Psychiatric and Mental Health Nursing 3rd Edition by Ruth Elder , Katie Evans RPN BA MLitSt PhD FANZCMHN , Debra Nizette – Ebook PDF Instant Download/Delivery: 0729540987 , 978-0729540988
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ISBN 10: 0729540987
ISBN 13: 978-0729540988
Author: Ruth Elder , Katie Evans RPN BA MLitSt PhD FANZCMHN , Debra Nizette
Psychiatric and Mental Health Nursing: 3rd Edition by Ruth Elder, Katie Evans, and Debra Nizette is a comprehensive textbook aimed at students and professionals in the field of psychiatric and mental health nursing. The book covers a wide range of topics relevant to both the theory and practice of psychiatric nursing, with a focus on evidence-based practice, therapeutic relationships, and the integration of mental health nursing into broader healthcare systems
Psychiatric and Mental Health Nursing 3rd Table of contents:
PART 1 Preparing for psychiatric and mental health nursing
Chapter 1 The effective nurse
Key points
Learning outcomes
Introduction
Caring
Hope and spirituality
CRITICAL THINKING CHALLENGE 1.1
ETHICAL DILEMMA
QUESTIONS
Therapeutic use of self
Empathy and therapeutic use of self
Evidence-based practice and therapeutic alliance
Self-awareness
Reflection
Developing reflective practices
Professional boundaries
Self-disclosure
ETHICAL DILEMMA: PROFESSIONAL BOUNDARIES
QUESTIONS
Stress and burnout
Stress
Burnout syndrome
Avoiding burnout syndrome
Professional supportive relationships
Clinical supervision
Preceptorship and mentoring
NURSE’S STORY: CLINICAL SUPERVISION
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Chapter 2 Recovery as the context for practice
Key points
Learning outcomes
Introduction
Recovery as the context of practice
Key concepts and definitions of recovery
Problems with the definition of recovery
Terms used to describe people who experience mental distress
Background to recovery in mental health
Research into recovery in mental health
CRITICAL THINKING CHALLENGE 2.1
Personal narratives
STORY OF RECOVERY: MARY O’HAGAN
The relationship between theory and practice
What is a theory?
Which theory best guides practice?
Putting theory into practice
Values base for recovery-informed practice
The importance of reflection in relationship to recovery-informed practice
Putting theory into practice: the wider context
Demand for evidence-based practice
Essentials of recovery-informed practice
Creating relationships of safety
Encouraging the person to have some sense of control
Engaging with curiosity
Attending to self-esteem and self-identity
Attending to language and meaning
Tapping into the person’s own capacity for self-knowing
Facilitating self-help and personal responsibility
BOX 2.1 ‘BEING WITH’ A PERSON TO PROMOTE SELF-HELP
BOX 2.2 CONSUMER ORGANISATIONS AND USEFUL WEBSITES
External environments that facilitate recovery
Recovery-informed service provision
The community
The mental health service
NURSE’S STORY: WHAT NURSING CAN ACHIEVE IN THE COMMUNITY
Changing beliefs about the focus of nursing practice
From deficits to strengths
NURSE’S STORY: LIMITATIONS OF PROFESSIONAL PRACTICE
NURSE’S STORY: RECOVERY-INFORMED PRACTICE WITHIN AN INDIGENOUS SETTING
CRITICAL THINKING CHALLENGE 2.2
Distinguishing rehabilitation from recovery
NURSE’S STORY: MOVING FROM DEFICITS-BASED TO STRENGTHS-BASED PRACTICE
CRITICAL THINKING CHALLENGE 2.3
Non-government organisations
Collaboration within enabling environments
NURSE’S STORY: COMMUNITY EDUCATION: INCREASING UNDERSTANDING OF MENTAL ILLNESS WITHIN A RECOVERY FRAMEWORK
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
SCENARIO 1
SCENARIO 2
Questions
SCENARIO 3
Question
References
Chapter 3 Historical foundations
Key points
Learning outcomes
Introduction
The value of historical antecedents
Past ideas about mental disorder
The ‘humours’
Supernatural influences
Greece and Rome
CLEOMENES OF SPARTA
ALEXANDER THE GREAT
The Christian era
Mental disorders found in Graeco-Roman sources
CICERO’S DEPRESSION
PHOBIAS
POSTTRAUMATIC STRESS DISORDER (PTSD)
Mental disorders not found in the ancient literature
Historical perspective on schizophrenia
CRITICAL THINKING CHALLENGE 3.1
Hysteria: a translation error
Gender and healthcare
Caring for the mentally ill
Graeco-Roman origins of Western care
ETHICAL DILEMMA
QUESTION
Eastern medical care
Western developments
The asylum
CRITICAL THINKING CHALLENGE 3.2
Doctors and nurses
Ancient Greece and Rome
Midwives and nurses
‘WHAT PERSONS ARE FIT TO BECOME MIDWIVES?’
‘WHO ARE THE BEST MIDWIVES?’
Pioneers and professionalisation
The USA
The UK
New Zealand
Australia
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Chapter 4 The Australian and New Zealand politico-legal context
Key points
Learning outcomes
Introduction
Historical landmarks
The current global perspective
BOX 4.1 RIGHTS OF THE MENTALLY ILL
BOX 4.2 WHO PRINCIPLES FOR GUIDING MENTAL HEALTH POLICY
Australian national mental health policy
The Fourth National Mental Health Plan
Prevention and early intervention
Service access, coordination and continuity of care
Quality improvement, transparency and innovation
CRITICAL THINKING CHALLENGE 4.1
New Zealand mental health policy
The Treaty of Waitangi
The National Mental Health Strategy
Principles of mental health law
Difficulties and dilemmas arising from mental health law
New Zealand mental health legislation
Australian mental health legislation
Voluntary and involuntary treatment of psychiatric consumers
Community treatment orders in Australia and New Zealand
CRITICAL THINKING CHALLENGE 4.2
Duty of care and decision-making capacity
The culture of risk assessment and management in mental health
CRITICAL THINKING CHALLENGE 4.3
What is the alternative?
