Mental Health Nursing - Assessing Mental Health
A physical exam is usually part of mental health assessments to rule out physical ailments. This could include urine tests, blood tests test or even brain scans.
Psychologists use a variety of tools for assessing mental health. These tools be anything from pencil and paper test forms to in depth interviews or self-completed questionnaires for postal mail.
Affect and mood
The doctor will first observe the patient's mood and affect. They are the most accurate indicators of a patient's emotional tone. This can be anything from sadness to happiness or irritability and anger. The effect can be analyzed by facial expressions, overall attitude and response to external or internal stimuli. You can express your emotions by smirking at an absurd joke, or crying when you lose a loved one.
Affect is an emotion that is temporary, while mood is a long-lasting emotion. It is often described as euthymic (normal) or dysphoric, meaning depressed. Psychologists should be cautious to avoid confusion between the terms because they are interpreted differently and can be affected by various factors.
While the MSE is a useful clinical tool however, it can be difficult to interpret based on subjective patient reports. Asking patients about their feelings over the past few weeks is more effective than relying on only observations from a physician. Recent research has revealed that assessment tools differed in their ability to identify a significant portion of symptoms. This included those that were grouped under the same disorder. This could be due to the different emphasis placed on emotional, cognitive or physical symptoms, as along with differences in the duration and frequency of reporting symptom reports.
It is also possible that the MSE relies on self-report which could be susceptible to bias. Patients who report both anxiety and headache is likely to get an lower score than a patient reporting only migraine. In addition, there is the tendency for patients to minimize negative emotions and overestimate the severity of positive ones.
The mood and the affect of a person can have an impact on the content of thought. This can affect the way people make decisions, their interpersonal behavior and physical function. They can be affected by fatigue, stress and social interactions. A positive mood can actually enhance creativity and mental power. A mood that is negative can cause confusion and lower concentration. Therefore, a careful and thorough mental health assessment is required to take into account the patient's mood and state of mind as in addition to the underlying causes.
Thought content
The ability to determine how a patient thinks is among the most crucial aspects of a mental state exam. Evaluation of thoughts and their content. Thought process refers to the coherence, logic, and organization of a patient's thinking. Normal thought processes are goal directed and logic-based. Thought processing can be distorted in a variety of mental health conditions. Examples include hallucinations, delusions and loose associations.
A mental health assessment also evaluates insight and judgement. Insight is the ability to identify the presence of a problem. Judgement is the process to make a rational decision after receiving information. Both can be impaired by a variety of mental health issues such as schizophrenia and depression. If a patient has impaired judgment or insight, they are at a higher chance of harming themselves or others. For instance if they are at risk of burning their home down the sensible judgment would tell them to leave the building immediately. However, a person with impaired judgment might decide to stay in the building and trying to put out the fire.
The content of a patient's thoughts include the subject matter, themes and beliefs. Typically, examiners discuss the clarity, connection and quality of a patient's thinking. They will also note tangential thoughts or circumstantial ones, and if the patient has digressions (digressions away from the subject of the conversation). They will also make comments on the speed at which someone is thinking, such as whether they seem fast or slower.
Other important areas to consider are whether the patient's thoughts are mood congruent or incongruent with their environment. For example, a patient who is depressed might hear voices that sound angry and threatening, while someone suffering from schizophrenia could experience a hallucination of the sound of a calm and soothing voice. A patient should also be asked about any homicidal or suicidal ideation. Although they are uncommon however, they can be life threatening and should be taken into consideration in every mental health evaluation.
Watching
The nurse's ability to observe is essential in 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, and aspects of cognition (including attention to orientation, attention memory, and orientation). A mental state examination for nurses also incorporates observation of mobility, which includes any physical activity like eating or drinking, brushing your teeth using the toilet and putting on shoes.
The observation component of the mental state exam is an essential element of determining if a patient may pose the risk to themselves or others. This is accomplished by determining if the patient appears to be moving in a deliberate manner that suggests they are planning to harming themselves or someone else.
A detailed assessment of the thought-based content is also made by monitoring the patient during the interview and determining the thoughts and concerns. It is crucial to determine if a patient is having suicidal or homicidal thoughts and to determine if they're having thoughts of delusion.
A global assessment of functioning (GAF) is an assessment of a numerical score on a scale ranging from 100 to 0 that measures the capacity of a person to perform in daily life along with their capacity to handle the stresses in their lives. The GAF is a key part of the mental state exam and helps guide the treatment decisions.
It is important to recognize that observing the behavior of a patient could cause distress. Therefore, it is essential that the process be conducted in a manner that does not provoke or feel intrusive. It is also crucial that the patient is fully informed about the purpose of the observation and the length of time it will last.
Nursing observation is an essential skill that should be the core of any nursing process. However, it should be kept in mind that patients could not agree with the degree of observation. If they are unable to reach an agreement with staff then they should have access to an advocate service which can represent their interests and assist patients in any discussions about their care. This should be a component of the local policy and practice, with the involvement and the support of groups of patients.
Questioning
Many people have a difficult to talk about their mental health issues, but loved ones are often able to tell the signs of something being wrong. They can also assist the person to take an assessment. These tests can cover a wide range of topics, including mood, appearance and the thought process. A mental health professional can also inquire about the person's personal life. They will ask them what they feel and what has happened recently.
The assessment also includes a cognitive assessment, which focuses on the person's ability to think clearly and remember information. The person may be asked to complete a few basic tasks, such as focusing their attention on the list of words or objects, memorizing simple lists or solving math problems. The test can be used to test the ability of the person's judgement and to make informed choices. The test also assesses the patient's insight that reflects their knowledge of their condition and its effects on them.
Another vital aspect of a mental health assessment is the person's attitude towards the world, himself and his illness. The tone of expression, facial expression and body language can indicate hostility, anger or depression, or a feeling of powerlessness. It is also important to know whether the patient appears to be seeking help or just living with their condition.
In more serious situations, an assessment of mental health might include a thorough examination of the patient's mental state, which may involve hallucinations or even illusions. It is crucial to recognize the presence of these conditions because they can be extremely risky and even life-threatening.
A mental health assessment should be holistic and focus on the person's relationship with their social world. assessment in mental health can employ images, music, or art or any other assessment tool to better understand the person. They should also talk about the difficulties that prompted the person to seek help, and assure that there is nothing wrong with seeing a mental health professional.