Final Project

NCM 117
Care of Clients with Maladaptive Patterns of Behavior (Acute & Chronic)

Submitted by:
Caira Mae P. Baroy
BSN-3A

Submitted to:
Lysivit Kabigting, RN
Foundation of Psychiatric- Mental Health Nursing
Let's take a stroll through history and peek into how people saw mental illness
back in the day. Imagine living in ancient times, where some folks thought being
a little "off" meant you were touched by the gods, while others believed you were
possessed by demons. It must've been quite a scene, with some folks being
celebrated like rock stars and others being shunned like outcasts based on how
they acted.

Exploring the ancient beliefs, we witness a captivating clash of interpretations

regarding mental illness some deemed divine, others perceived as demonic.
Imagine the societal upheaval as individuals oscillated between being adored
and ostracized based on their behavior. Aristotle's attempts to bridge the physical
and mental realms through his humoral theory offer a fascinating glimpse into the
early attempts to understand the complexities of the human mind.

Transitioning through the epochs, the early Christian era emerges as a period
shrouded in superstition and fear. Picture the chilling scenes of exorcisms and
draconian measures inflicted upon the mentally ill, their suffering exacerbated by
primitive beliefs in demonic possession.

As we journey through the Renaissance, the stark contrast between the

treatment of harmless versus "dangerous" individuals with mental illness paints a
vivid picture of societal attitudes. The establishment of the Hospital of St. Mary of
Bethlehem, while groundbreaking, symbolizes a paradoxical era where progress
in institutional care coexisted with the dehumanization of patients.

Enter the Enlightenment time of intellectual awakening and moral introspection.

Here, the pioneering efforts of figures like Pinel and Tuke spark hope for a more
compassionate approach to mental health care. Across the Atlantic, Dix's
crusade for reform echoes the sentiment of societal responsibility towards the
mentally ill, underscoring the evolving notion of empathy and care.
The advent of Freudian psychoanalysis injects a new dimension into the
discourse, challenging society to confront the complexities of human nature.
From Freud's groundbreaking work to the subsequent contributions of Kraepelin
and Bleuler, the landscape of mental health care undergoes a profound
transformation, marked by a deeper understanding of psychological phenomena.

Fast forward to the mid-20th century, where the dawn of psychopharmacology

heralds a new era of treatment possibilities. The introduction of Chlorpromazine
and lithium represents a paradigm shift, offering tangible relief for individuals
plagued by psychiatric disorders. With hospital stays shortened and symptoms
alleviated, the promise of a brighter future for mental health care becomes
palpable, signaling a departure from the dark ages of institutionalization and
mistreatment.

As we reflect on this journey through history, it becomes evident that while

progress has been made, challenges persist. Stigma, access to care, and
disparities in treatment remain pressing issues in the field of mental health. Yet,
amidst the complexities, there is cause for optimism a collective recognition of
the importance of empathy, understanding, and evidence-based interventions in
fostering healing and resilience.

As we stand on the threshold of a new era, let us heed the lessons of the past,
forging a path forward that prioritizes dignity, compassion, and inclusivity for all
those affected by mental illness. In doing so, we honor the enduring human spirit
and reaffirm our commitment to building a society where mental health is
recognized as a fundamental aspect of well-being.
Grief and Loss

Grief and loss are profound experiences that touch every aspect of human
existence. As individuals navigate the tumultuous terrain of loss, they encounter
a myriad of emotions, thoughts, and behaviors that shape their grieving process.
Grief, as defined, is not merely a state of sadness but encompasses a rich
tapestry of subjective feelings and responses triggered by the experience of loss.
It's a deeply personal journey, encompassing both the content of one's emotions
and the intricate process through which these emotions are experienced and
expressed.

Anticipatory grief adds another layer of complexity to this already intricate

process, as individuals confront the impending loss of a loved one. This pre-loss
grieving can be emotionally challenging as individuals grapple with the uncertain
future and the impending reality of separation. It's a delicate balance between
holding onto hope and preparing oneself for the inevitable.

