sychlaLrlc nurslng

I Cverv|ew
A9n|atr|n Nur|ng an lnLerpersonal process LhaL promoLes and
malnLalns behavlor LhaL conLrlbuLes Lo lnLegraLed funcLlonlng
Lhrough Lhe LherapeuLlc use of self (arL) and nurslng Lheorles
(sclence) Lo achleve psychosoclal wellbelng

8,enta| nea|t sLaLe of emoLlonal psychologlcal and soclal wellness
evldenced by saLlsfylng lnLerpersonal relaLlonshlps effecLlve
behavlor and emoLlonal sLablllLy
Aent of ,enta| nea|t
1moLlonal lnLelllgence
28eslllency
3SplrlLuallLy
4AuLonomy and lndependence
3MaxlmlzaLlon of one's poLenLlal
61olerance of llfe's uncerLalnLles
7SelfesLeem
8MasLery of Lhe envlronmenL
98eallLy orlenLaLlon
10 SLress managemenL
C,enta| I||ne a cllnlcally slgnlflcanL behavloral or psychologlcal
syndrome or paLLern LhaL occurs ln an lndlvldual and LhaL ls
assoclaLed wlLh presenL dlsLress or dlsablllLy or wlLh a slgnlflcanLly
lncreased rlsk of sufferlng deaLh paln dlsablllLy or an lmporLanL loss
of freedom
enera| Cr|ter|a to d|agnoe menta| d|order
1lssaLlsfacLlon wlLh one's characLerlsLlcs and
accompllshmenLs
2lneffecLlve or nonsaLlsfylng relaLlonshlps
3lssaLlsfacLlon wlLh one's place ln Lhe world
4lneffecLlve coplng wlLh llfe's evenLs
3Lack of personal growLh

1he concepLs of menLal healLh and menLal lllness are culLurally
deflned WhaL ls accepLable behavlor depends upon culLural norms
Cu|tura| |nf|uenne tat affent ow |nd|v|dua| v|ew menta| |||ne
1lncomprehenslblllLyLhe lnablllLy of Lhe general populaLlon Lo
undersLand Lhe moLlvaLlon behlnd Lhe behavlor
2CulLural relaLlvlLyLhe normallLy""of behavlor deLermlned by
Lhe culLure
9red|o|ng Iantor for ,enta| I||ne
1 poverLy
2 abuse
3 poor access Lo healLh care
4 geneLlc predlsposlLlon
3 mlsuslng subsLance
6 undergolng llfesLyle changes
O 1he nore of psychlaLrlc nurslng ls |ntererona| rone
O ,enta| ng|ene measures Lo promoLe menLal healLh prevenL
menLal lllness and sufferlng and faclllLaLe rehablllLaLlon and lf
necessary flnd meanlng ln Lhese experlences
O sychlaLrlc nurslng requlres e|fawarene whlch ls Lhe process by
whlch Lhe nurse galns recognlLlon of hls or her own feellngs LhoughLs
and values MeLhods Lo lncrease selfawareness lnclude
lnLrospecLlon dlscusslon experlence and role play
O eve| of revent|on
1rlmary measures Lo counLeracL clrcumsLances or condlLlons
LhaL are poLenLlally harmful 1hese measures generaLe coplng
skllls and reduce vulnerablllLy Lo lllness and promoLe healLh
xample PealLh Leachlng educaLlon as Lhe key componenL
2Secondary measures or lnLervenLlons used Lo curLall dlsease
process
xample medlcaLlon malnLenance crlsls lnLervenLlon
counsellng screenlng meLhods
31erLlary measures Lo mlnlmlze relapse and chronlc dlsablllLy
and resLore Lhe cllenL Lo an opLlmal level of funcLlonlng
xample adapLaLlon resLoraLlon rehablllLaLlon afLercare
ll ko|e of 9n|atr|n Nure
1Carrles ouL LradlLlonal Lask of admlnlsLerlng prescrlbed drugs
and monlLorlng drug effecLs
2AcLs as Lhe prlmary LheraplsLs and dlrecLs behavlor Lheraples ln
some cases
3uses an lnLerpersonal approach Lo promoLe malnLaln resLore
and rehablllLaLe lndlvldual famlly and communlLy menLal
healLh and funcLlonlng
4raws on Lhe psychosoclal and blophyslcal sclences as well as
Lheorles of personallLy and human behavlor when provldlng
care
lll tandard of Care
l AssessmenL collecLlng of cllenL healLh daLa
ll lagnosls analyzlng of daLa ln deLermlnlng dlagnosls
lll CuLcome ldenLlflcaLlon ldenLlflcaLlon of expecLed ouLcomes
lndlvlduallzed Lo Lhe cllenL
lv lannlng developlng a plan of care LhaL prescrlbes
lnLervenLlons Lo aLLaln expecLed ouLcomes
v lmplemenLaLlon
a Counsellng
b Mllleu 1herapy
c Selfcare AcLlvlLles
d sychoblologlc lnLervenLlons
e PealLh 1eachlng
f Case ManagemenL
g PealLh romoLlon and malnLenance
h sychoLherapy
l rescrlpLlve auLhorlLy and LreaLmenL
[ ConsulLaLlon
vl valuaLlon assessmenL of Lhe cllenL's progress ln aLLalnlng
expecLed ouLcomes
II 1eor|e |n 9erona||t and 8eav|or Deve|oment
A9erona||t endurlng paLLerns of percelvlng relaLlng Lo and
Lhlnklng abouL Lhe envlronmenL and oneself LhaL are exhlblLed
ln a wlde range of soclal and personal conLexLs
O lfferenL sLages of developmenL are deLermlned by
age buL are also lnfluenced by lnborn personallLy
characLerlsLlcs and Lhe envlronmenL
O 8ehavlors LhaL arlse from unsuccessful compleLlon of
developmenLal Lask can be changed and correcLed ln
laLer sLage because people conLlnually develop and
change LhroughouL llfe Lhereby suggesLlng Lhe
posslblllLy of renewal
O SLages may elLher overlap or an lndlvldual may become
flxed
89noana|t|n teor (|gmund Ireud) supporLs Lhe noLlon
LhaL all human behavlor ls caused and can be explalned
9noexua| Deve|oment
O Cral sLage (blrLh Lo 18 monLhs) pleasure and
graLlflcaLlon ls achleved Lhrough mouLh perlod of
compleLe dependence may have dlfflculLy LrusLlng
oLhers when flxaLed
O Anal sLage (18 monLhs Lo 3 years) anus and recLum
are cenLers of pleasure occurs durlng LolleL Lralnlng
behavlor of conLrolllng and expelllng feces provlde
pleasure and sense of conLrol
O halllc sLage (4 3 years) genlLals are Lhe cenLer of
pleasure chlld experlences lekLra and Cedlpus
Complex behavlor of masLurbaLlon and Louchlng of
genlLals offers pleasure Lask ls Lo ldenLlfy oneself
O LaLency sLage (6 12 years) energy ls dlrecLed Lo
physlcal and lnLellecLual acLlvlLles sexual lmpulses
Lend Lo be repressed behavlor sense of lndusLry and
masLery
O enlLal sLage (13 years and afLer) energy ls dlrecLed
Loward aLLalnlng a maLure sexual relaLlonshlp
reacLlvaLlon of pregenlLal lmpulses genlLal sLage of
maLurlLy behavlor sense of lndependence separaLlon
from parenLs and declslonmaklng develops sexual
ldenLlLy ablllLy Lo love and work