Conclusion
CRITICAL THINKING CHALLENGE 4.4
EXERCISES FOR CLASS ENGAGEMENT
References
Legislation
Further reading
Chapter 5 Professional and ethical issues
Key points
Learning outcomes
Introduction
Regulation of professional practice
BOX 5.1 AUSTRALIAN AND NEW ZEALAND REGULATORY BODIES
Australian Health Practitioner Regulation Agency
Australian Nursing and Midwifery Accreditation Council
Nursing and Midwifery Board of Australia
Nursing Council of New Zealand
Professional and industrial nursing bodies
BOX 5.2 PROFESSIONAL AND INDUSTRIAL BODIES IN MENTAL HEALTH NURSING
Australian College of Mental Health Nurses
Australian Nursing Federation
Health Services Union of Australia
New Zealand Nurses Organisation
Public Service Association
Royal College of Nursing Australia
Te Ao Maramatanga
Nursing education
Standards of practice
TABLE 5.1 Standards of practice for mental health nursing in Australia and New Zealand
Competencies
Career pathways
Advanced practice
Nurse practitioners
Nurse prescribers
The Mental Health Nurse Incentive Program
Ethics and professional practice
BOX 5.3 ETHICAL PRINCIPLES
Ethical issues in mental health practice
Psychiatric diagnosis
CRITICAL THINKING CHALLENGE 5.1
Psychiatric diagnosis
Psychiatric treatment
Psychopharmacology
CRITICAL THINKING CHALLENGE 5.2
Psychiatric treatment
Electroconvulsive therapy
Seclusion
Suicidal behaviour
Involuntary treatment
CRITICAL THINKING CHALLENGE 5.3
Involuntary treatment
Interpersonal therapy
Professional boundaries
CRITICAL THINKING CHALLENGE 5.4
Professional boundaries
BOX 5.4 EXAMPLES OF PROFESSIONAL BOUNDARY TRANSGRESSION
Confidentiality
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
Ethical issues to consider
SCENARIO 1
SCENARIO 2
SCENARIO 3
SCENARIO 4
QUESTIONS
References
PART 2 Mental health and wellness
Chapter 6 Mental health and illness in Australia and New Zealand
Key points
Learning outcomes
Introduction
The incidence and prevalence of mental disorders
Australian national surveys
Te Rau Hinengaro: the New Zealand mental health survey
Comorbidity
Suicidal behaviour
The cost of mental disorders
Disability and mental health
The media and perceptions of mental illness
Misconceptions about mental disorders
CRITICAL THINKING CHALLENGE 6.1
Social determinants of mental health in Australia and New Zealand
NURSE’S STORY
Income security
Meaningful activity and employment
Housing security
Food security
Education
Gender
CRITICAL THINKING CHALLENGE 6.2
Marital status
Violence
Imprisonment
Ethnicity
Social justice and equity
Figure 6.1 The vicious cycle of social determinants and mental disorders
Social inclusion
CRITICAL THINKING CHALLENGE 6.3
Cultural diversity in Australia and New Zealand
CRITICAL THINKING CHALLENGE 6.4
What is culture?
Cultures and health beliefs
CRITICAL THINKING CHALLENGE 6.5
Indigenous health beliefs
Other CALD groups
CRITICAL THINKING CHALLENGE 6.6
Cultural diversity and mental health nursing
Cultural competence and cultural safety
Incorporating culturally safe practice
CASE STUDY: GUY
CRITICAL THINKING CHALLENGE 6.7
Culture and communication style
Culture and self-reflection
CRITICAL THINKING CHALLENGE 6.8
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Further reading
Websites
GLOSSARY
Chapter 7 Indigenous mental health in Australia and New Zealand
Key points
Learning outcomes
Introduction
Aboriginal and Torres Strait Islander mental health
Mental health status
Social and emotional wellbeing
Fundamental principles
TABLE 7.1 Relevant documents for nursing and healthcare relating to Aboriginal health
CRITICAL THINKING CHALLENGE 7.1
Cultural safety
CRITICAL THINKING CHALLENGE 7.2
BOX 7.1 STEPS TO CULTURAL SAFETY
Time
CRITICAL THINKING CHALLENGE 7.3
Psychopharmacology
BOX 7.2 ISSUES AFFECTING THE SAFE USE OF MEDICATION
BOX 7.3 STRATEGIES FOR THE SAFE USE OF MEDICATION
CRITICAL THINKING CHALLENGE 7.4
Summary
Māori mental health
Snapshot of Māori mental health
Tino rangatiratanga: Māori self-determination
Whānau ora: family wellbeing
Māori holistic healing
Te Whare Tapa Whā: the four-sided house
Cultural safety
CRITICAL THINKING CHALLENGE 7.5
Ngaru Ngarunoa: Calming Restless Waves model of nursing practice
Figure 7.1 The Ngaru Ngarunoa (Calming Restless Waves) model of nursing practice (created by Hineroa Hakiaha 2007).
CRITICAL THINKING CHALLENGE 7.6
The seven pathways
Whakawātea—preparation
Hononga—partnership
Whakaruru—participation
Marumaru—protection
Mihi whakatau—formal greeting
Whakawhanaungatanga—connecting relationships
Whakaratarata—calming the soul
Whakanoa—providing a balance
Awhi mai awhi atu—reciprocity
Poroporoaki—farewell process
Summary
Conclusion
Acknowledgement
EXERCISES FOR CLASS ENGAGEMENT
References
Further reading
Useful websites
Glossary
Chapter 8 Beyond theory: understanding mental health and illness
Key points
Learning outcomes
Introduction
What is mental health?
Historical definitions of mental health
Recovery: mental health despite mental illness
‘Mental health’ as a euphemism for ‘mental illness’
CRITICAL THINKING CHALLENGE 8.1
Theories of personality
Biomedical model
Critique of the biomedical model
Psychoanalytic theory
Sigmund Freud (1856–1939)
Defence mechanisms
Critique of psychoanalytic theory
Behavioural psychology
Ivan Pavlov (1849–1936)
John B Watson (1878–1958)
Burrhus F Skinner (1904–1990)
Critique of behaviourism
Cognitive psychology
Albert Bandura (b. 1925)
Aaron T Beck (b. 1921)
Martin Seligman (b. 1942)
Jean Piaget (1896–1980)
Critique of cognitive psychology
Figure 8.1 Ivey, Ivey and Zalaquett’s (2010) interactive model of cognitive psychology
Humanistic psychology
Charlotte Bühler (1893–1974)
Carl Rogers (1902–1987)
Abraham Maslow (1908–1970)
Critique of humanistic psychology
Sociological theories
Emile Durkheim (1858–1917)
Thomas Szasz (b. 1920)
Critique of sociological models
TABLE 8.1 Personality theories and explanations of human behaviour
Personality theories and explanations of human behaviour
CRITICAL THINKING CHALLENGE 8.2
From theory to practice
TABLE 8.2 Production of a conditioned response (anxiety)
CRITICAL THINKING CHALLENGE 8.3
The influence of theories of psychology and sociology on nursing
CASE STUDY: KARIN
Hildegard Peplau (1909–1999)
Joyce Travelbee (1926–1973)
Phil Barker (b. 1946)
CRITICAL THINKING CHALLENGE 8.4
Personality and behaviour: nature versus nurture
Theoretical perspectives on nature versus nurture
Nature or nurture?
