Nursing Theories for Psychiatric Nursing

Identify nursing theories related to psychiatric/mental health nursing.
Appreciate the application of nursing theories in psychiatric/mental health nursing.
Understand the nursing process for mental health nursing.
Describe the steps of the nursing process in detail.
Apply the nursing process in mental health clinical practice.

Developed in the 1940s by psychologist Carl Roger.
Focuses on the individual’s positive growth potential and inherent tendency for self-actualization.
Emphasizes:
- All individuals are competent, trustworthy, capable of personal change, and able to solve their own problems.
- Each patient is unique regarding their experiences, emotions, and growth.
- Patients are encouraged to take the lead in therapy sessions.
Essential Nurse-Patient Attitudes:
- Unconditional Positive Regard: Acceptance and valuing of the patient’s feelings and thoughts.
- Congruence: Being genuine and honest in the nurse-patient relationship without superiority.
- Empathetic Understanding: Understanding and accepting the client's feelings and thoughts.

Model consists of 4 components: person, health, environment, and nursing.
Adaptation occurs when individuals positively respond to changes in their environment.
10 Assumptions of the Model:
1. Person is a bio-psycho-social being.
2. Person interacts with a constantly changing environment.
3. Uses coping mechanisms (innate and acquired) to respond to environmental changes.
4. Health and illness are integral dimensions of life.
5. Requires adaptations to respond positively to change.
6. Adaptation level indicates a range of stimuli leading to positive responses.
7. Four modes of adaptation are:
- Physiologic needs
- Self-concept
- Role function
- Interdependence
1. Nursing includes valuing others' opinions and perspectives.
2. Interpersonal relations are key to nursing.
3. The goal of existing is to achieve dignity and integrity.
Nursing Goals: Promote adaptation and preserve health by understanding behaviors affecting adaptive abilities.

Focuses on the significance of the nurse-patient relationship.
Trust is essential for effective care.
4 Phases of the Interpersonal Relationship:
1. Orientation: Establishing the nurse-patient connection, defining problems.
2. Identification: Patient feels capable due to the support of the nurse, helping build a care plan.
3. Exploitation: Active assistance using interview techniques to address issues and make use of services.
4. Resolution: Termination of the professional relationship once goals are met.
Nurse’s Roles in Peplau’s Theory:
- Stranger: Welcoming environment.
- Resource Person: Providing specific information.
- Teacher: Educating patients.
- Leader: Guiding patients in health processes.
- Surrogate: Providing emotional support.
- Counselor: Helping patients understand their feelings.
- Technical Expert: Providing nursing care.

Initiated at patient admission.
Aims to gather comprehensive data about mental, physical, and sociological health.
Involves data collection and interpretation to establish client profiles.
Approaches:
- Comprehensive interviews for holistic assessment.
- Observation of patient behavior.
- Assessment tools (e.g., Beck Depression Inventory).

Identifies client problems based on collected data.
Distinct from medical diagnosis, focusing on nursing interventions.
Consists of three parts: Problem, Contributing Factors, and Behavioral Evidence.
Examples:
- Risk for self-harm related to ineffective coping.
- Impaired social interaction due to lack of motivation.
- Hopelessness tied to chronic sadness.

Develops measurable and realistic goals in collaboration with the client.
Addresses both short-term and long-term outcomes.
Examples:
- Short-term: Reduction of auditory hallucinations in 48 hours.
- Long-term: Client identifies environment-related factors by discharge.

Assesses success of interventions toward achieving goals.
Establishes new strategies if necessary based on measured outcomes.
Reevaluation of outcome criteria if expectations are unrealistic for the client.