1
Q
a state of complete physical, mental, and social wellness, not merely the absence of disease or infirmity
WHO
A
Health
2
Q
- level of psychological well-being or an absence of mental illness
- “psychological state” of someone who is functioning at a satisfactory level of emotional and behavioral adjustment
- includes our emotional, psychological, and social well-being
A
Mental Health
3
Q
state of emotional, psychological, and social wellness evidenced by:
A
- satisfying interpersonal relationships
- effective behavior and coping
- positive self-concept
- emotional stability
4
Q
one is responsible, displays self-awareness, self-directive, reasonably worry
free, and can cope with usual daily tensions
A
a positive state
5
Q
or personal, factors include a person’s biologic
makeup, autonomy and independence, self-esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities.
A
Individual/Genetics
6
Q
or relationship, factors include effective communication, ability to help others, intimacy, and a balance of separateness and connectedness.
A
Interpersonal/Childhood Experiences
7
Q
Or environmental, factors include a sense of
community, access to adequate resources, intolerance of violence, support of diversity among people, mastery of the environment, and a positive, yet realistic, view of one’s world.
A
Social/Cultural/Life Circumstances
8
Q
a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain,
disability, or an important loss of freedom
A
Mental Illness
9
Q
include biologic makeup, intolerable or unrealistic worries or fears, inability to distinguish reality from fantasy, intolerance of life’s uncertainties, a sense of disharmony in life, and a loss of meaning in one’s
life
A
Individual
10
Q
include ineffective communication, excessive
dependency on or withdrawal from relationships, no sense of belonging, inadequate social support, and loss of emotional control
A
Interpersonal
11
Q
include lack of resources, violence, homelessness, poverty, an unwarranted negative view of the world, and discrimination such as stigma, racism, classism, ageism, and sexism.
A
Social/Cultural
12
Q
Mental health is like a violin with strings of interaction, behavior, affect and intellect. May
produce a pleasant or stimulating melody or they may be discordant and irritating. The tune continually changes.
A
Mental Health-Illness-Continuum
13
Q
No one is entirely mentally unhealthy and no one is fully healthy at all times.
A
Ebersole and Hess, 1985
14
Q
interpersonal process whereby the professional nurse practitioner through the therapeutic use of self, assist an individual, family, group or community to promote mental health, to prevent mental illness & suffering, to participate in the treatment &
rehabilitation of the mentally ill & if necessary to find meaning in this experiences
A
Psychiatric Nursing
15
Q
- the science that deals with measures to promote mental health, prevent mental illness and suffering and facilitate rehabilitation.
- As a specialized area of nursing practice employing theories of human behavior as its science & purposeful use of self as its art
A
Mental Hygiene
16
Q
Abraham Maslow (1970) - Hierarchy of Needs
A
- physiologic
- security and safety
- love
- self-esteem
- self-actualization
17
Q
Characteristics of a mentally healthy person
A
- ability to accept themselves, others & nature.
- form close relationships with others & display kindness, patience, & compassion for others
- perceive the world as it really is & people as they really are.
- appreciate and enjoy life.
- independent or autonomous in thought & action & rely on personal standards of behavior & values.
- creative, using a variety of approaches as they perform tasks or solve problems
- behavior is consistent as they appreciate & respect the rights of others, display a willingness to listen & learn from others & show reverence for the uniqueness of & difference in others
18
Q
Factors Influencing Mental Health Development
(Shives, 1994)
A
- Heredity
- Childhood Experiences
- Life Circumstances
19
Q
- Genetic background
- Nutritional status
- General health status
- Exposure to environmental toxins
A
Biological
20
Q
- Intelligence
- Verbal ability/skills
- Personality type
- Self-concept
- Past experiences
A
Pschological
21
Q
- Age
- Education
- Income
- Occupation
- Religious beliefs
- Social relationships
- Gender
A
Socio-cultural
22
Q
attempt to relate mental disorders to physical disorders
A
Aristotle (382-322 BC)
23
Q
- Possession by evil spirits, sorcerers, ghosts
- MOH: Magic, exorcism
A
Primitive culture
24
Q
- Supernatural forces & divine intervention
- MOH: Clinical observation replaces superstition, start of humane tx procedures, approches
A
Ancient Greece
25
* Possession by devils & sorceres
* MOH: Banishment, harsh method, 1st hospitals established
Medieval Period
26
* Naturalistic explanation of sickness
* MOH: Rebirth of humane attitude, clinical observation & description
Renaissance
27