Nature and nurture
CRITICAL THINKING CHALLENGE 8.5
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Legislation
Chapter 9 Mental health across the lifespan
Key points
Learning outcomes
Introduction
A lifespan approach
BOX 9.1 A LIFESPAN APPROACH: KEY POINTS
A lifespan approach to nursing practice
BOX 9.2 A LIFESPAN APPROACH: ROLE IN PRACTICE
CRITICAL THINKING CHALLENGE 9.1
Mental health across the lifespan
CRITICAL THINKING CHALLENGE 9.2
‘Ideal’ development
Stages and theoretical issues in human development
TABLE 9.1 Ideal outcomes of development
Sigmund Freud (1856–1939)
Erik Erikson (1902–1994)
Jean Piaget (1896–1980)
BOX 9.3 STAGES OF COGNITIVE DEVELOPMENT
Moral development
Attachment, parenting and family factors
Implications for nursing practice
Resilience and mental health
Primary healthcare and mental health promotion
TABLE 9.2 Examples of risk and protective factors across the lifespan
Mental illness prevention
Figure 9.1 The spectrum of intervention
Recovery
Childhood
Development and theoretical issues
Risk factors
Prevention and promotion
CRITICAL THINKING CHALLENGE 9.3
Adolescence
Development and theoretical issues
Identity
Risk factors
Prevention and promotion
CRITICAL THINKING CHALLENGE 9.4
Early and middle adulthood
Development and theoretical issues
Intimacy versus isolation (early adulthood)
Generativity versus self-absorption (middle adulthood)
Attachment, gender, identity and risk
Prevention and promotion
CRITICAL THINKING CHALLENGE 9.5
Older adulthood
Development and theoretical issues
Risk factors
Prevention and promotion
NURSE’S STORY
CRITICAL THINKING CHALLENGE 9.6
Conclusion
Acknowledgement
EXERCISES FOR CLASS ENGAGEMENT
References
Chapter 10 Crisis and loss
Key points
Learning outcomes
Introduction
What constitutes a crisis?
Consequences of a personal crisis
A framework for coping and adapting to crisis
Figure 10.1 A general conceptual framework of the coping process
Events and perceptions that can lead to personal crisis
BOX 10.1 STEPS IN CRISIS INTERVENTION
Intervening at a time of crisis
CRITICAL THINKING CHALLENGE 10.1
Crisis, loss and grief
Suicide and attempted suicide
BOX 10.2 HIGH-RISK INDICATORS FOR SUICIDE
Griever concerns following suicide
Self-harm
Being a victim of crime
BOX 10.3 MANAGING THE RISK OF SELF-HARM
Sudden death
Parental bereavement
BOX 10.4 WHAT IS VALUED BY RELATIVES WHO HAVE EXPERIENCED A SUDDEN DEATH
Sudden death of a partner
Attitudes to death
Interacting with a person adjusting to loss
Crisis, loss and culture
Nursing interventions: attitudes and skills
Acknowledging the importance of the social context
Developing enhanced cultural sensitivity
CRITICAL THINKING CHALLENGE 10.2
Trauma-informed care
Helping a client to deal with loss
Being there for the client
Allowing the client to express emotional pain
Being sensitive to cultural considerations in death and dying
Acknowledging the meaning of death and dying in different cultures
Acknowledging difficulties
Tackling the effects of stigma
Exploring opportunities for advanced training
A PERSONAL NARRATIVE
CRITICAL THINKING CHALLENGE 10.3
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Chapter 11 Assessment and diagnosis
Key points
Learning outcomes
Introduction
Classification systems
Assessment
Assessment methods
BOX 11.1 CRITERIA FOR NATIONAL STANDARDS OF ASSESSMENT AND REVIEW
Interviewing
Diaries and personal records
Questionnaires and rating scales
Direct observation
Essential nursing skills
The craft of interviewing
CRITICAL THINKING CHALLENGE 11.1
The interview setting
Safety
Biopsychosocial model of assessment
Psychiatric assessment
Identifying information
Example
Reason for referral
Example
Presenting problem
Example
BOX 11.2 PRECIPITATING ENVIRONMENTAL AND SOCIAL PROBLEMS
Example
Mental health/medical/drug history
Mental health history
Example
Medical history
Example
Drug history
Example
Psychosocial/relationship history
Example
Determining risk factors
Example
Assessment of strengths
Collaborative assessment of strengths
Mental state examination
Example
Appearance and behaviour
Speech
Mood and affect
Form of thought
Content of thought
BOX 11.3 TYPES OF DELUSIONS
BOX 11.4 TYPES OF HALLUCINATIONS AND OTHER PERCEPTUAL DISORDERS
Perception
Sensorium and cognition
CRITICAL THINKING CHALLENGE 11.2
Insight
Physical assessment
Present and past health status
Physical examination
Figure 11.1 Nursing physical assessment form
Physical functions
Laboratory results
Spiritual assessment
TABLE 11.1 Haematological tests related to psychiatric disorders
Cultural assessment
TABLE 11.2 Questions to use in spiritual and philosophical assessment
Triage assessment
BOX 11.5 COMMUNICATING WITH PEOPLE FROM DIFFERENT ETHNIC BACKGROUNDS
TABLE 11.3 Cultural assessment checklist
Risk of harm to others
Risk of harm to self
Risk of suicide
Risk of absconding
Risk assessment guidelines
Vulnerability to exploitation or abuse
Mental health assessment and outcome measures
TABLE 11.4 Mental Health Triage
What to measure?
