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Mental Health Nursing - Assessing Mental Health
A physical examination is typically included in mental health assessments to rule out physical conditions. This could include urine tests, blood testing, or even brain scans.
Psychologists also use a wide range of tools to evaluate mental health. They can use pen and paper test forms to in-depth interviews, or self-complete questionnaires sent to you by post.
Mood and affect
The clinician will first notice the patient's mood as well as their affect. They define a patient's general emotional state. This could be anything from sadness to happiness or irritability and anger. The affect can be assessed by facial expressions, overall attitude and reaction to internal or external stimuli. You can express your feelings by smiling at an absurd joke, or crying when you lose a beloved one.
Affect is a temporary emotion but mood is a longer-lasting emotional state. It is often described as being either euthymic (normal) or dysphoric, which translates to depressed. However, psychiatric professionals should be cautious not to confuse the terms because they have different definitions and are affected by a range of factors.
While the MSE is a helpful tool for clinical use however, it can be difficult to interpret based on subjective patient reports. It is therefore helpful to ask patients how they've been feeling in the last few weeks, as opposed to relying on physician observation only. Recent research showed that the assessment tools were different in their ability to detect a substantial portion of symptoms. This included the symptoms that were classified under the same disorder. This can be due to the differing emphasis on emotional, cognitive or physical symptoms as and also the different duration and frequency of symptom reporting.
It is possible that the MSE relies solely on self-reporting, which can be biased. A patient who reports both a headache and anxiety is likely to report an lower score than one who reports only migraine. Furthermore, there is an inclination for patients to minimize negative feelings and overestimate the severity of positive emotions.
Affect and mood can have a direct impact on the content of thought. This can affect the way we make decisions, our interpersonal behavior, and physical performance. They can be affected by stress, fatigue social interactions, world events, hormones and weather. A positive mood can boost creativity and mental energy. However, a mood that is negative can reduce concentration and lead to confusion. Therefore, a careful and thorough mental health assessment needs to consider the patient's current mood and affect as well as their underlying factors.
Thought content
One of the most crucial aspects of a mental state examination is to determine how the patient thinks. Evaluation of thought process and content. The thought process is the coherence, logic, and organization of a patient's thoughts. Normal thought processes are rational and goal-oriented. In several mental health conditions however, the thought process is altered. Examples include hallucinations, delusions and loose associations.
A mental state examination also assesses the quality of insight and judgement. Insight is the ability to see the presence of a problem, and judgement is the ability to make a considered decision when presented with information. Both can be impaired in various mental health conditions, like schizophrenia and depression. If a patient suffers from impaired judgment and/or insight is at a higher risk of harming themselves or others. If they are in danger, their sensible judgement would tell to leave the home immediately. A patient with impaired judgment might suggest that they remain in the building to try to put out the fire.
The content of a patient's thoughts includes their subject matter, themes, and beliefs. Typically, examiners discuss the clarity, connection and the content of a patient's thinking. They will note tangential thoughts or circumstantial ones, as well as if the patient has digressions (digressions away from the subject of the conversation). They will also comment on a person's pace of thinking, such as whether they seem to be faster or slower.
Other areas to be considered are whether the patient's thoughts are and in tune with their surroundings. For instance, a person who is depressed could hear voices that are aggressive and threatening, whereas a person with schizophrenia might have a hallucination of a calm and soothing voice. Ask the patient if they have any suicidal or homicidal thoughts. These are rare but can be life-threatening and should be taken into account in every mental health evaluation.
Watching
A nurse's observation skills are essential to a mental health assessment. They include a careful review of the appearance, behavior as well as any unusual beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention, orientation, memory). A mental state examination for nurses also incorporates observation of motility, including any physical movement, such as eating, drinking, brushing teeth or using the toilet, as well as taking off shoes.
The Observation portion of the mental state examination is vital in determining if a patient poses a risk to them or anyone else. This is done by assessing whether the patient is acting in a manner which suggests they are about to harm themself or someone else.
A thorough assessment of the thought content is also accomplished by observing the patient during the interview and determining their concerns. It is essential to check if the patient has any suicidal or homicidal ideas and to determine if they are having thoughts of suicide or delusions.
Global assessment of functioning (GAF), an assessment of functioning in numerical form, ranging from 0 to 100, combines the ability of a person to perform in everyday life along with their capacity for dealing with stressors. The GAF is an important element of the mental state exam and assists in guiding treatment decisions.
It is important to understand that observing the behaviour of a patient may cause distress. It is crucial to conduct the procedure in a manner that does not cause discomfort or make the patient feel uncomfortable. It is also essential that the patient is fully informed about the purpose of the observation as well as the length of time it will take.
Nursing observation is an essential skill and it must be a key part of the nursing process. However, it should be remembered that patients may not agree with the degree of observation and if they cannot reach an agreement with staff, then they should have access to an advocate service which can represent their needs and help them in any discussions regarding their treatment. This should be a fundamental part of local observation policy and practice, with the participation of user groups to ensure that patients are included in the creation of written documents and staff training on this aspect of clinical governance.
Questioning
Many people are reluctant to discuss their mental health issues, but their family members are often able to tell when something is amiss. They can also help the person to take an assessment. These assessments can be very broad and cover a range of subjects, including mood, appearance and memory, thought process and much more. In addition to these tests, a mental health professional will also ask the person questions about their personal life, such as what has been going on recently and what their emotions have been like.
The test also includes a cognitive evaluation, which focuses on the person's ability to think clearly and recall information. The test subject may require the person to complete basic tasks, such as focusing on a list or objects, memorizing lists, or solving math questions. full mental health assessment online will also test the person's ability to make sound decisions and use their judgment. The test determines a person's insight which is their understanding of their condition and how it affects them.
Another important component of an assessment of mental health is the person's attitude towards the world, himself and his illness. The tone of voice, facial expressions, and body language of a patient can signal depression, anger or a sense of helplessness. It is important to observe whether the patient seems to seek help or accepting their situation.
In more serious instances an assessment of mental health could include a thorough examination of the patient's thoughts that may include hallucinations (false perceptions of sensory stimuli that are not real stimuli) or illusions (misperceptions of real stimuli). These conditions can be harmful and even fatal.
A mental health assessment should be comprehensive and look at the person's relationship to their world. A health professional can use images, music, or art or any other assessment tool to gain a better understanding of the person. They should also discuss the issues that led to the person to seek help, and reassure that there is nothing wrong with seeing a mental health professional.