examine the role of the nurse in caring for clients with cognitive and/or mental health issues. You will identify your target audience (such as staff nurses, pre-licensure nursing students, etc.) and create an educational PowerPoint presentation (instructions below). This final assignment will reflect ability and achievement in the following areas:
Intentional Learning, Reflection, and Clinical Judgment
Decision Making and Evidence Based Practice
Organization and Presentation
Writing and APA Formatting
Objectives
Demonstrate collaborative standardization of safe practices through health promotion.
Integrate course concepts within management of a cognitive alteration.
Instructions
You are the nurse educator preparing an orientation on cognitive or mental health illness. There is a need to address the many clients with cognitive issues that seek healthcare services and how to better understand their needs. Choose a cognitive/mental health illness that you feel less knowledgeable about and address the following prompts by including two to three examples of each bullet point:
Choose a cognitive or mental health illness.
What is it? How is it diagnosed? How is it treated?
How does it differ from a physical or "visible" illness?
Address the following for your chosen diagnosis.
Historical
Socioeconomic impact
Political issues or impact
Educational needs
Topographical findings
Geographical impact
Cultural impact
Include interdisciplinary interventions for this disease.
Discuss the impact of a patient's value systems on management of this disease.
Address the following health-care practices:
Acute versus preventive care
Barriers to health care
Impact of pain and the sick role
Cultural practices
Identify challenges related to:
Learning styles
Autonomy
Educational preparation
Disease management
How is it Treated? The primary treatment for DID is long-term, intensive psychotherapy, often phase-oriented.
Phase 1: Focuses on safety, stabilization, and symptom reduction.
Phase 2: Involves trauma processing.
Phase 3: Aims for the integration and rehabilitation of the patient. Medications may be used to treat co-occurring conditions like depression or anxiety but do not treat the DID itself.
Slide 2: The Unseen Illness: DID vs. Physical Illness
DID differs significantly from a physical or "visible" illness in several ways, and understanding this is crucial for nursing students.
How it Differs:
Subjectivity of Symptoms: Unlike a broken bone or a bacterial infection, DID symptoms are entirely subjective and internal. They cannot be confirmed with blood tests, X-rays, or other objective diagnostic tools, which can lead to skepticism from both healthcare providers and family.
Stigma and Misunderstanding: Physical illnesses, even chronic ones, often carry less stigma than mental health disorders. DID, in particular, is frequently sensationalized in media, leading to misconceptions and social isolation for patients.
Treatment Modality: Treatment for physical illness is often straightforward (e.g., surgery, antibiotics), with clear endpoints. Treatment for DID is a long-term, intensive process focused on the mind and trauma, requiring a very different approach and mindset from providers.
Slide 3: Historical and Socioeconomic Impact
Historical Context:
Historically, DID was often misdiagnosed as other mental illnesses or even spiritual possession. The famous case of "Sybil" in the 1970s brought public awareness but also fueled misconceptions.
The diagnosis was largely forgotten until the late 20th century, leading to a long period where trauma-related dissociation was not understood.
Socioeconomic Impact:
High Healthcare Costs: Long-term psychotherapy and management of co-occurring conditions can be financially burdensome, leading to a significant socioeconomic impact on patients.
Employment Instability: The severe symptoms of DID, including memory gaps and emotional dysregulation, often make it difficult for patients to maintain stable employment, leading to financial hardship.
Slide 4: Political, Educational, and Topographical Impacts
Political Issues:
Funding Disparities: Mental health, especially complex disorders like DID, often receives less government funding and resources compared to physical health conditions.
Sample Answer
Slide 1: Introduction to Dissociative Identity Disorder
What is Dissociative Identity Disorder (DID)? Dissociative Identity Disorder (DID), formerly known as multiple personality disorder, is a complex mental health condition where an individual's identity is fragmented into two or more distinct personality states. These states, or "alters," can have their own unique memories, behaviors, and way of relating to the world. DID is almost always a result of severe, chronic childhood trauma.
How is it Diagnosed? Diagnosis is made clinically using the DSM-5 criteria. It requires the presence of two or more distinct identity states, recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events, and significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms are not better explained by another mental condition.