Mental Health Nursing: A South African Perspective

785 Pages·2004·47.5 MB·English

by  Leana Uys

Mental Health Nursing
A South African Perspective
LUys
(Editor)
L Middleton
(Co-editor)
JUTA
ACADEMIC
DISCLAIMER
In the writing of this book, every effort has been made to present accurate and
up-to-date information from the best and most reliable sources. However, the
results of nursing individuals depend on a variety of factors that are beyond
the control of the authors and publishers. Therefore, neither the authors nor
the publishers assume responsibility for, nor make any warranty as regards to,
the outcomes achieved from the procedures described in this book.
Mental Health Nursing - A South African Perspective
©Juta &Co. Ltd 2004
P O Box 24309
Landsdowne 7779
Cape Town
South Africa
This book is copyright under the Berne Convention. In terms of the Copyright
Act 98 of 1978, no part of this book may be reproduced or transmitted in any form
or by any means, electronic or mechanical, including photocopying, recording or
by any information storage and retrieval system, without permission in writing
from the publisher.
ISBN-10:0 7021 66421
ISBN-13:978 07021 66426
Reprinted February 2007
Project management: Fiona Wakelin
Copy editing and proofreading: Mariaan Nel
Indexing: Mariaan Nel
Cover design: Pumphaus Design Studio
DTP and design: Charlene Bate
Printed and bound in the Republic of South Africa by Paarl Print
Contents
Foreword xiii
About the Authors xiv
Section 1: Frameworks & Foundations 1
CHAPTER 1: THE HISTORY OF MENTAL HEALTH NURSING 3
LRUys
Objectives 3
Introduction 3
1.1 The early period up to the Renaissance 3
1.2 The Reformation 4
1.3 The nineteenth century 4
1.4 The twentieth century 6
Conclusion 12
Web resources 13
References 13
CHAPTER 2: A CONCEPTUAL FRAMEWORK FOR MENTAL HEALTH NURSING 14
L R Uys
Objectives 14
Introduction 14
2.1 Defining mental health nursing 15
2.2 Lifestyle functioning 19
2.3 Patterns of fulfilling biophysical needs 28
2.4 Patterns of building and maintaining relationships 29
2.5 Patterns of participation in group and community life 30
2.6 Patterns of participation in work 31
2.7 Patterns of utilizing resources 32
2.8 Guidelines for practice 34
2.9 The nurse and the multiprofessional team 36
Conclusion 38
Web resources 38
References 38
CHAPTER 3: COMPREHENSIVE MENTAL HEALTH CARE 39
LRUys
Objectives 39
Introduction 40
3.1 Comprehensive mental health care 41
3.2 Secondary prevention 46
3.3 Tertiary prevention
3.4 Planning programmes 50
3.5 Implementing programmes 54
3.6 Evaluating programmes 55
Conclusion 57
Web resources 57
References 58
CHAPTER 4: MENTAL HEALTH CARE IN THE HEALTH CARE SYSTEM 59
LRUys
Objectives 59
Abbreviations used 59
Introduction 59
4.1 Overview of the district health system 60
4.2 The integration of mental health care into primary health care 64
4.3 Description of primary mental health care 67
4.4 Team functioning skills 68
Conclusion 70
Web resources 71
References 71
CHAPTER 5: THE CONSUMERS IN MENTAL HEALTH 73
LRUys
Objectives 73
Introduction 73
5.1 The stigma of being mentally ill 74
5.2 Consumers' perceptions on recovery from mental illness 75
5.3 The family or 'carer' perspective 77
5.4 Support groups for consumers 82
Conclusion 86
Web resources 86
References 86
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CHAPTER 6: LEGAL STRUCTURE 88
E Madela-Mntla
Objectives 88
Introduction 89
6.1 Mental Health Care Act 89
6.2 Criminal Procedure Act 107
6.3 Medicines and Related Substances Control Act 108
6.4 Prevention and Treatment of Drug Dependency Act 110
6.5 Child Care Act 111
6.6 Acts governing the education of intellectually disabled children 112
6.7 Choice on Termination of Pregnancy Act 113
6.8 Sterilization Act 114
6.9 Health Professions Act 115
Conclusion 116
Web resources 116
References 116
CHAPTER 7: THE MANAGEMENT OF ETHICAL DILEMMAS IN MENTAL HEALTH 117
L van Rhyn
Objectives 117
Introduction 117
7.1 Ethical theories 119
7.2 The structure of a dilemma 121
7.3 Specific ethical problems in psychiatry 123
7.4 Patient rights 127
Conclusion 128
Web resources 128
References 129
CHAPTER 8: AFRICAN TRADITIONAL CONCEPTS OF HEALTH AND HEALTH CARE 129
A Pienaar
I Manaka-Mkwanazi
Objectives 129
Introduction 129
8.1 A particular world and life view 130
8.2 African traditional health and mental health care 134
8.3 Guidelines in mental health care delivery to African traditional people 137
Conclusion 139
Web resources 139
References 140
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Section 2: The Mental Health Nursing Process 141
