Terapia psicoeducativa para familias de pacientes con esquizofrenia paranoide / Psychoeducational therapy with families of paranoid schizophrenia patients

OBJETIVO: El objetivo del estudio fue medir la efectividad de la terapia psicoeducativa en la carga familiar de los pacientes con esquizofrenia paranoide. MÉTODOS: En este estudio se utilizó un diseño de investigación experimental con un grupo de control equivalente que utilizó 84 muestras de asignación aleatoria en un hospital psiquiátrico en Semarang. El instrumento del estudio fue la versión indonesia de la escala de carga del cuidador (CBS). Se utilizó la prueba Mann-Whitney para analizar los datos. RESULTADOS: Los hallazgos obtenidos muestran la efectividad de la terapia psicoeducativa sobre la carga familiar en el grupo experimental en comparación con la terapia estándar en el grupo control (antes: Z=−1,27; p = 0,092; después: Z=−3,47; p = 0,002). CONCLUSIÓN: Concluimos que la terapia psicoeducativa de la familia, como la aplicada en el grupo experimental, puede disminuir la carga familiar en las familias de pacientes con esquizofrenia paranoide. La aplicación de una terapia psicoeducativa familiar puede servir de guía a la enfermera psiquiátrica en la reducción de la carga familiar en el cuidado de pacientes con esquizofrenia paranoide

AIM: The study aimed to measure the effectiveness of psychoeducational therapy on the burden of families of paranoid schizophrenia patients. METHODS: An experimental research design was used in this study with an equivalent control group using 84 random allocation samples at a mental hospital in Semarang. The study instrument was the Indonesian version of the care burden scale (CBS). The Mann-Whitney test was used for the data analysis. RESULTS: The findings obtained show the effectiveness of psychoeducational therapy on family burden in the experimental group as opposed to standard therapy in the control group (before: Z=−1.27; P=.092, and after: Z=−3.47; P=.002). CONCLUSION: We conclude that family psychoeducational therapy, as given to the experiment group, can decrease the family burden for the family of a paranoid schizophrenia patient. The application of family psychoeducational therapy can serve as guidance for the psychiatric nurse in reducing the family burden in the care of patients with paranoid schizophrenia

Intervenciones de enfermería para la atención de adultos con esquizofrenia paranoide / Nursing interventions for the care of adults with paranoid schizophrenia

Introducción. Los trastornos mentales tienen una alta prevalencia en todo el mundo y contribuyen de manera importante a la morbilidad, la discapacidad y la mortalidad prematura. Métodos. Con el descriptor “Paranoid Schizophrenia” y el planteamiento de preguntas clínicas, se realizó la búsqueda sistemática en: PUBMED, CUIDEN y algunos sitios web para la revisión de guías clínicas, revisiones sistemáticas, ensayos clínicos, estudios observacionales entre otros, cuyas evidencias y recomendaciones con mayor gradación y fuerza respectivamente, dieran respuesta a la detección y diagnóstico oportuno, intervenciones durante la fase aguda, adherencia terapéutica, identificación y tratamiento de efectos adversos e intervenciones dirigidas a la familia para facilitar la psicoeducación y el autocuidado. Se consideraron documentos en inglés y español publicados en 2010-2015.Resultados. De 20 estudios analizados, la evidencia científica denota que para el diagnóstico de esquizofrenia, es necesario considerar las características del cuadro clínico, antecedentes personales, familiares y factores de riesgo, además del abordaje durante la etapa aguda mediante la seguridad, contención verbal, farmacológica y física. Así mismo, el seguimiento para la detección y tratamiento de efectos adversos derivados del tratamiento farmacológico y el planteamiento de programas que consideren la identidad y cosmovisión de la persona, su familia y los efectos adversos sobre la salud, vida personal, social y económica.Conclusiones. Se deben estandarizar estrategias que faciliten la atención integral farmacológica, psicosocial y de autocuidado, con la finalidad de mejorar la calidad de la atención a personas con trastornos mentales así como de su familia.