Methods of administering client outcome measures
The Health of the Nation Outcome Scales
Classification of mental disorders
ICD-10-AM: International Classification of Diseases
ICD-10-AM diagnostic categories
DSM-IV-TR: Diagnostic and Statistical Manual
Multi-axial classification
CRITICAL THINKING CHALLENGE 11.3
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
PART 3 Understanding mental illness
Chapter 12 Intellectual disabilities
Key points
Learning outcomes
Introduction
The language of disability services
Terminology
Systems of classification
Causes of intellectual disability and associated disorders
Legislation and changes to services for people with an intellectual disability
NURSE’S STORY: UNDERSTANDING THE PERSON’S EXPERIENCE FROM A DEVELOPMENTAL PERSPECTIVE
New Zealand–specific legislation regarding compulsory care
Service philosophy in disability services
The prevalence of dual disability
Falling through the cracks
Comments on case studies ‘Roy’ and ‘John’
CASE STUDY: ROY
CASE STUDY: JOHN
CRITICAL THINKING CHALLENGE 12.1
CRITICAL THINKING CHALLENGE 12.2
Acute assessment
Assessment and communication issues
NURSE’S STORY: COMMUNICATING
BOX 12.1 JOMAAC ASSESSMENT AT A GLANCE
Judgement
Orientation
Memory
Affect
Attitude
Cognition
Enhancing the assessment process
Acute nursing management
CRITICAL THINKING CHALLENGE 12.3
CASE STUDY: MARGARET
Facilitating continuous care
Understanding disability support services
Discharge planning
Information sharing
Mental health support plans
CASE STUDY: SOPHIE
Providing resources for clinicians and clients
Figure 12.1 Example of a mental health support plan
NURSE’S STORY: LIVING WITH A RELATIVE WITH DUAL DISABILITY
Conclusion
Acknowledgements
Disclaimer
EXERCISES FOR CLASS ENGAGEMENT
References
Legislation
Useful websites
Chapter 13 Disorders of childhood and adolescence
Key points
Learning outcomes
Introduction
Diagnosis in child and adolescent mental healthcare
BOX 13.1 COMMON DSM-IV-TR DIAGNOSTIC CATEGORIES FOR DISORDERS USUALLY FIRST DIAGNOSED IN INFANCY, CHILDHOOD OR ADOLESCENCE
BOX 13.2 CHILD BEHAVIOUR CHECKLIST
General areas
Specific areas
Incidence
Mental illness in context
Services available to children and young people
CRITICAL THINKING CHALLENGE 13.1
The nursing role
CRITICAL THINKING CHALLENGE 13.2
Engaging with children and adolescents
CASE STUDY: ADAM
Children
Discussion of case study: Adam
CRITICAL THINKING CHALLENGE 13.3
CASE STUDY: TIM
Discussion of case study: Tim
CASE STUDY: FIONA
Discussion of case study: Fiona
Skills required
Approach taken and outcome achieved
CRITICAL THINKING CHALLENGE 13.4
Adolescents
NURSE’S STORY
CRITICAL THINKING CHALLENGE 13.5
Psychosis and behaviour issues
CASE STUDY: DAVID
Discussion of case study: David
Depression and suicide
CASE STUDY: JULIE
Discussion of case study: Julie
CRITICAL THINKING CHALLENGE 13.6
Family therapy
Confidentiality
Medication adherence
Legal issues
Conclusion
Acknowledgement
EXERCISES FOR CLASS ENGAGEMENT
References
Chapter 14 Mental disorders of old age
Key points
Learning outcomes
Introduction
Demography of ageing in Australia and New Zealand
Assessment of older people
Ageism in assessment
CRITICAL THINKING CHALLENGE 14.1
NURSE’S STORY: SUSAN
Mental health disorders in the older population
Anxiety disorders
Depression
Presentation
Prevalence
Aetiology
Assessment
Nursing management of depression in older people
Psychotherapeutic support
TABLE 14.1 Geriatric Depression Scale
Pharmacotherapy and electroconvulsive therapy
CRITICAL THINKING CHALLENGE 14.2
Suicide
CASE STUDY: LINDA
Prevalence
Substance misuse
Delirium
Risk factors
Dementia
Prevalence
Aetiology
Clinical features
Nursing management of the individual with dementia
Comparing delirium, dementia and depression
TABLE 14.2 Comparison of dementia, delirium and depression
Schizophrenia
CRITICAL THINKING CHALLENGE 14.3
Nursing management of older people
CASE STUDY: JULIA
The nurse–patient relationship
Maintaining health and function
Staff attitudes
Conclusion
CRITICAL THINKING CHALLENGE 14.4
CASE STUDY: JOAN
CONCLUSION
EXERCISES FOR CLASS ENGAGEMENT
References
Further reading
Chapter 15 Schizophrenic disorders
Key points
Learning outcomes
Introduction
Prevalence
Aetiology
Biological theories
Neuroanatomical abnormalities
Genetic predisposition
Biochemical theories
The diathesis-stress model
CRITICAL THINKING CHALLENGE 15.1
Diagnostic criteria
Diagnostic and statistical manual-IV-TR
A. Characteristic symptoms of schizophrenia
B. Social/occupational dysfunction
C. Duration
D. Excluding other diagnoses
RESEARCH BRIEF: SECOND LIFE
Schizophrenia subtypes
Paranoid type
Catatonic type
Disorganised type
Undifferentiated type
Residual type
Historical development in understanding schizophrenia
Contemporary understanding of schizophrenia
Prodromal phase
Acute phase
NURSE’S STORY: PRODROMAL PHASE OF SCHIZOPHRENIA
Chronic phase
Non-psychopharmocological treatment
