Conclusion: The study illustrate the role of nurses in a therapeutic relation to .. means of providing the right level of interventions and supports to enable people . Drawing bloodwork and performing invasive procedures does not necessarily make a nursing intervention therapeutic. Read this lesson to learn what. For example, in mental health and community nursing, the therapeutic relationship may be the primary intervention to promote awareness and growth and/or to.
Nursing interventions in schizophrenia: the importance of therapeutic relationship
In addition, the reference lists of potential papers retrieved were examined to identify any further material that met the inclusion criteria. Both versions of British and American spellings were used to construct the search strategy as to reflect a systematic and comprehensive approach. The concept of therapeutic interpersonal relationships is not confined to any specific time period or type of peer-reviewed publication, and so no limitations were placed on these parameters to ensure a broad and diverse scope of knowledge.
Papers that focused on pediatrics and adolescence were also excluded as this review focused on adult patient—staff interaction. In addition, papers involving student cohorts were also excluded as were papers that reported solely on satisfaction surveys. Data evaluation The search strategy initially identified papers after removal of duplicates Figure 1. The authors RK and KW independently identified 37 potential papers for inclusion based on titles and abstracts.
The authors RK, KW, and JD independently appraised the 37 identified papers based on the inclusion and exclusion criteria. Disagreements that arose were resolved by debate and consensus.
Establishing Therapeutic Relationships | Registered Nurses' Association of Ontario
Thirty studies were subsequently excluded, leaving a total of seven. The reference lists of the included studies were reviewed, which eventuated in the identification of three additional studies for inclusion with ten studies included in this integrative review.
This sharing is important to avoid unwanted reactions towards the self or others, if command hallucinations are present. Listening to music or watching television may be a good technique to distract the patient from the attention given to auditory hallucinations. Caring for these patients requires that nurses have a great capacity for understanding and empathy and non-stigmatization of mental illness, so that an effective and efficient therapeutic relationship can be established.Video Clip #2: Professional Boundaries - The Therapeutic Relationship
The nurse must be able to see that beyond the symptoms, there is a person in terrible mental suffering, despair, hopelessness and incomprehension, and may even entertain suicidal thoughts. Nurses must be able to understand that these people live in a frightening unreal world and has difficulty distinguishing reality from delusions and hallucinations, because everything seems real to them.
For all of these reasons, it takes a great deal of hard work for nurses to understand the person with schizophrenia who is suffering from a mental pathology and that it is essential to learn to live with symptoms and adhere to therapy to prevent relapse.
Establishing Therapeutic Relationships
Rogers reinforces this idea, pointing out that in a therapeutic relationship, one who assumes the role of helping the other must have a high level of self-knowledge, be genuine, authentic and capable of empathy. What is essential at this stage is to have the patient understand the difficulties they are facing and the need for cooperation. In the exploitation phase, the patient is expected to explore all the possibilities and services offered.
In the resolution phase, individual patient requirements must be met for completion of the relationship. Therefore, establishing a therapeutic relationship is not easy, requiring special attention on the part of the nurse.
Authenticity is necessary, allowing the person to distinguish between what is part of the disease and what is not part of it, i.
It is crucial to help the patient find their personal resources and identify achievable goals in the medium and long term and the means to achieve them. The family may be scared by the situation feeling unwell.
The patient has difficulty expressing requests for help, even though the relationship is accepted. The patient may express difficulties but does not participate in the relationship. The patient engages in the relationship, but refuses to accept some symptoms as part of the disease. In these cases, the nurses must be clear about the limits of their actions, explaining to the patients that non-treatment or non-acceptance may lead to them being a danger to themselves or others. In addition, patients must be informed that the legislation of most democratic countries provides for involuntary hospitalization in a psychiatric unit for symptom control.
This option should be used only as a last resort as it is a painful situation for the person and may further compromise the therapeutic relationship.
This is a complex task given that most patients tend to abandon medication not only because of the difficulty in understanding their own need, but also because of the side effects. It is therefore essential to convey to the patient how important compliance with the therapeutic regime is. In addition to the therapeutic relationship The effectiveness of nursing interventions in schizophrenia depends not only on patient performance, but also on the involvement of the entire family and society.
This is extremely important in the recovery process. For this, a multidisciplinary and networked effort is crucial. Once the therapeutic relationship has been established, besides controlling medication, it is important to implement psychoeducation for the patient and the family regarding schizophrenia, symptomatology and the importance of adherence to treatment.
Psychoeducation is a psychotherapeutic intervention that goes beyond the simple transmission of knowledge. Besides the understanding of the mental illness, its aim is to provide the capacity to deal with it. Psychoeducational programmes should therefore inform about the disease and its evolution as well as enabling the use of effective coping strategies to adapt to the disease, to awaken the patient to the warning signs of a psychotic crisis, and to prevent relapse.
A further aim is to prevent or reduce the family burden, avoiding the appearance of a pathology in the family. Taking into consideration that the therapeutic relationship in the psychosocial rehabilitation of the patient, family and community is more than a technical intervention, it is an ethical imperative.
Conclusion In conclusion, we believe that establishing a therapeutic relationship with the person with schizophrenia is a constant challenge and must accompany the various stages of the disease in cooperation with the family and the community.