Mental Health Nursing - Assessing Mental Health
A physical examination is typically part of mental health tests to rule out any physical issues. This may include blood tests and urine tests as well as brain scans.
Psychologists also use a wide variety of tools to assess mental health. These range from pen and paper test forms to in-depth interviews, or self-complete postal questionnaires.
Affect and mood
Mood and affect are the most crucial elements of the mental state exam (MSE) and are the first to be viewed by the clinician. They are the general emotional state that can range from joy to sadness, or even irritability to anger. The affect can be assessed by facial expressions, overall demeanor and the response to external or internal stimuli. smiling at an absurd joke or crying over the loss of a loved one).
Affect is an emotion that is temporary, whereas mood is a state of constant emotion. It is often described as either euthymic (normal) or dysphoric, which translates to depressed. However, psychiatric specialists must be careful not to confuse the terms as they have varying definitions and are influenced by a variety of factors.
While the MSE is a useful clinical tool however, it can be difficult to interpret based on subjective patient report. It is therefore important to inquire about how patients have been feeling in the last few weeks, rather than using only the observation of a physician. Recent research has revealed that assessment tools differed in their ability to identify a significant portion of symptoms. This included the symptoms that were classified under the same disorder. This could be due to the different emphasis placed on cognitive, emotional or physical symptoms, as along with differences in duration and frequency of symptom reporting.
It is possible that the MSE relies on self-reports which is susceptible to bias. For example, a patient who describes experiencing a headache and anxiety will likely report less than a patient who reports only the sensation of a headache. In addition there is an inclination for patients to downplay negative emotions and overestimate the severity of positive feelings.
The mood and the affect of a person can have a direct influence on the content of thought. This can affect the way people make decisions, their interpersonal behavior and physical performance. They are influenced by fatigue, stress, social interactions, world events, hormones and the weather. Positive moods can increase creativity and mental strength. A negative mood can cause confusion and decrease concentration. A thorough and meticulous mental health assessment must take into account the patient's mood and affect and the other factors.
Thought content
One of the most important aspects of a mental health exam is assessing how a patient thinks. Specifically, evaluating thought process and thoughts. Thought process refers the logic, organization and coherence of a patient's thought processes. A normal thought processes is objective-oriented and logical. In several mental health conditions however, the thought process is distorted. Examples include hallucinations, delusions, and loose associations.
A mental status examination also evaluates insight and judgement. Insight is being able to recognize the presence of a problem. Judgement is the process to make a well-considered choice after receiving information. Both are affected by various mental health conditions such as schizophrenia and depression. If a patient is impaired in judgment or insight is at greater risk of causing harm to themselves or others. If they are in danger, their rational judgement would tell to leave the home immediately. However, someone with impaired judgment might decide to stay in the building and attempting to put the fire out.
Thought content includes the topics, subjects and beliefs that a patient holds. Generally, examiners comment on the clarity, connection and the content of a patient's thoughts. They will note any thoughts that are circumstantial or tangential, and whether the patient is prone to having a flurry of ideas (digressions from the subject of conversation). They will also comment on the speed of someone's thoughts, including whether they seem fast or slow.
Other important areas to consider are whether the patient's thoughts are compatible or not in line with their surroundings. A patient with depression might be able to hear angry voices, whereas those suffering from schizophrenia may experience a hallucination that a soothing voice is speaking. The patient should be asked about any homicidal or suicidal thoughts. These are uncommon, but could be life-threatening and should be taken into account in every mental health assessment.
Watching
The nurse's ability to watch is vital in the mental assessment. They involve a thorough evaluation of behavior, appearance as well as any peculiar beliefs or perceptions (such delusions or hallucinations) and mood cognition (including memory, attention, orientation). A mental health assessment for nursing also involves observing the ability to move, which includes physical movement such as eating or drinking, brushing your teeth, using the toilet and taking off shoes.
The Observation portion of the mental health examination is crucial in determining if the patient poses a risk to themselves or anyone else. This is determined by assessing whether the patient appears to be acting in a manner that suggests they are planning to harm themselves or another person.
Additionally, a thorough thought content assessment is made by observing the patient throughout the interview and determining their preoccupations. It is important to check whether the patient has suicidal, homicidal or delusional thoughts.
A global assessment of functioning (GAF) is a numerical rating on a scale ranging from 100 to 0 that measures the capacity of a person to function in everyday life with their ability to cope with the stressors in their life. The GAF is an important part of the mental status assessment and aids in making the treatment decisions.
It is essential to be aware that observing the behavior of a patient could cause anxiety, and it is important to conduct the procedure in a manner that doesn't provoke the patient and does not feel intrusive. It is important that the patient is aware of the goal of the observations and the duration of the procedure.
Nursing observation is a crucial skill that should be a central part of any nursing procedure. It is crucial to keep in mind that patients may disagree about the degree of observation. If they cannot reach a consensus with staff members, they should be able to use an advocate service that can represent their interests and assist in any discussions regarding their care. This should be part of the local policy and practice, with the participation and support of groups of users.
Questioning
Many people are hesitant to discuss their mental health issues, however family members are often able to tell when something is amiss. They can also assist the person take steps to get an assessment. These assessments can be very broad and cover a variety of subjects such as mood, appearance as well as memory, thought process and much more. In addition to these tests, a mental health professional will also ask the person questions regarding their personal life, including what's been happening recently and what their emotions have been like.
The test consists of an evaluation of the cognitive capacity which focuses on an individual's ability to think clearly and remember information. The test subject may require the person to complete basic tasks, such as paying attention to a list of objects, memorizing lists or completing math problems. The test can be used to test the person's judgment and ability to make informed choices. The assessment determines a patient's awareness, which is the understanding of their illness and how it affects them.
Another important component of a mental health assessment is the person's attitude towards the world, himself and his illness. The patient's tone of expression, facial expression and body language may convey hostility, anger, depression or a sense of powerlessness. It is important to check whether the patient appears to be asking for assistance or is accepting their situation.
In more serious cases the assessment of mental health might include a look at the patient's thoughts that may include hallucinations or illusions. It is crucial to recognize the presence of these disorders because they can be extremely hazardous and even life-threatening.
A mental health assessment must be holistic and examine the person's relationship with their social world. A health professional might use art, music, photos or a range of assessment tools that are electronic to better understand the person and their unique view of the world around them. private mental health assessment should also talk with the person about the issues that caused them to seek assistance and assure them that there is nothing wrong with visiting a mental health professional.