* Irrationality & social deviance
* MOH: Isolation of inhumane psychiatric treatment
17th to 18th century
28
* Sickness & mental illness
* MOH: Discovery of animal magnetism & hypnosis
Mid 18th-early 19th century
29
* Intrapsychic, usually unconscious conflict
* MOH: Psychotherapy, analysis, intepretation of dreams
Late 19th-early 20th century
30
* Conflics between individual, family, community, social forces
* MOH: Marital, family, community interventions
Mid 20th century
31
* Biochemical abnormalities in combination with psychological factors
* MOH: Chemical therapies
1970-1980's
32
year developed a hospital of St. Mary Bethlehem declare for hospital for insane
| Renaissance (1300-1600) at England
1547
| Renaissance (1300-1600) at England
33
a year where visitors were charge for fee for viewing inmates
| Renaissance (1300-1600) at England
1775
| Renaissance (1300-1600) at England
34
period were concerning persons with mental illness
Period of Enlightenment & Creation of Mental Institutions 1790
| 1790's
35
They formulate Asylum as a state of refuge/offering protection at institution
Philippe Pinel (in France)
William Tuke (in England)
36
* began crusade to reform treatment of mental illness
* she open 32 state hospitals
* advocated adequate shelter, food, & clothing
Dorothea Dix (in US)
37
* challenge society to view human beings as objectively
* period of scientific study & treatment of mental disorders
* studied the mind & disorders & treatment no one done before
Sigmund Freud
38
classifying disorders according to its symptoms
Emil Kraepelin
39
coined the term Schizophrenia
Eogen Blueler
40
Principles of Psychiatric Nursing
1. Views the client as a holistic being with interdependent & interrelated needs.
2. Accepts client as a unique human being who has inherent value and worth exactly as he is.
3. Focuses on patient’s strengths & assets & not on his weaknesses & liabilities
4. Explores the patient’s behavior for the need it is designed to meet & the message it is
communicating
5. Establishes therapeutic relationship with most, if not all, patients.
6. Views client’s behavior nonjudgmentally while assisting him to learn more effective adaptations or coping.
7. Determines the degree of change that can occur in the patient’s behavior through the quality of nurse-patient relationship.
41
intervention altering causative or risk factors to hinder development of illness & promotion of mental health
* Health education
* Information dissemination
* Counseling
* Stress reduction
* Psycho-social support
Primary
42
interventions that limit the severity of a disorder
* Screening & case finding
* Crisis intervention
* Prompt treatment – administration of
medication
* Hospitalization
Secondary
43
interventions aimed at reducing the disability after a disorder
* Rehabilitation programs
* Vocational training
* After-care support
Tertiary
44
the abiliy to see beyond outward behavior and sense accurately another person's inner experiences
Empathy
45
ability to use therapeutic tools appropriately
Genuineness/Congruence
46
respect
Unconditional Positive Regard
47
Roles of a Nurse
* Ward-manager
* Socializing agent
* Counselor
* Parent surrogate
* Patient advocate
* Teacher
* Technician
* Therapist
* Reality-based model
* Healthy role model
48
creates a therapeutic environment
Word-manager
49
assists the patient to feel comfortable with others
Socializing agent
50
listens to the patient's verbalization
Counselor
51
assists the patient in the performance of activities of daily living
Parent surrogate
52
enables the patient & his relatives to know their rights & responsibilities
Patient advocate
53
assists the patient to learn more adaptive ways of coping
Teacher
54
facilitates the performance of nursing procedures
Technician
55
explores the patient's needs, problems, & concerns through varied therapeutic means
Therapist
56
enables the patient to distinguish objective reality & subjective reality
Reality-based model
57
act as a symbol of health by serving as an example of healthful living
Healthy role model
58
wear and tear that life causes on body
Stress
59
stress response occurs whenever a person encounters continuous stress
Selye
60
mobilizes the body's defenses & homeostastic responses against the stressor - "fight or flight response"
Alarm reaction - 1st phase
61
the body attempts to reduce damage from the stressor
Stage of resistance - 2nd phase
62
evolves after the body's attempts to adapt to change fail to manage the stressors if appropriate interventions to reduce the stress are unsuccessful
Stage of exhaustion - 3rd phase
63
* Focuses on intrapsychic processes
* Personality refers to aggregate of the physical & mental qualities of the individual as these interact in characteristic fashion with his environment
Freud's Psychoanalytic Model and Psychodynamic Framework
64
Personality is expressed through behavior. It is the sum total of one’s behavior
John Watson
65