CHAPTER 9: THE MENTAL HEALTH NURSING PROCESS 143
LRUys
Objectives 143
Introduction 143
9.1 Interpersonal nursing attitudes 143
9.2 Interpersonal nursing competencies 149
9.3 The nurse-patient relationship 157
9.4 The nursing process 159
Conclusion 160
Web resources 161
References 161
CHAPTER 10: ASSESSMENT OF THE PSYCHIATRIC PATIENT 162
G E Pietersen
L Middleton
Objectives 162
Introduction 162
10.1 Assessment of own learning needs 163
10.2 A context for psychiatric nursing assessment and diagnosis 166
10.3 Assessment for a medical diagnosis 169
10.4 Assessment for a nursing diagnosis 183
10.5 Doing a quick assessment using a time-event chart 188
10.6 Nursing diagnosis 190
10.7 Group assessment 191
10.8 Example of a psychiatric report 194
Conclusion 201
Web resources 201
References 201
CHAPTER 11: NURSING INTERVENTIONS 202
LRUys
Objectives 202
Introduction 202
11.1 Functional assessment and skills training 202
11.2 Group therapy 211
11.3 Mental health education 216
11.4 Social skills teaching 220
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11.5 Psychoeducation 222
11.6 Milieu therapy 225
11.7 Counselling 229
11.8 Crisis intervention 234
11.9 Symptom management 240
11.10 Case management 245
11.11 Dealing with aggression 254
Conclusion 265
Web resources 266
References 266
Section 3: Psychopatholoey & Nursing Interventions 267
.f .& oy c?
CHAPTER 12: NURSING THE PATIENT WITH AN ANXIETY DISORDER 269
L Middleton
Objectives 269
Introduction 269
12.1 Understanding anxiety 270
12.2 The anxiety response 275
12.3 Normal and pathological anxiety 278
12.4 Classification of anxiety disorders: DSM-IV-TR 278
12.5 Working with the anxious patient 287
12.6 Assessing anxiety 290
12.7 Intervening in anxiety 293
Conclusion 316
Web sites 316
References 316
CHAPTER 13: NURSING THE PATIENT WITH A MOOD DISORDER 318
M Jarvis
L Middleton
Objectives 318
Introduction 318
319
13.1 Depression
13.2 Nursing assessment and intervention 322
348
13.3 Suicide
13.4 Bipolar disorders 356
13.5 Nursing assessment and intervention 357
Conclusion 363
Web Resources 364
References 364
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CHAPTER 14: NURSING THE PATIENT WITH SCHIZOPHRENIA 366
LRUys
Objectives 366
Introduction 366
14.1 Diagnosis and treatment 367
14.2 Facilitation of a healthy lifestyle 373
Conclusion 392
Web resources 393
References 393
CHAPTER 15: NURSING THE PATIENT WITH A SUBSTANCE-RELATED DISORDER 395
LRUys
0 Adejumo
Objectives 395
Introduction 396
15.1 Alcohol-related disorders 402
15.2 Other common dependence-producing substances 428
15.3 Treatment of substance-dependent people 434
Conclusion 435
Web resources 436
References 436
CHAPTER 16: NURSING THE PATIENT WITH A COGNITIVE DISORDER 438
L Middleton
LRUys
Objectives 438
Introduction 438
16.1 Understanding cognitive disorders 439
16.2 Patterns of lifestyle functioning associated with cognitive disorders 445
16.3 Working with the organically impaired person 450
16.4 Intervening in cognitive disorders 458
16.5 Intervening within the family situation 472
16.6 Psychopharmacology 473
16.7 Epilepsy and coping: principles for psychosocial nursing intervention 475
16.8 HIV/Aids and mental health 482
Conclusion 484
Web resources 484
References 484
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CHAPTER 17: NURSING CARE OF PERSONS WITH INTELLECTUAL DISABILITIES 486
LRUys
Objectives 486
Introduction 486
17.1 Prevention 488
17.2 Intellectual disability 490
17.3 Assessment 492
17.4 Support of the parents of children with an intellectual disability 498
17.5 Stimulation of development 502
17.6 Institutional care 531
17.7 Management of problem behaviour 534
17.8 The adult person with an intellectual disability 534
Conclusion 536
Web resources 537
References 537
Section 4: Care of Special Groups 539
CHAPTER 18: MENTAL HEALTH NURSING OF CHILDREN AND ADOLESCENTS 541
L van Rhyn
L Middleton
Objectives 541
Introduction 541
18.1 Mental health disorders in children and adolescents 542
18.2 The assessment of children with mental health disorders 566
18.3 Managing emotionally and behaviourally disturbed children 579
Conclusion 582
Web resources 583
References 584
CHAPTER 19: NURSING FORENSIC PSYCHIATRIC PATIENTS 585
LRUys
Objectives 585
Introduction 585
19.1 Historical background 586
19.2 Current legal provisions in South Africa 587
19.3 Services provided for a mentally ill offender 591
19.4 Classification of forensic psychiatric patients 591
19.5 The nurse in the observation unit 592
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