Schizophrenia is a complex mental disorder which has a broad variety of symptoms which can be positive and negative. Negative are the ones which result in losing the ability of normal function, whereas the positive ones are the normal function but in an altered manner.
Positive symptoms are delusions, hallucinations, catatonic behavior and disorganized speech. Delusions are beliefs which are stated on a wrong and unreasonable perception of reality. An example of such behavior can be thinking that someone else is thinking something bad of them, that they are tricked, tortured. They can think that the media, newspaper, and neighbors are commenting them, trying to hurt them or they could think that someone is stealing their thoughts because they have the ability to broadcast their thinking. There are some somatic delusions like thinking that their body is being eaten from inside or perhaps some grandiose delusions where they have distorted the sense of self-aggrandizement. Hallucinations can be in a form of five senses, where the auditory ones are the most common ones, where the patients hear voices, they can’t differentiate their own thoughts from what they conceive. Disorganized speech can be in a way that they change topics randomly with no connection in between, they can have neologisms and perservation symptoms where they can create new words that don’t exist or repeat the same word without any reason. Other symptoms like catatonic and disorganized movement can be in a form of rigor movement where they can’t deal with everyday activity and have stiff motor activity with stupor.
Negative symptoms show in a way of flattening, alogia, and avolition. The schizophrenia is a multifactor disease which runs in families. The exact cause of this disease has remained unknown, but there are some visible changes in the body but are not specific to this disease. The thing that is positive is that the neurotransmitters and neuroanatomy play an important role. This abnormality can affect the brain function and can provoke this kind of disorder in the presence of other precipitating factors.
What is Nursing Diagnosis?
Nursing diagnosis stands for knowing the symptoms and diseases and dealing with it in a certain way of preventing complications and stopping the precipitating factors from causing damage. Because schizophrenia has many symptoms which are sometimes hard to differentiate, it is important to know how to recognize and deal with it. This kind of patients have disturbances in thoughts, perception, behavior and communication and ability to speak in general combined with an overall decrease in function. There are three phases and five types of schizophrenia.
Phases of schizophrenia: prodromal, active and residual.
Types of schizophrenia: paranoid, catatonic, disorganized, undifferentiated, residual.
Risk Of Self-Violence Or Directed Towards Others
There can be many symptoms and causes. Some characteristics for this risk are an angry facial expression, threatening speech, strange suspicious behavior, acceleration of the pace, talk about some violent actions, high psychomotor activity. There are some factors that can provoke violence like hallucinations, delusions, anger, lack of trust and other. There are short-term and long-term interventions.
- Keep the surrounding free of anger stimuli
- Don’t make rude comments and odd statements that can aggravate the patient
- Give proper medications and monitor patients behavior, movement and drug effect
- Shift the patients anger to another thing to calm him down
- Have the ability to restrain the patient if needed and have boundaries for certain behavior
Sensory And Perceptual Alterations Related To Hallucinations
This kind of alterations are mostly visual or auditory like a hallucination of some sounds, inside voice, feeling strange body sensations, lack of interaction, difficult to concentrate, inappropriate reactions to reality. It can be caused by hallucinations, illusion, brain damage, traumatic events, wrong interpretation of stimuli.
- Monitor the patients’ state for hallucinations, illusion and strange movement like looking across the room, tilting the head to one side or so
- If hallucinating, talk to the patient, give him the knowledge of hallucination, talk back to reality and encourage him to talk about it
- Refer the patient to possible stimuli for the exact hallucination in order to find the source
Impaired Verbal Communication
Patients are unable to establish speaking pattern, they use symbolic speaking, they talk little, have difficulty making eye contact. It can be due to disorganized thinking, lack of interaction, regression, anxiety, lack of trust.
- Inform the patient that you don’t understand their speaking
- Encourage him to establish one-on-one communication
- Try to find exact words for the patient to express his feeling
- Initiate communication on an everyday basis
Ineffective Individual Coping
This can be seen in a way of lack of interaction and avoidance of people, withdrawal of emotions and actions, defense and regression, low self-care.
- Establish a trust relationship and talk to explore the problems and to handle dealing with them
- Monitor the patients’ behavior in some situations and everyday life
- Try to explain the consequences of such behavior
- Use physical restraint as the last intervention
Depression, no eye contact, isolation, sad expressions, loneliness, non-verbal communication.
- Maintain distance and encourage patient to initiate interaction
- Establish a schedule for frequent but short contact
- Give positive feedback for an attempt of interaction
- Prepare and help patient for group therapy