Journal Articles Related Assessment and Provision of Care of Clients with Maladaptive Patterns of Behavior XI. Attributes and Core Values of a Nurse in Psychiatric Mental Health Practice XII. Entrepreneurial Opportunities in Psychiatric Mental Health Nursing Practice A. Home Health Care B. Wellness Program 1
NCM 117 LEC PRELIMS by TONS and MADS MENTAL HEALTH AND THE PHILIPPINES Mental health conditions ❖ increasing worldwide and 14% of the total global burden is due to untreated versions of these. ❖ 20%: estimated percentage of the world's children and adolescents that have a mental health condition, causing 1 in 5 years LWD. ❖ 14% (out of 1.4 M Filipinos): According to a 2010 census, these were the amount of Filipinos who identified to have a disability due to a mental disorder. ❖ Trend of the suicide rates in the Philippines from 1984 to 2005: Increased (0.23 to 3.59 per 100,000 in males and 0.12 to 1.09 per 100,000 in females) ❖ Six disorders which has been included in the 2017 global burden of disease study (S, B, MD, E, AU, DU) ➢ Schizophrenia (0.2%) ➢ Bipolar disorder (0.5%) ➢ Major depressive disorder (1.1%) ➢ Epilepsy (0.4%) ➢ Alcohol use disorders (0.9%) ➢ Drug use disorders (0.7%) COVID-19 pandemic ❖ After the declaration of this, there was a dramatic increase in the prevalence of mental health problems both nationally and internationally. ❖ Patients and healthcare workers = psychological effects ❖ Negative emotions and psychological distress - general population: These are how patients, healthcare workers, and the general population were affected by the pandemic 1. True or False: While human resources for health (HRH) are few, they are distributed around the Philippines. a. False (HRH in the mental health specialty is very few and most are employed in Metro Manila. Most provinces even have no access to a psychiatrist.) b. Examples of human resources for mental health: Psychiatrists, psychiatric nurses, psychologists, trained health providers in mhGAP, and trained staff on MHPSS disaster preparedness 2. True or False: Specialized care is mainly offered by private provider and in tertiary health institutions. There are only 2 government-owned psychiatric hospitals, 46 psychiatric inpatient units, and 29 outpatient mental health facilities nationwide. The scarcity of health facilities offering specialized mental health care leads to a gap in the availability of mental health specialists in provinces to offer mental health at secondary health institutions and those who are capable of supervising the integration of mental health services in the primacy care setting. 3. True or False: Informed consent is waived in instances when the client is accompanied by caregivers such as family members during the course of treatment. This can be attributed to Filipinos having close-knit families who render care to members with physical and psychological illnesses. Republic Act. no. 11036 (Philippine Mental Health Act) ❖ This republic act seeks to develop and establish access to comprehensive and integrated mental health services, responsive to the needs of the clients. The majority of mental health services are provided in hospital settings. ❖ This legislation seeks to establish a national mental health policy which will enhance the delivery of integrated mental health services while promoting and protecting the rights of individuals accessing mental health services. ❖ Under its provisions, it commits to promoting the mental well-being of individuals and allows for persons affected by mental health conditions to exercise the full range of human rights (i.e.; informed patient consent for treatment) and participate fully in society free from stigmatization and discrimination. ❖ It also incorporates the rights of patient relatives and/or guardians and the provision of psychosocial support to concerned individuals as required. It further recognizes the role of mental health professionals (medical doctor, psychologist, nurse, social worker, or any other appropriately-trained and qualified person with specific skills in mental health service provision) ❖ Philippine Council for Mental Health (PCMH) ➢ Under the mental health act or RA 11036, this is established as a policy-making advisory body chaired by the DOH and composed of other government agencies such as the Departments of Education, Labor and Employment, Interior and Local Government, the Commissions on Human Rights (CHR), and Higher Education (CHED) ❖ National Mental Health Program ➢ In the mid 1990s, this was institutionalized to integrate mental health services in community settings through trainings of municipal health doctors and nurses on the identification and management of psychiatric morbidities and psychosocial problems. Though there are mental health services offered in the community, these services are known to be underdeveloped and lack the resources needed for its full implementation and evaluation. DOH Administrative Order No. 8 series of 2001, followed by DOH Administrative Order No. 2016- 0039 Revised Operational Framework for a Comprehensive National Mental Health Program ❖ These were the first few mental health policies. During this period, there was still no singular mental health legislation, and the laws concerning mental health services are governed by different laws such as the Revised Penal Code. ❖ Health budget is largely allocated to mental hospitals and payment for health care is mostly from an out-of-pocket basis by service users- This is how the health budget is allocated in the Philippines and how it affects the general population ❖ Professional accountability, unconditional respect, wholistic health, quality practice milieu, respect for autonomy, protecting against discrimination - These are core values that mental health nurses are obliged to exercise (PA, UR, WH, QPM, PAD, R for A) ❖ Informed consent and supported decision-making - These are included to be core principles of RA 11036 aside from defining mental illness and establishing an integrative mental health system ❖ Informed consent - The act provides for this which refers to consent voluntarily given by a service user to a plan for treatment. This necessitates this from the client before receiving treatment or care, including the right to withdraw such consent. 2