trunture of 9erona||t
O ld parL of one's naLure LhaL reflecLs baslc or
lnnaLe deslres such as pleasure seeklng behavlor
aggresslon and sexual lmpulses
O Superego parL of a person's naLure LhaL reflecLs
moral and eLhlcal concepLs values and parenLal
and soclal expecLaLlons
O go balanclng or medlaLlng force beLween ld
and superego lL represenLs maLure and adapLlve
behavlor LhaL allows Lo funcLlon successfully ln
Lhe world
eve| of awarene of erona||t
O Consclous refers Lo percepLlons LhoughLs and
emoLlons LhaL exlsL ln Lhe person's awareness
O reconsclous LhoughLs and emoLlons are noL
currenLly ln Lhe person's awareness buL can be
recalled wlLh some efforL
O unconsclous realm of LhoughLs and feellngs
LhaL moLlvaLe a person even Lhough he or she ls
LoLally unaware of Lhem
go Defene ,enan|m
O CompensaLlon overachlevemenL ln one area Lo
offseL real or percelved deflclencles ln anoLher
area
O Converslon expresslon of an emoLlonal confllcL
Lhrough Lhe developmenL of a physlcal sympLom
usually sensorlmoLor ln naLure
O enlal fallure Lo acknowledge unbearable
condlLlon fallure Lo admlL reallLy of a slLuaLlon
O lsplacemenL venLllaLlon of lnLense feellngs
Loward persons less LhreaLenlng Lhan Lhe one
who aroused Lhose feellngs
O lssoclaLlon deallng wlLh emoLlonal confllcL by
a Lemporary alLeraLlon ln consclousness or
ldenLlLy
O ldenLlflcaLlon modellng acLlons and oplnlons of
lnfluenLlal oLhers whlle searchlng for ldenLlLy or
asplrlng Lo reach a personal soclal or
occupaLlonal goal
O lnLellecLualllzaLlon separaLlon of emoLlons of a
palnful evenL or slLuaLlon from Lhe facLs lnvolved
O lnLro[ecLlon AccepLlng anoLher person's
aLLlLudes bellefs and values as one's own
O ro[ecLlon unconsclous blamlng of
unaccepLable lncllnaLlons or LhoughLs on an
exLernal ob[ecL
O 8aLlonallzaLlon excuslng own behavlor Lo avold
gullL responslblllLy confllcL anxleLy or loss of
selfrespecL
O 8eacLlon formaLlon acLlng opposlLe of whaL one
Lhlnks or feels
O 8egresslon movlng back Lo a prevlous
developmenLal sLage ln order Lo feel safe or have
needs meL
O 8epresslon excludlng emoLlonally palnful or
anxleLyprovoklng LhoughLs or feellngs from
consclous awareness
O SubllmaLlon subsLlLuLlng a soclally accepLable
acLlvlLy for an lmpulse LhaL ls unaccepLable
O Suppresslon consclous excluslon of
unaccepLable LhoughLs and feellngs from
consclous awareness
O undolng exhlblLlng accepLable behavlor Lo
make up for or negaLe unaccepLable behavlor
1ranferenne occurs when a cllenL dlsplaces onLo nurse
Lhe aLLlLudes and feellngs LhaL Lhe cllenL orlglnally
experlenced ln oLher relaLlonshlps
Countertranferenne occurs when Lhe nurse dlsplaces
onLo Lhe cllenL aLLlLudes or feellngs from hls or her pasL
C9noon|a| 1eor ( r|k r|kon ) psychosoclal growLh
occurs ln sequenLlal phases and each sLage ls dependenL on
compleLlon of Lhe prevlous sLage and llfe Lask
Centra| 1ak] Age Ind|nator of 9o|t|ve Ind|nator of Negat|ve
keo|ut|on keo|ut|on
1rusL vs MlsLrusL
(8lrLh 18 monLhs)
Learnlng Lo LrusL
oLhers
MlsLrusL and
wlLhdrawal hosLlllLy
and susplclousness
AuLonomy vs Shame
and oubL ( 18
monLhs 3 years)
eLermlnaLlon and
lndependence self
esLeem and self
conLrol
lmpulslvlLy
compulslon doubLlng
one's ablllLles
lnsecure
lnlLlaLlve vs ullL
( 3 3 years)
Pavlng a poslLlve
response Lo Lhe
world's challenges
Laklng on
responslblllLles and
feellng purposeful
asslve and apaLheLlc
lndusLry vs lnferlorlLy
( 6 12 years )
compeLence Lack of moLlvaLlon
feels lncompeLenL
ldenLlLy vs 8ole
confuslon
( 12 20 years )
lldellLy belng able Lo
declde on Lhelr own
o noL acLuallze hls
poLenLlals no
moLlvaLlon of self
dlrecLlon
lnLlmacy vs lsolaLlon
( 18 23 years )
Love commlLmenL
and accepLance
romlsculLy and
excluslon
eneraLlvlLy vs
SLagnaLlon
(23 63 years )
roducLlvlLy perform
obllgaLlons and
responslblllLles
SelfabsorpLlon
re[ecLlvlLy
lnLegrlLy vs espalr
(63 years deaLh )
Wlsdom accepLance
of deaLh
lear of deaLh flnds no
meanlng ln hls llfe



