Schizophrenia And Auditory Hallucinations: Understanding The Challenges And Implementing Effective Nursing Interventions

Auditory hallucinations for certain persons experiencing mental disease are commonly experienced as foreign and under the power of some external source. These are generally heard as voices that are disturbing to the individual and can induce social retreat and isolation. Mental diseases like schizophrenia are related with auditory hallucinations, although they can occur in healthy people as well. As many as 10% to 25% of the population is reported to have experienced voices at some point in their lives (Telles-Correia, et. al., 2015). Voice hearing has traditionally been seen as a sign of mental disorder and prescribed anti-psychotic medicine. In this method, voices are perceived as being related to actual or present events and the focus is on embracing the reality of the voices. For people experiencing hallucinatory voices, the more supportive their social environment, the better they were able to deal with the voices.

One of the most dangerous forms of mental disease, schizophrenia is defined by the presence of psychotic symptoms such disorganised thinking and behaviour as well as hallucinations. Negative symptoms including social exclusion, a lack of effort, or a lack of enthusiasm for formerly pleasurable activities are also common. This symptomatology resulting in substantial impairment to social and vocational functioning. An individual with schizophrenia has a hard time comprehending their symptoms and recognising what is going on around them because they live in an alternate reality, a parallel universe, to the actual world. A lack of knowledge about the condition causes stigmatisation for those who are ignorant of its prevalence. The individual gets more and more isolated as a result of this inclination to distrust people, which causes the start of therapy to be postponed, further aggravating the clinical picture. Frequently, the initial encounter with the health care system happens after the onset of symptoms. Schizophrenia patients generally lack insight into their condition because they are unable to discriminate between what is genuine and what is not. This makes the therapeutic connection a continual challenge (Mahone, et. al.,2016). It is the goal of this brief overview to address some of the problems that face the nurse-schizophrenic patient interaction and implementing effective evidence based practices to deal with the relationship, specifically in the case of Indigenous Australian (ATSI people). Experience Of Auditory Hallucinations In Schizophrenia Essay Paper

Due to their inability to provide valid information in the early stages of schizophrenia, most nursing assessments of schizophrenia patients need gathering of data from many sources. It is vital to consult with close friends and family members, as well as medical records if any are available. As a first step, an evaluation of the patient’s mental state should be carried out to identify any current symptoms (such as delusions and hallucinations). If the nurse is to conduct an accurate assessment, she or he must be familiar with the typical behaviours associated with this condition (Pinho, et. al., 2017).

When we talk about providing culturally safe nursing interventions for a patient of any mental illness, it is important to consider their cultural values and background, as specifically in the case of patients from Australian Aboriginal and Torres Strait Islander community. Culture impact upon the health of people in several ways, which includes, the cultural stigma, the knowledge and understanding of the mental health issue and its symptoms, conveying them to understand and accept their situations while treating them and so on.

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The Challenges Of Diagnosing And Treating Schizophrenia

It is important for the nurses to understand their cultural difference with the patients. When it came to recognising or treating an Indigenous Australian mental health patient differently, several of the nurses found the concept unpleasant. The reasons for this were different across nurses. Some nurses were concerned that bringing attention to differences would be viewed as discrimination against certain groups of patients or clients. A respectable understanding of differences in culture and having significant knowledge of their cultural atrocities is an important step of effective nursing care intervention.

Providing a secure and therapeutic environment for a patient who is in a condition of acute perplexity is the goal of Delusion Control (6440), according to the Nursing Interventions Classification. Because delusions are not shared by the nurse, the patient must be shown acceptance. Beliefs should not be discussed or denied in order to avoid undermining trust. Doubt should be utilised as a kind of therapy because of this. The most common type of hallucination is auditory, therefore nurses need to be on the lookout for things like a listening attitude, unmotivated laughing, talking to oneself, and mental barriers, as well as a general loss of focus and attention. Because of these warning indications, the nurse should not touch the patient without first alerting him or her. The patient’s delusion should be shared with the nurse by displaying an attitude of acceptance. If commanding hallucinations are present, this sharing is essential to avoid undesirable reactions against oneself or others which is very common with patients of Schizophrenia. In order to prevent reinforcing the hallucination, the word “voices” should be used instead of “they,” which may imply validation. Additionally, it’s crucial to let the client know that the health care official does not share their experience by stating, “I am aware that the sounds about you are genuine, but I am not able to hear any voices.” Using distraction strategies can help the patient realise that the voices are not real, and that they are a symptom of the sickness. Patients with auditory hallucinations may benefit from listening to songs or watching tv as a distraction.

People’s lives are on the line when it comes to health care decisions, so it’s imperative that they have all of the information they need. In the case of schizophrenia, this is especially true when it comes to creating treatment regimens. Lack of insight, noncompliance with therapy, and a poor prognosis are all common characteristics of schizophrenia. In contrast, research shows that understanding about one’s disease may be quite beneficial to those suffering with schizophrenia. When looking at the effectiveness of psychoeducational therapies in treating schizophrenia, the Cochrane Collaboration found that these methods decreased relapse and admission rates while also allowing patients to spend less time in the hospital (Bonsack, et. al., 2015).