Introduction. Mental disorders are highly prevalent worldwide and contribute significantly to morbidity, disability and premature mortality manner.Methods. With the descriptor "Paranoid Schizophrenia" and approach to clinical questions, the systematic search was conducted: PUBMED, CUIDEN and some websites for review of clinical guidelines, systematic reviews, clinical trials, observational studies among others, whose findings and recommendations more gradation and strength respectively, would respond to the detection and timely diagnosis, interventions during the acute phase, adherence, identification and treatment of adverse effects and interventions aimed at facilitating family psycho-education and self-care. documents were considered in English and Spanish published in 2010-2015.Results. 20 studies reviewed, scientific evidence indicates that for the diagnosis of schizophrenia, it is necessary to consider the clinical characteristics, personal history, and family risk factors, in addition to the approach during the acute stage by security, verbal, pharmacological containment and physical. Similarly, monitoring for the detection and treatment of adverse effects from the drug treatment programs and approach to consider the identity and worldview of the person, his family and adverse health effects, personal, social and economic life.Conclusions. Strategies should be standardized to facilitate the pharmacological, psychosocial self-care and comprehensive care in order to improve the quality of care for people with mental disorders and their family.

Introdução. Os transtornos mentais são altamente prevalentes em todo o mundo e contribuir significativamente para a morbidade, incapacidade e mortalidade prematura maneira.Métodos. Com o descritor "esquizofrenia paranóide" e abordagem de questões clínicas, a busca sistemática foi conduzida: PubMed, CUIDEN e alguns sites de revisão de diretrizes clínicas, revisões sistemáticas, ensaios clínicos, estudos observacionais, entre outros, cujas conclusões e recomendações mais gradação e força, respectivamente, iria responder ao diagnóstico de detecção e oportuna, as intervenções durante a fase aguda, a adesão, a identificação e tratamento de efeitos adversos e intervenções destinadas a facilitar família psico-educação e auto-cuidado. documentos foram considerados em Inglês e Espanhol publicado em 2010-2015.Resultados. 20 estudos revisados, evidências científicas indicam que, para o diagnóstico de esquizofrenia, é necessário considerar as características clínicas, história pessoal e fatores de risco familiar, além da abordagem durante a fase aguda de segurança, verbal, contenção farmacológica e física. Da mesma forma, o monitoramento para a detecção e tratamento dos efeitos adversos dos programas de tratamento de drogas e abordagem a considerar a identidade e visão de mundo da pessoa, sua família e efeitos adversos à saúde, vida pessoal, social e económico.Conclusões. As estratégias devem ser padronizados para facilitar a auto-atendimento psicossocial e farmacológico atendimento integral a fim de melhorar a qualidade dos cuidados para as pessoas com transtornos mentais e seus familiares.

[Cooking as a therapy for dangerous mental health patients: controlled risk-taking]. / La cuisine comme thérapie pour des malades mentaux dangereux : une prise de risque maîtrisée.

Among the range of therapeutic mediators used with dangerous mental health patients in the unit for dangerous patients in Cadillac, cooking holds an important place. Led by caregivers, this activity has undeniable positive effects for the psychotic and non-psychotic patients taking part. These effects concern notably their capacities for conception, creation, organisation, execution, sensation, collaboration and socialisation. For some patients, it is also the opportunity to take the drama out of handling utensils which they previously used as weapons. As the risk factors are controlled before and during the activity, no dangerous acting out has ever occurred.

[Senses and crumbs: psychosis and self-neglect at home]. / Les sens et les miettes: psychose et incurie à domicile.

What care can be given in cases of self-neglect? How can one be a good caregiver when one's senses and values are assaulted by the complete lack of hygiene? What is the bestway to help a patient who is used to living independently, when their health is under threat? What approach should be taken in order to rehabilitate their living place? A clinical illustration.

[Preventing dangerous psychotic acting out]. / Prévenir les passages à l'acte dangereux psychotiques.

Delusions of having been wronged, of persecution, of having a mission or order to execute, are frequently the causes of dangerous psychotic acting out. The regular clinical assessment of these patients and their treatment is essential for preventing this acting out, which can have dramatic consequences on the potential victims. If there is a treatment indication but refusal on the part of the patient to cooperate, it is necessary to resort to treatment without the patient's consent.

