Schizophrenia is a severe mental illness characterized by a variety of symptoms,including loss of contact with reality, bizarre behavior, disorganized thinkingand speech, decreased emotional expressiveness, and social withdrawal.
Thisillness affects those parts of the mind that are fundamental to a person’s senseof self. It changes a person’s perception of reality, through hallucinations anddelusions. This mental illness is diagnosed in about one person in every 100. Schizophrenia has been categorized into two specific classes and has possiblecauses for each class. We will also focus on the roles of the nurse and thefamily and the importance of medication.
(Anonymous, 1996a, 1996b, Fontaine& Fletcher, 1999). A psychiatrist’s classical categories of schizophreniaonce included undifferentiated, catatonic, paranoid, and disorganized subtypes. A new classifying system which is widely used has replaced the formercategories. This system includes two categories which are positivecharacteristics and negative characteristics.
There are five sub-characteristicswhich can be described as positive and negative. These are behavioral,affective, perceptual, cognitive and social (Fontaine ; Fletcher, 1999). Positive characteristics are additional behaviors which are not usually found innormal adults. These patients experience delusions, hear voices, and haveinappropriate emotional responses.
These clients feel as if people are harassingthem and they cannot do anything about it. They experience feelings of guilt andtry to punish themselves and others with aggression (Fontaine ; Fletcher,1999). Negative characteristics can be described as the lack of behaviors, or”flat effect. ” Symptoms include anhedonia and attention deficits.
Mostof these clients forget about self-care and their appearance can be a signal ofnegative Schizophrenia. These patients often have feelings of worthlessness andsome eventually commit suicide. Negative characteristics have been found moredifficult to treat (Fontaine ; Fletcher, 1999). There is a wide range ofcauses of Schizophrenia.
Research has yet to come to a conclusive overall causeof Schizophrenia. There are a number of possible causes to this disorder. Onedetermining factor is that the disorder may be a genetic problem that runs inthe family. Another factor may be an imbalance in the brain that results in theclient obtaining jumbled thought processes. Other factors may include birthcomplications, many stresses in life, and family structure. Any of these factorsand many more can have a trigger action that leads to insane behavior(Anonymous, 1996a).
The role of the nurse in treating someone diagnosed withSchizophrenia has to start with a trusting relationship. The nurse must firstspend time with the patient to discover the problems the patient finds the moststressful and what the patient does to alleviate his or her symptoms. The nursecan set specific goals and preferred expectations with the client that will helpbuild a one-to-one relationship with the client and will also help the clientcope with regressive behaviors. Nurses should pay specific attention to all ofthe clients actions, verbal and nonverbal. Furthermore the clients are veryaware and sensitive to our verbal and nonverbal actions.
For example, a patientthat is at high risk for violence, directed at others, related tosuspiciousness, may be a result of a misunderstanding in communication. Therefore, these particular clients should never be underestimated. The client’sassessment is an ever-changing evaluation of how treatments are working(Anonymous, 1996b). Antipsychotic medications are used to control the symptomsof Schizophrenia. Examples of these Antipsychotic medications includephenothiazines, thioxanthenes, butyrophenones, dibenzoxazepine, dihydroindolone,and diphenylbatylperidine. These medications are the most useful in helpingintervention with these clients suffering from Schizophrenia.
For the drug to bemost effective it has to be taken consistently as a relapse of symptoms iscommon when medication is discontinued. It is usually prescribed on a long termbasis and has serious side effects. Because of these side effects, the patientmay discontinue the use of these drugs. This is when the nurse has a major roleto educate these clients about the medication and it’s importance.
The clientsshould fully understand the effects of the drug. Also the nurse and the clientshould freely discuss what particular effects the drug has on the client and ifnecessary to help negotiate a change in medication with the client. The familyshould also help in dispensing doses to the patient therefore the nurse needs toeducate the family about the drug as well (Fontaine ; Fletcher, 1999,Anonymous, (1996b). Nurses need to focus on the importance of family membersalong with the individual with Schizophrenia.
Not only do the clients suffer,but the family is involved also. The nurse should show equal compassion to thefamily as well as the patient. Nurses should encourage family relationships withthe patient, this can be a positive treatment for the individual withSchizophrenia. A nurse’s greatest contribution to mental disorders is thedevelopment of clinical interventions that target in on families and systemneeds. Statistics show that family intervention has helped reduce the rate of arelapse, reduce hospital admissions, and improve medication compliance (Fontaine & Fletcher, 1999, Droogan & Bannigan, 1997). Nurses who go intothe field of Schizophrenia need to be very sociable and have plenty of patience.
Two thirds of the patients diagnosed with the illness will never fully recover,so long term care is inevitable. Many of these patients will only get worse andfor others it will lead to suicide. It takes a special kind of person toestablish a working relationship with clients diagnosed with Schizophrenia. Anurse must dedicate herself to this specific field and have excellent talent inobserving patients and promoting support with the families.
Nurses should alwaysremember that these are real “people” and deserve a chance to copewith their disorders to the best of their abilities (Anonymous, 1996a). BibliographySchizophrenia: knowledge for practice. Nursing Times, 92(30), 1-4. Anonymous(1996b). Schizophrenia: the role of the nurse. Nursing Times, 92(31), 5-8.
Droogan, J. & Bannigan, K. (1997). A review of psychosocial familyinterventions for schizophrenia. Nursing Times, 93(26), 46-47. Fontaine, K.
L. & Fletcher, J. S. (1999).
Schizophrenic disorders. Essentials of mentalhealth nursing (4th ed. , pp. 281-309). Redwood City, CA: Addison-Wesley.Psychology
