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Mental Health Nursing - Assessing Mental Health
Mental health assessments typically involve a physical examination, to rule out physical ailments. This could include urine tests, blood test or even brain scans.
Psychologists also use a wide variety of tools to assess mental health. These tools can range from paper and pencil test forms to in depth interviews or self-completed questionnaires for postal mail.
Affect and mood
The clinician will first notice the patient's mood and affect. They are the general emotional tone, which can range from joy to sadness, or even irritability to anger. Affect can be assessed by looking at facial expressions and demeanour as well as the response to external or internal stimuli (e.g. smiling at an absurd joke or crying over the loss of a loved one).
Affect is a temporary emotion while mood is a more sustained emotional state. It is often described as being either euthymic (normal) or dysphoric, meaning depressed. Professionals in psychiatry must be careful to avoid confusion between the terms, as they are different in their definition and are affected by many factors.
The MSE can be a useful tool for clinical diagnosis, but it is difficult to interpret from an individual patient's report. It is therefore important to ask patients how they've been feeling over the last few weeks, rather than using only the observation of a physician. Recent research revealed that assessment tools were different in their ability to identify a significant part of symptoms. This included those that were classified under the same disorder. This can be due to the different emphasis placed on emotional, cognitive or physical symptoms, as along with differences in duration and frequency of reporting symptom reports.
It is also possible that the MSE relies on self-reports, which may be prone to bias. For example, a patient who describes experiencing anxiety and a headache will likely report an lower score than a person who describes only a headache. Additionally there is the tendency for patients to minimize negative feelings and overestimate the severity of positive feelings.
Mood and affect can have a direct impact on the content of thought. This could affect the way people make decisions, their interpersonal behavior and physical performance. They are affected by fatigue, stress and social interactions. In fact, a positive mood has been shown to enhance the ability to think and be creative. A mood that is negative can cause confusion and lower concentration. A thorough and meticulous mental health evaluation must take into account the patient's mood and affect and the fundamental factors.
Thought content
One of the most essential elements of a mental status examination is to determine how the patient thinks. Evaluation of thoughts and their content. The term "thought process" refers to the coherence, logic, and organization of a patient's thoughts. Normal thought processes are rational and focused on goals. Thought processing may be altered when a person suffers from mental health issues. Examples include hallucinations, delusions and loose associations.
A mental state examination also examines judgment and insight. Insight is the ability to recognize that there is an issue, and judgement is the ability to make a considered decision when presented with information. Both can be impaired in several mental health conditions, like schizophrenia and depression. Patients with impaired insight or judgement is more prone to harm themselves or others. If they are in danger, their rational judgment would advise them to leave the house immediately. However, a person with impaired judgment might recommend staying in the house and trying to put the fire out.
The thoughts of a patient include their themes, subject matter, and beliefs. Examiners will evaluate the clarity, relevance, and content of patient's thoughts. They will take note of any thoughts that are circumstantial or tangential, and whether the patient is having flashes of ideas (digressions from the topic of conversation). They will also comment on a person's pace of thinking, such as whether they seem to be more or less fast.
It is also essential to determine whether the patient's mood is similar to the environment in which they live. A patient with depression might hear angry voices, whereas someone suffering from schizophrenia may experience the illusion that a peaceful voice is speaking. Ask mental illness assessment if they are experiencing any thoughts of suicide or homicide. They are not common, but they can be life-threatening and should be taken into consideration during every mental health assessment.
Watching
Nurses' observation skills are essential to an assessment of mental health. They are a thorough review of appearance, behaviour and any strange beliefs or perceptions (such as hallucinations or delusions) mood, as well as aspects of cognition (including attention, orientation memory, and orientation). A mental state examination for nurses also includes observing mobility, which includes any physical activity like eating or drinking, brushing your teeth or using the toilet, as well as putting on shoes.
The Observation component of the mental health examination is essential in determining whether the patient is a danger to themselves or others. This is determined by assessing whether the patient appears to be moving deliberately in a way which suggests they are in danger of harming themselves or anyone else.
A thorough assessment of the thought-based content is also made by monitoring the patient during the interview and determining thoughts and concerns. It is crucial to check if the patient is suffering from suicidal or homicidal thoughts and to determine if they're experiencing delusions.
Global assessment of functioning (GAF) is an assessment of functioning in numerical form, ranging between 0 and 100, combines the ability of the person to function in daily life and their capability of coping with stressors. The GAF is an essential part of the mental state examination and aids in making treatment decisions.
It is essential to be aware that watching a patient's behaviour can cause distress and it is important that the process is conducted in a manner that does not cause anxiety for the patient and does not make them feel uncomfortable. It is important that the patient be fully aware of the goal of the observation and the duration of the procedure.
Nursing observation is an essential skill that should be a key element of the nursing process. It is crucial to keep in mind that patients can disagree with staff about the extent of observation. If they cannot reach a consensus with the staff, they should be able to access an advocate service to represent their interests and assist in any discussions about their care. This should be a component of the local policy and practice, with the involvement and support of groups of patients.
Questioning
Many people are reluctant to discuss their mental health issues, but their family members can often tell when something is amiss. They can also help the person to take an assessment. These tests can be extremely broad and cover a range of subjects, including appearance, mood, memory, thought process and much more. In addition to these tests, the mental health professional will also ask the person questions about their personal life, such as what has been going on lately and what their feelings have been like.
The test also includes a cognitive test that focuses on the person's ability to think clearly and remember information. The person may be asked to complete basic tasks, such as focusing their attention on an alphabet of words or objects and recollecting lists of basic information or solving math problems. The test can be used to test the individual's judgment and ability to make informed choices. The test also evaluates the patient's insight that reflects their understanding of their condition and its effects on them.
Another vital aspect of the mental health assessment is the patient's attitude towards other people, himself and the illness. The patient's expression, facial expression and body language can indicate anger, hostility or depression, or a feeling of insecurity. It is also important to determine whether the patient is seeking help or just living with their illness.
In more serious instances, an assessment of mental health may include an examination the patient's thinking which could include hallucinations or illusions. These conditions can be dangerous and even deadly.
In general, a mental health assessment should be holistic and consider the person's connection to their social world. Health professionals can employ photographs, music, art or any other electronic assessment tool to better understand the individual. They should also talk about the challenges that led the person to seek help, and reassure them that there is nothing wrong with seeing a mental healthcare professional.