Mourning, on the other hand, is the outward expression of grief, often manifested
through rituals and ceremonies that honor the departed and provide a sense of
closure for the bereaved. These rituals play a crucial role in helping individuals
process their emotions and begin the journey toward healing. They serve as
tangible markers of loss and remembrance, allowing individuals to find solace in
shared experiences and collective support.

Theories of grieving, such as Kübler-Ross's stages, Bowlby's phases, Engel's

stages, and Horowitz's stages, offer valuable frameworks for understanding the
different facets of the grieving process. Each theory highlights the multifaceted
nature of grief and the various stages individuals may pass through as they come
to terms with their loss. These theories provide a roadmap for navigating the
complexities of grief, offering insight into the emotional, cognitive, and behavioral
changes that accompany loss.
Moreover, dimensions of grieving, including cognitive, emotional, spiritual,
behavioral, and physiological responses, further illustrate the depth and
complexity of the grieving experience. From questioning and trying to make
sense of the loss to experiencing profound emotional upheaval and grappling
with spiritual anguish, individuals traverse a wide spectrum of emotions and
reactions. These dimensions underscore the holistic nature of grief, highlighting
its impact on every aspect of human existence.

Furthermore, disenfranchised grief and complicated grieving underscore the

societal and individual factors that can complicate the grieving process. Factors
such as low self-esteem, previous psychiatric disorders, or ambivalent
attachment to the deceased can exacerbate the challenges individuals face as
they navigate their grief. These factors highlight the importance of providing
tailored support and intervention to address the unique needs of bereaved
individuals.

In conclusion, grief and loss are universal human experiences that transcend
cultural, social, and geographical boundaries. Understanding the intricacies of
the grieving process, acknowledging the diversity of individual experiences, and
providing compassionate support are essential steps in helping individuals cope
with their loss and embark on the journey toward healing and eventual
acceptance.
Schizophrenia

Schizophrenia is a multifaceted condition that exerts its influence across various

dimensions of an individual's life. It's crucial to recognize that the manifestations
of schizophrenia can differ significantly from one person to another. While some
individuals may grapple primarily with delusions and hallucinations, others may
confront challenges such as social withdrawal and diminished motivation.

The management of schizophrenia is far from being a one-size-fits-all endeavor.

Rather, it necessitates a personalized and nuanced approach tailored to the
unique needs and circumstances of each individual. This could entail a
combination of pharmacological interventions, psychotherapy, and the
involvement of a supportive network comprising healthcare professionals and
loved ones.

For families of individuals living with schizophrenia, navigating the complexities of

the disorder can be an overwhelming journey. Emotions ranging from
apprehension and shame to culpability may surface, underscoring the
importance of comprehensive education and inclusion in the treatment process.
Equipping families with knowledge about schizophrenia can help assuage some
of these sentiments and empower them to provide effective support to their loved
ones.

One of the primary obstacles in the management of schizophrenia is ensuring

adherence to prescribed medications and treatment regimens. Unfortunately,
non-compliance and substance misuse can exacerbate the condition,
underscoring the critical need for healthcare providers to collaboratively address
any barriers to adherence and furnish ongoing support.

In terms of nursing interventions, the strategies employed hinge upon the client's
current clinical state. For those grappling with acute psychotic symptoms, the
priority lies in ensuring their safety and privacy while concurrently aiding in
maintaining a tether to reality. Conversely, for individuals whose symptoms are
stabilized with medication, the focus shifts to furnishing sustained support,
fostering trust, and facilitating the acquisition of essential life skills.

Engaging with clients afflicted by schizophrenia can exact an emotional toll on

nurses as well. Coping with their symptoms, concerns regarding personal safety,
and grappling with the frustration of relapses all constitute valid challenges. Thus,
cultivating self-awareness and prioritizing self-care are imperative for nurses to
safeguard their own well-being while furnishing compassionate care to their
patients.

In essence, the management of schizophrenia mandates a holistic and

individualized approach that acknowledges the diverse array of needs inherent in
the condition. Through the provision of support, education, and empathy, strides
can be made towards ameliorating outcomes and enhancing the quality of life for
individuals grappling with schizophrenia and their families.