Cognitive behavioural therapy
CBT interventions for hallucinations
TABLE 15.1 Commonly experienced symptoms: acute phase of schizophrenia
TABLE 15.2 Commonly experienced symptoms: chronic phase of schizophrenia
TABLE 15.3 Positive and negative symptoms of schizophrenia
CBT interventions for delusional thinking
CBT interventions for stigma and stress
RESEARCH BRIEF: CBT
CRITICAL THINKING CHALLENGE 15.2
Supportive psychotherapy
Psychopharmacological intervention
TABLE 15.4 Management interventions: supportive psychotherapy
CRITICAL THINKING CHALLENGE 15.3
CASE STUDY: JIM
RECENT HISTORY
PSYCHIATRIC INTERVIEW
Goals of antipsychotic medication administration
TABLE 15.5 Adverse effects of antipsychotics
Adverse effects
Weight gain
Nursing interventions
Parkinsonian effects
Nursing interventions
Akathisia
Nursing interventions
Neuroleptic malignant syndrome
Nursing interventions
Tardive dyskinesia
Nursing interventions
Acute dystonic reaction (spasm)
Nursing interventions
Medication adherence
BOX 15.1 CLIENT EDUCATION GUIDELINES
CRITICAL THINKING CHALLENGE 15.4
Living with schizophrenia
Homelessness
Work
Labelling and stigma
General health
CRITICAL THINKING CHALLENGE 15.5
Recovery
CRITICAL THINKING CHALLENGE 15.6
RESEARCH BRIEF: PHYSICAL HEALTH
A THOUGHT FROM A CONSUMER
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Chapter 16 Mood disorders
Key points
Learning outcomes
Introduction
Epidemiology
Depression
Major depressive disorder
BOX 16.1 MAJOR DEPRESSIVE EPISODE
Criteria for a major depressive episode
Criteria for a mixed episode
Appearance and behaviour
Mood and affect
Thinking and speech
Perception
Biological symptoms
Depression and anxiety
CRITICAL THINKING CHALLENGE 16.1
TABLE 16.1 Nursing interventions for clients with major depression
Aetiology of depression
Biopsychosocial model of causation
Genetic factors and the gene–environment interaction
Neurochemical factors, hormonal systems, circadian rhythms and environmental factors
BOX 16.2 MANIC EPISODE
Criteria for a manic episode
Criteria for a mixed episode
Sex differences
Bipolar disorder
Appearance and behaviour
Mood
Thinking and speech
Perception
Biological symptoms
Aetiology of bipolar disorder
Genetic factors
Psychosocial factors
Neurochemical factors
TABLE 16.2 Nursing interventions for clients with mania
Hormone systems and circadian rhythms
Overview of causation
CRITICAL THINKING CHALLENGE 16.2
CASE STUDY: CLIENT WITH BIPOLAR DISORDER
Dysthymia and cyclothymia
Childbirth and mood disorders
Postpartum ‘blues’
Prenatal and postpartum depression
Psychotherapeutic interventions
Postpartum psychosis
Grief and mood disorders
Old age and mood disorders
BOX 16.3 MEDICAL CONDITIONS THAT CAUSE DEPRESSION AND MANIA
Neurological disorders
Endocrine disorders
Virus infections
Vitamin deficiencies
BOX 16.4 DRUG REACTIONS THAT CAUSE DEPRESSION AND MANIA
Medical conditions and drug reactions
Suicide
CRITICAL THINKING CHALLENGE 16.3
Suicide prevention contracts and close observation
Suicide prevention contracts
Close or constant observation
Pharmacology
Antidepressants
BOX 16.5 ANTIDEPRESSANT DRUGS
Selective serotonin reuptake inhibitors (SSRIs)
Selective noradrenaline reuptake inhibitors
Serotonin and noradrenaline reuptake inhibitors
Tricyclic antidepressants
Monoamine oxidase inhibitors
Atypical antidepressants
BOX 16.6 SIDE EFFECTS OF SODIUM VALPROATE
Mood stabilisers
Sodium valproate
Medication collaboration
Psychotherapy
Self-help interventions
Cognitive behavioural therapy
Group therapy
Interpersonal use of self
NURSE’S STORY: A DEPRESSED YOUNG MAN
Hospitalisation
Electroconvulsive therapy
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Websites
Chapter 17 Personality disorders
Key points
Learning outcomes
Introduction
The personality–disorder continuum
CASE STUDY: JODIE
Classification of personality disorders
Problems of diagnosis
TABLE 17.1 Criteria for classification of the personality disorders
Epidemiology
Aetiology
Assessment
BOX 17.1 CRISIS ASSESSMENT OF A CLIENT WITH A PERSONALITY DISORDER
CRITICAL THINKING CHALLENGE 17.1
Interventions: working with people with a personality disorder
Self-harm
Crisis intervention
BOX 17.2 PRINCIPLES FOR WORKING WITH PEOPLE WITH A PERSONALITY DISORDER
Limit-setting
Self-management
NURSE’S STORY
Interactive therapies
Therapeutic community
Triumvirate, or team, nursing approach
Pharmacological interventions
Education of health professionals for attitudinal change
CRITICAL THINKING CHALLENGE 17.2
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Websites
Chapter 18 Anxiety disorders
Key points
Learning outcomes
Introduction
Anxiety disorders
BOX 18.1 PROGRESSIVE LEVELS OF ANXIETY
BOX 18.2 TYPES OF ANXIETY DISORDER
CRITICAL THINKING CHALLENGE 18.1
Epidemiology
CRITICAL THINKING CHALLENGE 18.2
Aetiology
Comorbid disorders
Assessment and diagnosis
Panic attacks
BOX 18.3 SYMPTOMS OF A PANIC ATTACK