DlnLerpersonal 1heory ( Parry SLack Sulllvan ) emphaslzes Lhe
lmporLance of lnLerpersonal relaLlonshlps ln one's llfe and
one's personallLy lnvolves more Lhan lndlvldual characLerlsLlc
parLlcularly how one lnLeracLed wlLh oLhers
tage Age Ionu
lnfancy 8lrLh Lo onseL of
language
need for bodlly conLacL and
Lenderness
needs are meL sense of well
belng
unmeL needs dread and
anxleLy
Chlldhood Language Lo 3
years old
arenLs are source of pralse and
accepLance
needs are MeL self esLeem
ModeraLe anxleLy uncerLalnLy
and lnsecurlLy
Severe AnxleLy self defeaLlng
paLLerns of behavlor

!uvenlle 3 8 years Chlld learns Lo relaLe Lo peers
and learns compeLlLlon
compromlse and cooperaLlon

readolescence 9 12 years Chlld learns Lo be concerned
wlLh anoLher lndlvldual and puLs
Lhe needs of LhaL lndlvldual
ahead of hlm
arly
Adolescence
12 14 years Learns lndependence and how
Lo relaLe Lo opposlLe sex
xperlence sexual urges called
lusL
eer group ls sLlll lmporLanL Lo
regulaLe feellngs and behavlors
LaLe
Adolescence
uberLy onwards evelops lnLlmaLe relaLlonshlp
wlLh opposlLe sex
Ma[or Lask ls Lo lncorporaLe
lnLlmacy wlLh lusL
Learns Lo be economlcally
lnLellecLually and emoLlonally
selfsufflclenL







Cogn|t|ve 1eor (Iean 9|aget)
SensorlmoLor lnfanL uses senses and moLor ablllLles Lo undersLand
Lhe world
8eglns wlLh reflexes and ends wlLh complex
comblnaLlons of sensorlmoLor sklls
re
CperaLlonal
Chlld learns menLal represenLaLlons and Lo preLend
gocenLrlc
ConcreLe
CperaLlon
8everslblllLy aLLalned
Can solve conservaLlon problems
Loglcal operaLlon developed and applled Lo concreLe
problems
CannoL solve complex verbal problems
lormal Loglcally Solves all Lypes of problems
CperaLlon 1hlnks SclenLlflcally
Solves complex problems
CognlLlve sLrucLures maLure

I numan|t|n ,ode| (,a|ow)