Case study: a young male with auditory hallucinations in paranoid schizophrenia.

PURPOSE: The purpose of this case study is to demonstrate use of the nursing process and the standardized nursing languages of NANDA International (NANDA-I), the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) to assist a young male with paranoid schizophrenia to deal with auditory hallucinations. DATA SOURCES: Data were obtained from the experience and expertise of the author and published literature. DATA SYNTHESIS: This case study demonstrates nurses' clinical decision making in providing care for an adolescent with mental illness. CONCLUSION: This case study provides the pertinent nursing diagnosis, patient outcomes, and nursing interventions for a young male with auditory hallucinations in paranoid schizophrenia. IMPLICATIONS FOR NURSING: The use of NANDA-I, NOC, and NIC can provide the necessary framework for enhancing and improving the management of care with patients who experience auditory hallucinations in paranoid schizophrenia.

[Paranoia and persecution]. / Paranoia et persécution.

The idea of paranoia has existed since Antiquity, but it was only in the 19th centurythat psychiatrists became interested in it and sought to describe it. Delusion and the feeling of persecution are common in all paranoiacs. The origins of the disease can be found in the patient's psychic structure. Establishing and maintaining contact with a caregiver is one way of helping the patient.

[Erotomania, adapting to the engendered dangerousness]. / Erotomanie, s'adapter à la dangerosité induite.

Erotomania is a dangerous pathology which is based up on the three stages of hope, pique and rancour. In the relationship, it implies the personal commitment of the therapist who must proceed with great care. Reducing, or eliminating this dangerousness is one aim but must not constitute the only goal.

Integrating a professional apprenticeship model with psychiatric clinical simulation.

In this article, we present a theory-based application of clinical simulation in psychiatric-mental health nursing education. As described by Benner, Sutphen, Leonard, and Day, a three-pronged apprenticeship that integrates intellectual, practical, and ethical aspects of the professional role is critical in the development of practical reasoning in nursing education and training. Clinical encounters are often fraught with ambiguity and uncertainty. Therefore, educating for a practice discipline requires experiential and situated learning. Using the three-pronged experiential model in simulated psychiatric-mental health nursing practice supports the development of critical nursing skills, ethics, and theoretical concepts. A clinical scenario is presented that demonstrates the application of this model of professional apprenticeship in psychiatric-mental health education. Applications of the concept presented may be used in training nurses new to the practice of psychiatric-mental health nursing.

[Paranoia, schizophrenia, delusions of persecution and dangerousness]. / Parandoïa, schizophrénie, délires de persecution et dangerosité.

Unfounded feelings of prejudice and persecution are frequent delusional themes. They are common to people suffering from paranoia and schizophrenia. If they arm the intrafamilial psychotic homicidal acting-out, their criminogenic dimension is much wider. Many more people other than family members can be victims.

'I'm not an outsider, I'm his mother!' A phenomenological enquiry into carer experiences of exclusion from acute psychiatric settings.

Contemporary standards and policies advocate carer involvement in planning, implementing, and evaluating mental health services. Critics have questioned why such standards and policies fail to move from rhetoric to reality, this particularly being applicable to carer involvement within acute psychiatric settings. As there is only limited UK research on this topic, this interpretive phenomenological study was undertaken to explore the perceived level of involvement from the perspective of carers of service users who were admitted to acute inpatient settings within the previous 2 years. Interviews were conducted with four individuals who cared for a loved one with a mental illness. The interview analysis was influenced by Van Manen, whose interpretive approach seeks to generate a deeper understanding of the phenomenon under study. Four main themes emerged: powerlessness, feeling isolated, needing to be recognized and valued, and a desire for partnership. The findings reflect the views expressed by carers in other studies, identifying that while carers seek to work in partnership with health-care professionals, at a clinical level they often feel excluded. The study concludes by discussing ways of improving and promoting carer involvement and advocating a partnership in care approach within acute psychiatry.