Mental Health Nursing - Assessing Mental Health
A physical exam is usually included in mental health tests to rule out any physical ailments. These can include urine tests, blood test or even brain scans.
Psychologists also employ a range of tools to evaluate mental health. These tools can range from paper and pencil test forms to more in-depth interviews or self-completed postal questionnaires.
Mood and affect
Mood and affect are among the most important components of the mental status exam (MSE) and are the first things to be observed by the clinician. They define the patient's general mood that can range from joy to sadness or irritability to anger. The degree of affect can be determined by observing facial expressions and overall manner of speaking as well as the reaction to external or internal stimuli (e.g. You can express your emotions by smirking at a joke, or crying when you lose a beloved one.
Affect refers to an emotion that is only temporary, whereas mood is a state of sustained emotion. It is often described as euthymic (normal) or dysphoric, which means depressed. However, psychiatrists must be careful not to mix the two as they have varying definitions and are influenced by a variety of factors.
While the MSE is a useful tool for clinical use, it can be difficult to interpret based on a subjective patient reports. It is therefore helpful to inquire about how patients have been feeling in the last few weeks, rather than relying solely on the observations of doctors. A recent study revealed that a significant proportion of symptoms, even those grouped together within the same disorder category, differ between assessment tools. This could be due the different emphasis on emotional, cognitive or physical symptoms, as along with differences in time periods and frequency of reporting symptoms.
It is possible that the MSE relies on self-reporting which could be biased. A patient who reports both anxiety and headache is likely to report lower scores than those who report only migraine. Furthermore there is a tendency for patients to minimize negative feelings and overestimate the severity of positive feelings.
Affect and mood can have an impact on the content of thought. This can affect the way we make decisions, our interpersonal behavior, and physical function. They can be affected by stress, fatigue and social interactions. A positive mood can actually enhance creativity and mental power. A negative mood can cause confusion and decrease concentration. Therefore, a thorough and thorough mental health assessment needs to consider the patient's mood and state of mind as well as their underlying factors.
Thought content
One of the most important aspects of a mental state examination is to determine how the patient thinks. Particularly, evaluating thought processes and thought content. The thought process is the coherence, logic, and organization of a patient’s thoughts. Normal thought processes are objective-oriented and logic-based. In many mental health disorders however, thought processing is altered. Examples include hallucinations, delusions and loose associations.
Insight and judgment are assessed in a mental status test. Insight is the ability to identify that there is a problem, while judgement is the ability to make a considered decision when presented with information. Both are affected 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 that they should leave the premises immediately. A patient with impaired judgement might suggest they stay in the house to try to put out the fire.
The contents of a patient's mind includes their themes, subject matter, and beliefs. Examiners generally comment on the clarity, connection and the content of a patient's thoughts. They will note any thoughts that are circumstantial or tangential or thoughts, and also if the patient has flights of ideas (digressions from the topic of conversation). They will also make comments on the pace at which a person is thinking, for example, if they seem to be more or less fast.
Other important aspects to consider are whether the patient's thoughts are compatible or not in line with their surroundings. A person suffering from depression could hear voices of anger, while a person suffering from schizophrenia might experience an illusion that a calm voice is speaking. Ask the patient if they have any suicidal or homicidal ideas. Although they are not common, they can be life-threatening and should be taken into account during every mental health assessment.
Observation
The nurse's ability to observe is essential in an assessment of mental health. They include a careful review of appearance, behaviour and any strange beliefs or perceptions (such as hallucinations or delusions), mood, and aspects of cognition (including attention to the environment, orientation, memory). The nursing mental status exam is also a way of observing motility. This is any physical activity, like eating, drinking or brushing teeth.
The Observation component of the mental status examination is a key component of determining if the patient could pose the risk to themselves or others. This is accomplished by determining whether or not the patient is moving in a way that suggests that they may be threatening to harm themselves or someone else.
In addition, a comprehensive assessment of thought content is done by observing the patient throughout the interview and identifying their main concerns. It is crucial to determine if the patient is suffering from suicidal or homicidal thoughts and to determine if they're experiencing delusions.
A global assessment of functioning (GAF) is an assessment of a numerical score on a scale from zero to 100 that evaluates the ability of a person to function in everyday life along with their ability to deal with the stresses that come with life. The GAF is a crucial component of the mental state examination and aids in making the treatment decisions.
It is crucial to realize that observing the behavior of a patient could cause anxiety. Therefore, it is essential to conduct the procedure in a manner that does not cause discomfort or cause discomfort. It is also crucial that the patient is aware of the reason for the observation and the amount of time it will last.
Nursing observation is an essential skill and it must be a key element of the nursing process. However, it should be noted that patients might be dissatisfied with the quality of observation. If they are unable to reach an agreement with the staff, they should be able to access an advocate service that can represent their needs and help them in any discussions regarding their care. This should be a component of the local policy and practice, with the involvement and support of groups of users.
Questioning
Many people are reluctant to discuss their mental health issues, but family members are often able to detect if something is not right. They can also help the person to take an assessment. These assessments be conducted on a variety of topics that include mood, appearance and the thought process. In addition to these tests, mental health professionals will also ask the person questions about their life, including what's happened lately and what their feelings have been like.
The assessment also includes a cognitive assessment that focuses on the ability of the person to think clearly and retain information. The test subject may require the person to complete simple tasks such as paying attention to a list of objects, memorizing lists or solving math questions. The test can be used to test the person's judgment and ability to make informed choices. The assessment also determines the patient's insight and level of understanding about their illness and its impact on them.
The attitude of the patient towards others, himself and the illness is an important part of a mental evaluation. The patient's tone of voice, facial expressions and body language can convey anger, hostility depression or a feeling of powerlessness. It is important to observe whether the patient appears to be asking for help or accepting their condition.
In more serious cases the assessment of mental health could include a thorough examination of the patient's thinking that may include illusions or hallucinations. These conditions can be dangerous and even fatal.
In general the mental health assessment should be holistic and consider the person's interactions with their social environment. Iam Psychiatry could use photographs, music, art or a variety of assessment tools that are electronic to help understand the person and their unique perspective on the world around them. They should also speak to the person about the issues that have caused them to seek help and reassure them that there is nothing wrong with visiting an expert in mental health.