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Nursing care as applied to a client with a mental health problem

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An extended essay demonstrating the candidate's ability to evaluate how the application of theoretical knowledge gained during the course influences and effects the provision of quality nursing care as applied to a client with a mental health problem. The aim of this assignment is to explore the application of theory to practise with regards to a client with a mental health problem. In order to effectively care for clients, nurses need to regularly evaluate their knowledge and assess this knowledge increases the quality of mental health nursing care. The client chosen for this assignment was a female, 39 year-old suffering with agoraphobia. She was a single Asian origin, but living in a council flat in London with her father and sisters. The duration of the clients' illness was approximately nine years, since about 1987. For the purpose of the reader, this essay will be written in the first person, as it will make the assignment more coherent. I worked with the client in the community for the duration of my placement. Therefore, for two months I had regular contact with the client everyday. The client needed nursing intervention because she needed help in coping with her agoraphobia. Due to this phobia she was reliably housebound and could not successfully carry out her activities of daily living. Her father did the shopping and housework. In addition to this the client's functioning was impaired due to other physical problems. She suffered from epilepsy and she had a tumour growing in the left hemisphere, which affected her right-sided mobility. "A phobia is a fear of a specific of a specific object or scenario" "A phobia is s persistent irrational fear of a specific object, activity or situation." (Wilson and Kneisl 1996). The client's usually identifies her phobia as unrealistic but she still perceives it as anxiety provoking. Agoraphobia is associated with a fear of open spaces. ...read more.


It aims to decrease the pulse rate and respiratory rate, blood pressure and perspiration, which are both heightened in anxiety. (Wilson and Kneisl 1996). As the client experienced those feelings the technique seemed relevant to attempt to alleviate the uncomfortable feelings. So graded exposure and relaxation techniques are highly effective when combined together to alleviate fears and phobias. The principles of the treatment are to substitute a response that is incompatible with anxiety, that is, relaxation. It is difficult to be anxious and relaxed all the same time. (Atkinson 1993). Before we begin the exposure and relaxation, the client could not even make it as far as the front step outside her front door. By the time the exposure therapy was undergoing she began to gradually improve until more comfortable with going outside. She was far from cured but she was gradually becoming more confident when been exposed. Current research on behaviour therapy supports it as a treatment for agoraphobia. For example; "Behavioural treatment based on exposure and can provide lasting relief to the majority of patients. (Giovanne et al 1995 p 87). The education I engaged in with a client regarding relaxation techniques and the biology of anxiety could be said but to be health prolonging. We were trying to work together to empower the clients to make her own decisions about her treatment based on the knowledge of her illness. Once she understood her illness she could begin to make health choices. This education may affect her perception of her illness. Perceived health stresses play a role in the frequency of health promotion behaviour (Pencle 1987). Before we began the therapies the client had a very negative opinion of herself and her abilities, this affected her self-esteem and therefore her experiences of well being. Therefore this affected her perceptions of her illness. Through education, knowledge and practice the client began to fill more positive and began making more decisions about her health and treatment. ...read more.


He knew he could improve his quality of life because the graded exposure reinforced his belief in himself. In addition to this we can use the importance of the theory learnt during the course in application to nursing practice. It gives us knowledge to work with clients as individuals. The client may not have responded well to graded exposure in which case we could have tried a number of different techniques learned during the course to cope with agoraphobia. For example flooding or possible imagery. Nurses need to be able to adapt their knowledge and to the clients individual needs. Having varied knowledge but gives the client and us more options more options to care. Another important aspect that improve this clients' quality of care or supervision both the occupational therapist and myself engaged in. This would involve the clients' programme of care, whether it was benefiting him in our perception and the clients' other options we could use and how we felt. For example I often felt drained after my sessions because the client would ruminate for lengthy periods on his problems. With supervision I gained some knowledge of how to focus the client. One-way of doing this was that I wrote down at comprehensive list of the clients and its topics for discussion before each session. I then used his list as a reference when the client began to ramble. If supervision had not been used we could have become stressed through interpretation and lack of reflection. Supervision is important because it enhances nurses' education, orientation, support and facilities and nurses to think about how to use of self. (Hinchcliffe 1994). Therefore, the nurses are constantly learning and gaining insight, which impresses clients'. Quality of cares and protects nurses. So we can see from this essay that all the care subjects we have gained knowledge of in the course can greatly improve the clients' care it and our ability to care for them. We are constantly learning in practice and need to use knowledge, but supervision, reflection and other disciplines to improve our standard of care. ?? ?? ?? ?? 2301194 ...read more.

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