Recovery has been increasingly important to schizophrenia treatment providers in recent years, since long-term incapacity linked with the disorder has become less prominent. Patient engagement and the facilitation of a collaborative connection are both stressed in a rehabilitation paradigm, which emphasises psychoeducation to facilitate a collaborative relationship. Psychoeducation helps to foster a collaborative decision-making strategy that brings together the clinician’s skills and the patient’s treatment choices in a positive way. As a result, shared decision making promotes autonomy, resulting in decisions that are more in line with the individual’s preferences, beliefs, and interests. In the context of health care, shared decision making refers to a process in which clinicians and patients of health care work together as partners to choose the course of treatment (Cort, et. al., 2018).

Cultural Sensitivity In Nursing Interventions For Schizophrenia

Relationships between two individuals are classified as “therapeutic” when they promote growth and/or illness prevention by fostering a healing environment for the patient and the nurse (Cort, et. al., 2018). It is challenging for nurses to work with patients who have schizophrenia because they are often desperate, have issues conveying their symptoms, are terrified of the consequences, and cannot address the need for change. The efficacy of therapeutic measures in schizophrenia is dependent not only on the performance of the patient, but also on the participation of the whole family and the wider community. In the rehabilitation process, this is incredibly crucial to remember. Multidisciplinary and networked efforts are required to achieve success in this endeavour. As a result of this, one of the most important skills of a nurse is her ability to operate in a team. Nurses must be able to comprehend and empathise with these patients and not stigmatise mental illness in order to build a successful and efficient treatment interaction. In addition to recognising the physical signs, the nurse should be able to recognise that the individual suffering from severe mental despair, distress, incomprehension and hopelessness , and can be the one thinking of committing suicide. As everything seems to them to as real, this group of people lives in a frightened unrealistic world and it becomes difficult in distinguishing between reality and hallucinations and delusions. Nurses must be able to recognise this and help them grasp it. To comprehend a person with schizophrenia, nurses must put in a lot of time and effort to learn about the individual’s mental illness and the importance of learning to live with symptoms and adhering to therapy (Vreeland, 2012).

As soon as the therapeutic connection is established, it becomes difficult to provide psychoeducation to the ATSI patient and his or her family about the mental disorder schizophrenia, the symptoms, and the importance of adhering to the prescribed treatment regimen. An intervention in psychotherapy that goes beyond the basic transmission of knowledge is known as psychoeducation. Additionally, it seeks to provide individuals with the knowledge and skills necessary to manage with mental illness, which is very less likely to be there in people for ATSI culture. As a result, psychoeducational programmes are introduced to educate patients on the disease and its development, and to help them learn required coping techniques, and help them recognise the early warning signals of a psychotic crisis. Another goal is to minimise or lessen the load on the family, so avoiding the emergence of a pathology within the family. The use of psychoeducation in conjunction with adherence and psychological rehabilitation has been shown to be helpful in delaying relapses and the need for hospitalisation (Stanley, & Laugharne, 2010).

In order to develop an effective and a successful therapeutic connection, it is important to incorporate counselling towards healing and pulling them apart from self-stigma, in addition to concentrating on psychoeducational treatments, enhancing knowledge, and boosting commitment to therapy. In addition, the client should be included in a psychosocial rehabilitation facility, wherein the nurses must participate actively within their competences, including maintaining the therapeutic connection and collaborating with the interdisciplinary team on behalf of the patient. Mental health counselling for patients, their families, and the broader society is more than just a matter of science and technology; it also necessitates an ethical commitment.

Conclusion

Finally, building a therapeutic connection with a person suffering from schizophrenia is an ongoing task that must be met in collaboration with the patient’s family and community throughout the course of the illness. Before entering into a connection with a patient, nurses should have a thorough understanding of themselves and the condition, as well as an understanding of their own limitations and the patient’s current stigma. A dedication to the patient is essential following initial development and early symptoms, and it is important to focus on reducing self-stigma and the significance of adherence to treatment. When providing nursing care to these clients, it is essential to build a strong and ongoing therapeutic connection that includes frequent monitoring not just of the patient, but also about the patient’s surroundings, and to include family members and others in the rehabilitation process.

References

Mahone, I. H., Maphis, C. F., & Snow, D. E. (2016). Effective strategies for nurses empowering clients with schizophrenia: Medication use as a tool in recovery. Issues in Mental Health Nursing, 37(5), 372-379.

Bonsack, C., Rexhaj, S., & Favrod, J. (2015, February). Psychoéducation: définition, historique, intérêt et limites. In Annales Médico-psychologiques, revue psychiatrique (Vol. 173, No. 1, pp. 79-84). Elsevier Masson.

Pinho, L. G. D., Pereira, A., & Chaves, C. (2017). Nursing interventions in schizophrenia: the importance of therapeutic relationship. Nurse Care Open Acces J, 3(6), 00090.

Cort, E., Meehan, J., Reeves, S., & Howard, R. (2018). Very late–onset schizophrenia-like psychosis: a clinical update. Journal of psychosocial nursing and mental health services, 56(1), 37-47.

Telles-Correia, D., Moreira, A. L., & Gonçalves, J. S. (2015). Hallucinations and related concepts—their conceptual background. Frontiers in Psychology, 6, 991.

Stanley, S., & Laugharne, J. (2010). Clinical guidelines for the physical care of mental health consumers. Perth: Culture and Mental Health Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia.

Vreeland, B. (2012). An evidence-based practice of psychoeducation for schizophrenia: A practical intervention for patients and their families. Psychiatric times, 28(14), 34-34.  Experience Of Auditory Hallucinations In Schizophrenia Essay Paper