Panic disorder
NURSE’S STORY: DEALING WITH PANIC ATTACK IN A&E
Agoraphobia
CASE STUDY: ROBERT
Social phobia (social anxiety disorder)
Specific phobia
CASE STUDY: SUSANNA
Stress-related disorders
Adjustment disorder
BOX 18.4 COMMON COPING METHODS
Acute stress disorder
Posttraumatic stress disorder
Generalised anxiety disorder
Obsessive-compulsive disorder
CASE STUDY: MOIRA
Treatment and nursing interventions
Hyperventilation first aid
Panic attack first aid
Distraction
Exposure therapy and systematic desensitisation
CRITICAL THINKING CHALLENGE 18.3
Progressive muscle relaxation
Meditation
Problem solving
Response prevention
Cognitive behavioural therapy
Role-play
Psychopharmacology
Benzodiazepines
Non-benzodiazepine anxiolytic
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
Acknowledgement
References
Anxiety disorder resources
Chapter 19 Eating disorders
Key points
Learning outcomes
Introduction
Characteristics of eating disorders
Anorexia nervosa
Bulimia nervosa
Eating disorder not otherwise specified
BOX 19.1 DIAGNOSTIC CRITERIA FOR ANOREXIA NERVOSA
BOX 19.2 DIAGNOSTIC CRITERIA FOR BULIMIA NERVOSA
Eating disorders in children and adolescents
Eating disorders in males
Incidence and prevalence
Aetiology and risk factors
Gender
Age
History of dieting
Sociocultural factors
CRITICAL THINKING CHALLENGE 19.1
Psychological factors
Familial factors
Genetic and biological factors
Medical complications
Cardiovascular effects
Electrolyte abnormalities
Renal dysfunction
Gastrointestinal effects
Endocrine effects
Musculoskeletal effects
Dental and oral effects
Skin/integument effects
Neurological effects
Cognitive changes
Psychiatric comorbidity
Assessment
Physical assessment
BOX 19.3 CALCULATION OF BODY MASS INDEX
Psychiatric assessment
Body image assessment
Nutritional assessment
CRITICAL THINKING CHALLENGE 19.2
Disordered eating behaviours and rituals
BOX 19.4 EXAMPLES OF EATING-RELATED ABNORMAL BEHAVIOURS
Family assessment
Treatment
Hospitalisation
BOX 19.5 MEDICAL INDICATIONS FOR HOSPITALISATION
Nutritional rehabilitation
CASE STUDY: LUCY
Nursing care of medical instability
ETHICAL DILEMMA
QUESTIONS
Figure 19.1 Example of a flowchart for adolescent eating-disordered patients who are medically unstable and require cardiac monitoring
Re-feeding syndrome
Ongoing nursing care
Therapeutic relationship
Normalisation of eating patterns
NURSE’S STORY: WORKING WITH ADOLESCENTS WHO HAVE ANOREXIA
Binge eating and purging behaviours
Monitoring weight gain
Psychotherapeutic techniques and treatments
Specialist supportive clinical management
Cognitive behavioural therapy
Interpersonal therapy
Motivational enhancement therapy
Psychoeducation
Family therapy
Self-help programs
CASE STUDY: MARY
WEIGHT/HEIGHT
MARY’S SON
MARY’S BEST FRIEND
MARY’S MOTHER
MARY’S FATHER
MARY’S SIBLING
CURRENT SITUATION
Pharmacotherapy
CRITICAL THINKING CHALLENGE 19.3
Outcome
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Chapter 20 Substance-related disorders and dual diagnosis
Key points
Learning outcomes
Introduction
Substance use and misuse in Australia and New Zealand
Epidemiology
Substance use and misuse among Indigenous Australians
Substance use and misuse among New Zealand Māori
Pregnant and/or breastfeeding women
Lactation and alcohol use
Pharmacology of psychoactive drugs
How do drugs work?
Core diagnoses for substance use
Intoxication
Hazardous use
BOX 20.1 DSM-IV-TR CRITERIA FOR SUBSTANCE INTOXICATION
BOX 20.2 GENERAL PRINCIPLES OF MANAGING INTOXICATION
Harmful use
TABLE 20.1 Glasgow Coma Scale
BOX 20.3 DSM-IV-TR DIAGNOSTIC CRITERIA FOR SUBSTANCE ABUSE
Substance abuse
Dependence
BOX 20.4 DSM-IV-TR DIAGNOSTIC CRITERIA FOR SUBSTANCE DEPENDENCE
Tolerance
Assessment and diagnosis
Presentation, setting and history
Substance-use history
Taking a substance-use history
NURSE’S STORY: WORKING IN AOD NURSING
Guidelines
Observations
BOX 20.5 SIGNS OF CURRENT DRUG USE
CRITICAL THINKING CHALLENGE 20.1
Tests
Mental status examination
Laboratory tests
Screening tests
Interventions
Early and brief interventions
BOX 20.6 ALCOHOL USE DISORDERS IDENTIFICATION TEST (AUDIT) SCREENING INSTRUMENT
CRITICAL THINKING CHALLENGE 20.2
CASE STUDY: HELEN
QUESTIONS
NURSE’S STORY: WHY I WORK AS AN ALCOHOL & OTHER DRUG NURSE
Motivational interviewing and cognitive behavioural therapy
NURSE’S STORY: USING MOTIVATIONAL INTERVIEWING ON THURSDAY AFTERNOON IN DETOX—A CONVERSATION WITH ISABELLA, CNC
Relapse prevention
Harm minimisation and harm reduction
Managing an intoxicated client
Substance withdrawal and detoxification
BOX 20.7 DSM-IV-TR CRITERIA FOR SUBSTANCE WITHDRAWAL
Amphetamine and cannabis withdrawal
Alcohol withdrawal
Other interventions
CRITICAL THINKING CHALLENGE 20.3
Dual diagnosis
Clinical significance of dual diagnosis
NURSE’S STORY: COLLABORATIVE APPROACH TO KEEPING CLIENTS IN THEIR OWN HOMES
Why do people with a mental illness use non-prescribed drugs?