The ___ plays an active role in determining behavior
unconscious
66
each individual is unique
Distinctiveness
67
personality is predictable
Stability and consistency
68
Factors Which Influence Personality
1. Heredity/Biologic
2. Training/Social
3. Environment/Fam/Cultural
69
heredity, brain, physical feature
Biological factors
70
heredity, brain, physical feature
Biological factors
71
traditional practices, norms, customs, procedures, rules, regulations, procedures & vales
Cultural factors
72
coordination & cooperation, society and real
Family factors
73
relationships, coordination, cooperation, interaction, environment in family, organization, workplaces
Social factors
74
a father of pschoanalysis, stresses that early childhood experiences is important in the development of personality
Sigmund Freud
75
* unconscious part of the person, which serves as the reservoir of primitive & biologic drives & urges
* part of personality in which we are born, primitive, & demands immediate satisfaction, functions according to pleasure principle & developed during infancy
Id
76
* the self or the Ï, known as the integrator of
personality, part of the mind which acts with the outside world, partly conscious & partly
unconscious, operates on reality principle – controls the demands of & mediates between the id & the superego, developed during the toddler period
Ego
77
* “the conscience” or the censoring force, developed during preschool age or about 7 years of age
* incorporates standards, restrictions, taboos,
ideals imposed by parents & other individuals with whom the child associates with
Superego
78
rewards the person with feelings of well-being & pride when the person conforms to demands of superego
Ego ideal
79
punishes the person with guilt feelings when person deviates from the demands of the superego
Conscience
80
* aware of here & now, in contact with reality, functions only when the person is awake
* concerned of thoughts, feelings, & sensation
* past experiences are recalled without exerting effort
* corresponds to EGO or SELF.
Conscious
81
* part of the mind in which ideas & reactions are stored & partially forgotten
* serves as a watchman by preventing unacceptable & anxiety producing memories
from reaching the conscious or awareness
* thoughts & experiences can be recalled at will
* manifested during the “tip of the tongue” experience
Subconscious or Preconscious
82
* largest part of the mind which exerts greatest influence in one’s personality
* storehouse for all memories, feelings & responses experienced by the individual
during his entire life
* memories cannot be recalled at will
* expressed in dreams, slip of the tongue, jokes
Unconscious
83
Freud's Psychosexual Development
1. Oral Stage (0-18mos)
2. Anal Stage (18-3years old)
3. Phallic Stage (3-6years old)
4. Latency Stage (6-12years old)
5. Genital Stage (12-20years old)
84
Behavior: control of holding on & letting go
Anal Stage
85
attraction to father
Elektra complex
86
attraction to mother
Oedipal complex
87
Because of desire to possess parent of opposite sex, the child develops guilt feelings & fear of punishment by parent of the same sex
Castration complex
88
Erickson's Psychosocial Development
1. Trust vs Mistrust
2. Autonomy vs Shame & Doubt
3. Initiative vs Guilt
4. Industry vs Inferiority
5. Identity vs Role Confusion
5. Intimacy vs Isolation
6. Generativity vs Stagnation
7. Integrity vs Despair
89
The sense of “___” may develop which could
restrict initiative
badness
90
Learning how to do things well
Industry vs Inferiority
91
Highest incidence of schizophrenia
Identity vs Role Confusion
92
Highest incidence of schizophrenia
Identity vs Role Confusion
93
The stage of mid-life crisis
Generativity vs Stagnation
94
The stage of mid-life crisis
Generativity vs Stagnation
95
driving force of human behavior
libido
96
results when person has difficulty to transition from one stage to another; regresses to an earlier stage
Psychopathology
97
occurs when client displaces onto the therapist attitudes & feelings the client originally experienced in other relationships
Transference
98
occurs when the therapist displaces onto the client attitudes/feelings from their own past
Countertransference
99
focuses on discovering the causes of the clients unconscious & repressed thoughts, feelings, & conflicts, believe to cause anxiety & on helping the client again insights into and resolve these conflicts & anxiety
Psychoanalysis
100
therapist try to uncover the clients thought & feelings by saying word & asking client to respond quickly w/ the FIRST THING THAT COMES TO MIND
free association
101
* primary technique use in psycho analysis
* discussing a clients dream to discover their true meaning & significance
Dream Analysis
102
* uncovering & reliving traumatic events
* an emotional release
* releasing strong/motion through art
Catharsis
103
can be used to understand
& interpret client behavior
Psychodynamic theory
104
provides developmental
