psychology part 1

• Common learning outcomes for the student include:
• Defining common terms related to Psychiatric Nursing
• Outlining significant historical events in psychiatric care
• Describing the basic principles, goals, and scope of MHPN
• Identifying the different collaborative roles of the members of the mental health team
• Describing the different roles and essential qualities of a mental health nurse in primary, secondary, and tertiary prevention
• Psychiatric nursing

  Concerned with the promotion of mental health, prevention of mental disorders, and nursing care of patients during mental illness and rehabilitation
• Concerned with the promotion of mental health, prevention of mental disorders, and nursing care of patients during mental illness and rehabilitation
• Evolution of Mental Health - Psychiatric Nursing Practice:
• Ancient times:

  • Insanity associated with sin and demonic possession
  • Healers used rituals, herbs, ointments, and precious stones
  • Treatment was sometimes inhumane and brutal
  • Aristotle related mental disorders to physical disorders
  • Early Christian times had primitive beliefs and superstitions
• Middle Ages:

  • Mentally ill people often imprisoned or forced to live on the streets
  • Hospital of St. Mary of Bethlehem built in 1547
  • Visitors charged a fee in 1775
• 15th through 17th centuries:

  • Skepticism about curability continued
  • Asylums became repositories
  • Care was custodial by ill-treated attendants
• 18th century:

  • French and American Revolutions transformed society's attitude
  • Benjamin Rush emphasized pleasant environment and moral treatment
  • Philippe Pinel emphasized kindness and understanding
  • William Tuke advocated humane treatment
• 19th century:

  • First psychiatric hospital established in America in 1773
  • Dorothea Lynde Dix crusaded to reform mental illness treatment
  • McLean Asylum built in 1817
  • Society obligated to mentally ill
• 20th century:

  • Improved social attitudes towards mentally ill
  • Exploration of reasons for mental disease accelerated
  • Various individuals made significant contributions to psychiatric care
• Advent of Somatic Therapies:

  • Development of psychotropic drugs like lithium, chlorpromazine, and others
  • Period of Community Mental Health in the 1960s
  • Enactment of the Community Mental Health Center Construction Act
  • Deinstitutionalization and new psychotherapies
• 21st century:

  • Focus on neuroscience and genetics
  • Information systems, complementary therapies, and cultural considerations
• The Mental Health Nurse:
• Psychiatric-mental health nursing is a specialized field emphasizing the skillful use of the interpersonal process for therapeutic goals
• Historical figures like Linda Richards, Dorothea Lynde Dix, and others contributed to the development of psychiatric nursing
• Roles and essential qualities of a mental health nurse:

  • Roles include teacher, caregiver, advocate, counselor, and more
  • Expanded roles like managed care nursing and parish nursing
  • Essential qualities include therapeutic use of self, genuineness, empathy, and more
• Interdisciplinary Team:
• Core skill areas for the interdisciplinary team:

  • Interpersonal skills, humanity, knowledge, communication skills, personal qualities, teamwork skills, risk assessment, and risk management skills
• The Mental Health-Mental Illness Continuum:
• Definition of mental health and mental illness as a state of well-being where a person can realize their own potential
• Definition of Mental Health and Mental Illness:

  • Mental health is a state of well-being where a person can cope with normal stresses of life and work productively (WHO)
  • Mental health is a state of emotional, psychological, and social wellness
• Factors that Influence Mental Health:

  • The ability of people to respond adaptively to internal and external stressors
• Characteristics of a Mentally Healthy Person:

  • Self-acceptance
  • Perceives reality accurately
  • Exhibits environmental mastery
  • Self-determination or autonomy
  • Achieves a unifying, integrated outlook in life
• Factors Influencing Mental Health:

  • Individual/Personal factors: age, growth, development, physical health, genetics, response to drugs, self-efficacy, hardiness, resilience, resourcefulness, spirituality
  • Interpersonal factors: sense of belonging, social networks, family support
  • Social/Cultural/Environmental factors: beliefs about causes of illness, biologic variations, socioeconomic status, cultural patterns and differences
• Ego Defense Mechanisms:

  • Protective barriers used to manage instinct and affect in stressful situations
• Mental Disorder:

  • A medically diagnosable illness that impairs cognitive, affective, or relational abilities
• Mental Illness:

  • State in which an individual shows deficit in functioning and is unable to maintain personal relationships due to various disturbances
• Populations at Risk for Mental Illness:

  • Those with familial or genetic predisposition
  • Those with poor access to health care
  • Those disadvantaged
  • Those undergoing significant lifestyle changes
  • Those misusing substances
  • Victims of violence
  • Elderly poor
• Misconceptions about Mental Illness:

  • Abnormal behavior is easily recognized
  • Abnormal behavior can be predicted and evaluated
  • Internal forces are responsible for abnormal behavior
  • People who exhibit abnormal behavior are dangerous
  • Maladaptive behavior is always inherited
  • Mental illness is incurable
• attachment theory states that infants form attachments with caregivers through repeated interactions
• social referencing is when we look at others reactions to something new or unfamiliar to determine how to react ourselves
• ORAL Birth – 18 months

  • Mouth
  • Greatest need is security; greatest fear: anger and anxiety
  • Narcissistic - Insecurity may cause fixation
• ANAL 18-36 months

  • Anus
  • Elimination/retention/toilet training
  • Greatest need – power
  • - Reality principle is introduced
  • – ego development/beginning superego development
  • - Exhibits motor self-control and independence through negativistic behavior
  • - Compulsive (clean), frugality, stinginess, greed, excessive messiness, disorderly habits
• PHALLIC 3-6 years old - Genital region - Masturbation, fantasy, play activities, experimentation, questioning of adults (sex) - Penis envy, castration anxiety - Oedipus complex - Resolution with the identification of same sex parent - Guilt neurosis
• PHALLIC 3-6 years old

  • Genital region
  • - Masturbation, fantasy, play activities, experimentation, questioning of adults (sex)
  • Penis envy, castration anxiety
  • Oedipus complex
  • Resolution with the identification of same sex parent
  • - Guilt neurosis