Management of clients with a dual diagnosis
BOX 20.8 GUIDELINES FOR DIFFERENTIATING BETWEEN A PRIMARY PSYCHOTIC AND A SUBSTANCE-INDUCED DISORDER
BOX 20.9 MANAGEMENT PRINCIPLES FOR CLIENTS WITH SCHIZOPHRENIA AND SUBSTANCE ABUSE
Assessment
Treatment
NURSE’S STORY: BEST PRACTICE ADVICE
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Useful resources: Websites
Telephone services
Chapter 21 Somatoform and dissociative disorders
Key points
Learning outcomes
Introduction
Somatoform disorders
BOX 21.1 THE SOMATOFORM DISORDERS
Somatisation disorder
Conversion disorder
Pain disorder
Hypochondriasis
Body dysmorphic disorder
Undifferentiated somatoform disorder
Somatoform disorder not otherwise specified
BOX 21.2 SOMATIC SYNDROMES ARRANGED BY MEDICAL SPECIALTY
BOX 21.3 SYMPTOMS OF FUNCTIONAL DISORDERS
The process of somatisation
Epidemiology
Aetiology
Psychoanalysis
Amplification
Interpersonal theory
Developmental theory
Personality
Biological theories
Behavioural theory
Familial factors
Culture
Assessment
Somatisation disorder
BOX 21.4 COMMON SYMPTOMS OF SOMATISATION DISORDER
Hypochondriasis
BOX 21.5 HELPFUL QUESTIONS
CASE STUDY: PAULINE
Pain disorder
BOX 21.6 CHRONIC PAIN SYNDROMES
Conversion disorder
NURSE’S STORY: LISTENING TO A CLIENT’S PHYSICAL COMPLAINTS
CASE STUDY: JIM
Body dysmorphic disorder
CASE STUDY: MARIAN
Interventions
BOX 21.7 PRINCIPLES FOR INTERVENING IN SOMATISATION
The therapeutic relationship
BOX 21.8 PRINCIPLES OF CARE
Reassurance
Relief of symptoms
Cognitive behavioural therapy
Psychopharmacology
Support
Family involvement
Validation
Reality therapy
Lifestyle interventions
CRITICAL THINKING CHALLENGE 21.1
Dissociative disorders
BOX 21.9 DIAGNOSTIC CRITERIA FOR THE DISSOCIATIVE DISORDERS
Dissociative amnesia
Dissociative fugue
Dissociative identity disorder (previously known as multiple personality disorder)
Depersonalisation disorder
Dissociative disorder not otherwise specified
Dissociative amnesia
Dissociative fugue
Dissociative identity disorder
CASE STUDY: MARLA
Depersonalisation disorder
Assessment
Interventions
CRITICAL THINKING CHALLENGE 21.2
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Chapter 22 Forensic mental health nursing
Key points
Learning outcomes
Introduction
The development of forensic mental health services
Identifying forensic clients
The legal status of forensic clients
BOX 22.1 FORENSIC MENTAL HEALTH LEGISLATION AND INFORMATION WEBSITES
New Zealand
Australia
Demographic characteristics
Cognitive and social skills
Social disadvantage
Mental illness and risk to others
BOX 22.2 EXAMPLES OF RESEARCH EXAMINING THE LINKS BETWEEN SCHIZOPHRENIA, SUBSTANCE USE AND OFFENDING
Substance use
Forensic mental health services
Police custody centres
The courts
NURSE’S STORY: KEVIN SEATON, COURT LIAISON NURSE
Prison
NURSE’S STORY: KATHERINE DUFFY, CLINICAL NURSE THERAPIST IN A PRISON MENTAL HEALTH TEAM
Forensic mental health hospitals
CRITICAL THINKING CHALLENGE 22.1
Physical security
Procedural security
NURSE’S STORY: TONY BERRY, INPATIENT FORENSIC MENTAL HEALTH NURSE
Relational security
CRITICAL THINKING CHALLENGE 22.2
ETHICAL DILEMMA
The community
The knowledge, skills and attitudes required of the forensic mental health nurse
Assessment and management of risk
Gathering accurate information
BOX 22.3 RISK FACTORS CONSIDERED IN THE THREE MOST-USED FORENSIC RISK ASSESSMENT TOOLS
Understanding the pathway to violence
Developing a pathway to safety
CRITICAL THINKING CHALLENGE 22.3
Use of coercion
ETHICAL DILEMMA
Safety
Promote optimal physical health
The ethical dimension in forensic mental healthcare
Multidisciplinary team involvement
Culture and family
Minimising stigma and discrimination for forensic clients
Conclusion
CASE STUDY: REDEMPTION VERSUS STIGMA
EXERCISES FOR CLASS ENGAGEMENT
References
PART 4 Developing skills for mental health nursing
Chapter 23 Settings for mental healthcare
Key points
Learning outcomes
Introduction
Historical overview
Therapeutic community
Principles governing the inpatient therapeutic milieu
Open communication
BOX 23.1 THE SIX PRINCIPLES OF EFFECTIVE COMMUNITY MEETINGS
CRITICAL THINKING CHALLENGE 23.1
Democratisation
Reality confrontation
Permissiveness
Group cohesion (communalism)
Multidisciplinary team
BOX 23.2 MEMBERS OF THE MULTIDISCIPLINARY TEAM
Psychiatrist
Psychologist
Mental health nurse
Social worker
Occupational therapist
Goals of the therapeutic milieu
Containment
BOX 23.3 NURSING OBSERVATION IN AN INPATIENT MILIEU
ETHICAL DILEMMA 1
CRITICAL THINKING CHALLENGE 23.2
ETHICAL DILEMMA 2
Structure
BOX 23.4 EVIDENCE-BASED PRACTICES
Support
Involvement
Validation
Symptom management
Maintaining links with the client’s family or significant others
Developing and maintaining links with the community
Living in the community
BOX 23.5 ACCOMMODATION IN THE COMMUNITY
Unsupervised hostels or boarding houses
Supervised hostels
Group homes
Community care units
The multidisciplinary team in the community
NURSE’S STORY: A CLIENT IN THE COMMUNITY
Primary healthcare
The Mental Health Nurse Incentive Program
Case management
BOX 23.6 CORE FUNCTIONS OF CASE MANAGEMENT
BOX 23.7 EXAMPLES OF CASE MANAGEMENT FUNCTIONS
Assessment of medication management
Linking a client who enjoys reading
CASE STUDY: JOHN
The broker model and the clinical case management model
Assertive community treatment
Intensive case management
The strengths model
The rehabilitation model
Principles of caring in the community
Self-determination
Normalisation
Focus on client strengths
Recruiting environmental agencies
Mental healthcare in general health settings
The internet
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Websites
Chapter 24 Working with consumers
Key points
Learning outcomes
Introduction
Communicating with consumers and families
CRITICAL THINKING CHALLENGE 24.1
Therapeutic relationships
The role of empathy
Active listening
Closed and open-ended questions
TABLE 24.1 Examples of closed and open-ended questions
Reflective listening
Paraphrasing
Summarising
Body language and touch
Influence
Transference and countertransference
Boundaries
Issues in working with families and carers
Skills in specific risk situations
Risk assessment and management
Managing the person who is aggressive, and preventing violence
BOX 24.1 BEHAVIOURS LINKED TO ESCALATING AGGRESSION
BOX 24.2 NURSING SKILLS FOR USE WITH THE PERSON WHO IS AGGRESSIVE
Seclusion
Why use seclusion?