perspective on client behavior
Psychodynamic approach
105
personality development results from interaction with significant others & that the child internalizes approval or disapproval by significant others
Interpersonal Framework (Sullivan's Theory)
| Harry Stack- Sullivan
106
resulting from positive approval & leading to good feelings about self
Good Me
107
resulting from experiences related to increase
anxiety & leading to anxiety state
Bad Me
108
results from very disapproving message & leading to overwhelming anxiety
Not Me
109
Interpersonal Framework (Harry Stack-Sullivan's Theory)
1. Infancy
2. Toddlerhood
3. Preschooler
4. Schooler
5. Adolescence
6. Young Adulthood
110
* "good me and bad me"
* solitary play
Infancy
111
* emphasized the sense of POWER
* favorite word "NO"
* parallel play
Toddlerhood
112
* known as Later Childhood
* favorite word "WHY"
Preschooler
113
Acquires important interpersonal tools – ability to compete, compromise & values of loyalty
Juvenile Era (6-10years old)
114
Intimacy & acceptance provided by chum
relationship reinforces positive self-esteem leading to develop a healthy heterosexual relationship
Preadolescence (11-12 years old)
115
intense love relationship with a particular person of the same sex whom the child perceives to be similar to himself
Chum relationship
116
Development of heterosexual relationship
Adolescence
117
Learns to be economically, intellectually self-sufficient
Young Adulthood (20-40yrs old)
118
Focuses on the cognitive processes which includes expectations, beliefs & memories & thinking patterns which influence behavior & feelings
Cognitive Framework- Jean Piaget
119
Piaget's Cognitive Theory
* Sensorimotor (birth to 2 yrs)
* Pre-operational (2-7yrs old)
* Concrete operations (7-12yrs old)
* Formal operations (12yrs to adulthood)
120
* Uses senses & motor abilities to understand the world
* Egocentric
Sensorimotor (Birth to 2 yrs)
121
infants begin to display behavior (cry-hungry, wet)
Primary Circular Reaction
122
awareness of independence of his own actions & perception
Object Permanence
123
proceeds from sensory motor learning to pre-logical thought (understand symbols & learn languages to communicate)
2-4 yrs: pre-conceptual-development
124
learns to understand (relationships: same-different, family placement, classes = books, birds)
4-7 yrs: intuitive thought
125
refers to completion of certain operation in reverse order & ending up the same
Reversibility
126
modifies ideas to fit reality
Accomodation developed
127
* Employs logical, mathematical & scientific
reasoning.
* Has solution to all kinds of problems
* Abstract thinking is fully utilized
Formal operations (12yrs to adulthood)
128
Individual's ___ is the basis for mental illness
distorted thinking
129
holding beliefs in absence of supporting evidence
Arbitrary evidence
130
concentrating on a single detail while ignoring others
Selective abstraction
131
making global assumptions based on an isolated incident
Overgeneralization
132
greatly exaggerating a situation
Magnification
133
Belittling personal ability, action or response
Minimization
134
"all or nothing" patterns of thought
Dichotomous thinking
135
Focuses on learned behavior
Behavioral Framework
136
reward will help continue behavior
Positive reinforcement
137
punishment for the behavior that will help continue
Negative reinforcement
138
* operant behavior that can be reinforced
* says "people learned their behavior, from their history or past experiences that were repeated, reinforced"
Operant Conditioning by B. F Skinner
139
gradually confronting a situation that evokes anxiety
Systematic desensitization
140
immersing oneself in a situation
Flooding
141
applying an unpleasant stimulus to discourage a maladaptive behavior
Aversive therapy
142
used to counteract tension
Relaxation techniques
143
to overcome passivity or aggression in interpersonal situations
Assertiveness training
144
Focuses on conscious human experiences of here & now
Humanistic (Existential) Framework
145
fundamental human anxiety
fear of death
146
Therapist attempts to achieve emphatic rapport, listens carefully to the patient & reflect what is understood
Client-centered therapy by Rogers
147
Patient is assisted to express feelings such as in role playing, confronting feelings leading to acceptance of self & to a more mature behavior
Gestalt therapy by Perls
148
Focuses on disease approach such as identification of syndromes, establishment of diagnosis & search for etiologies. Mental illness have certain symptoms that can be classified & treated
Psychobiologic Framework
149
Mental illness is a disorder of the body & can be classified in ___ & labeling a mental disorder as an illness help patient on treatment & recovery
DSM lV-TR
150
Psychobiologic Treatment
1. Diagnostic tools - brain scanning, imaging, & laboratory test
2. Pharmacotherapy
3. Psychotherapy
Prelims
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