Consumer perspectives on seclusion
Nurse perspectives on seclusion
Legal perspectives on seclusion
CASE STUDY: MARIA (PART A)
LINKS TO THE MENTAL HEALTH ACTS
CRITICAL THINKING CHALLENGE 24.2
BOX 24.3 TERMS USED TO DESCRIBE SELF-HARM AND SUICIDE
Working with the person who self-harms or is suicidal
Self-harming behaviours and suicide risk
CRITICAL THINKING CHALLENGE 24.3
CASE STUDY: MARIA (PART B)
Working with the person who self-harms
Reasons for self-harming behaviour
NURSE’S STORY: SELF-HARM
Providing care and communicating with the person who self-harms
Comprehensive assessment of the person who self-harms
Interventions for self-harming behaviour
CRITICAL THINKING CHALLENGE 24.4
Working with the person who is suicidal
BOX 24.4 NURSING SKILLS USED WITH THE PERSON WHO IS SELF-HARMING
Reasons for suicidal behaviours
Assessing for risk of suicide
BOX 24.5 ASSESSMENT OF SUICIDALITY: DIRECT QUESTIONS
BOX 24.6 ASSESSMENT OF SUICIDALITY: QUESTIONS
BOX 24.7 RISK FACTORS FOR SUICIDAL BEHAVIOUR
SUICIDE RISK ASSESSMENT
Caring for and communicating with the person who is suicidal
Consumer perspectives on being cared for while suicidal
BOX 24.8 NURSING STRATEGIES FOR USE WITH THE PERSON WHO IS SUICIDAL
Nursing interventions for the person who is suicidal
NURSE’S STORY: MANAGING THE PERSON WHO IS AT RISK
CASE STUDY: BEN (PART A)
CRITICAL THINKING CHALLENGE 24.5
CASE STUDY: BEN (PART B)
CRITICAL THINKING CHALLENGE 24.6
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Chapter 25 Therapeutic interventions
Key points
Learning outcomes
Introduction
Basic counselling skills
Stress management
Relaxation training
BOX 25.1 BELLY BREATHING
Assertiveness training
TABLE 25.1 Comparing passive, assertive and aggressive styles
CRITICAL THINKING CHALLENGE 25.1
Risk assessment
CRITICAL THINKING CHALLENGE 25.2
Risk for violence
Self-harm and suicide
CASE STUDY: AN AVOIDABLE DEATH?
CASE STUDY: GEORGIA
Crisis intervention
CASE STUDY: SUE
Telephone counselling
CRITICAL THINKING CHALLENGE 25.3
Psychotherapy
Individual psychotherapy
Planned short-term psychotherapy
Motivational interviewing
Cognitive behavioural therapy
Figure 25.1 The five-part model for problem identification using cognitive behavioural therapy
Dialectical behaviour therapy
Solution-focused brief therapy
Behaviour therapy
CRITICAL THINKING CHALLENGE 25.4
CASE STUDY: GEORGE
Group therapy
Activity groups
NURSE’S STORY: FACILITATING A GROUP
Family therapy
Psychoeducation
CASE STUDY: BILL AND JOAN
Psychosocial rehabilitation
Instilling hope
NURSE’S STORY: GOALS
Social skills training
Interviewing
Case management
NURSE’S STORY: THE THERAPEUTIC ENCOUNTER
CULTURAL NOTE
Electroconvulsive therapy
NURSE’S STORY: ECT
Repetitive transcranial magnetic stimulation
Conclusion
EXERCISES FOR CLASS ENGAGEMENT
References
Websites
Chapter 26 Psychopharmacology
Key points
Learning outcomes
Introduction
Important pharmacological principles
NURSE’S STORY: THE IMPORTANCE OF WORKING WITH THE PERSON
Important psychotropic drugs
Anti-anxiety or anxiolytic medications
TABLE 26.1 Classification of psychotropic drugs
Benzodiazepines
Indications for use
Side effects
TABLE 26.2 Managing benzodiazepine side effects
BOX 26.1 BENZODIAZEPINE WITHDRAWAL SYNDROME
Contraindications/precautions
Interactions
Consumer education
Non-benzodiazepine anti-anxiety drugs
Antidepressant drugs
Indications for use
Side effects
Tricyclic antidepressants
BOX 26.2 SIGNS OF TRICYCLIC OVERDOSE
Monoamine oxidase inhibitors
BOX 26.3 FOOD AND DRUGS TO BE AVOIDED BY CONSUMERS TAKING MAOIS
Selective serotonin reuptake inhibitors
Contraindications/precautions
Interactions
Tricyclics
MAOIs
SSRIs
Consumer education
Mood-stabilising drugs
Indications for use
Lithium
Anticonvulsants
Side effects
Lithium
Anticonvulsants
Contraindications/precautions
Lithium
Anticonvulsants
Interactions
Lithium
Anticonvulsants
Consumer education
Lithium
Anticonvulsants
BOX 26.4 SIGNS OF LITHIUM TOXICITY
NURSE’S STORY: LITHIUM INTOXICATION
Antipsychotic or neuroleptic drugs
Indications for use
Side effects
Typical antipsychotics
TABLE 26.3 Side effects of the typical antipsychotics
NURSE’S STORY: ANTIPSYCHOTIC DRUG SIDE EFFECTS
BOX 26.5 USEFUL TOOLS FOR ASSESSING DRUG SIDE EFFECTS
LUNSERS
AIMS
BOX 26.6 NEUROLEPTIC MALIGNANT SYNDROME
Atypical antipsychotics
Antiparkinsonian medications
TABLE 26.4 Antiparkinsonians: action and side effects
Contraindications/precautions
Typical antipsychotics
Atypical antipsychotics: clozapine
Interactions
Typical antipsychotics
Atypical antipsychotics
CONSUMER EDUCATION
Typical antipsychotics
Atypical antipsychotics
prn (as-needed) antipsychotic drug administration
Adherence to medications
BOX 26.7 INTERVENTIONS TO HELP WITH ADHERENCE TO MEDICATION
Consumer education
CASE STUDY: NON-ADHERENCE TO PSYCHOTROPIC MEDICATIONS (PART A)
CRITICAL THINKING CHALLENGE 26.1
CRITICAL THINKING CHALLENGE 26.2
Depot preparation of antipsychotic drugs
TABLE 26.5 Depot antipsychotic drugs
CASE STUDY: NON-ADHERENCE TO PSYCHOTROPIC MEDICATIONS (PART B)
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Ruth Elder,Katie Evans RPN BA MLitSt PhD FANZCMHN,Debra Nizette,Health Nursing
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