Mental Health Nursing - Assessing Mental Health
A physical exam is often included in mental health tests to rule out any physical issues. These can include blood tests, urine testing, or even brain scans.
Psychologists also utilize a array of tools to measure mental health. These tools can be anything from pencil and paper test forms, to in-depth interviews or self-completed questionnaires for postal mail.
Affect and mood
Mood and affect are among the most significant components of the mental status exam (MSE) and are the first to be viewed by the medical professional. They define the patient's general emotional state, which can range from happiness to sadness, or even irritability to anger. The degree of affect can be determined by observing facial expressions and overall demeanour as well as the response to external or internal stimuli (e.g. You can express your emotions by smiling at an absurd joke, or crying when you lose a loved one.
Affect is a feeling that lasts only a few minutes but mood is a longer-lasting emotional state. It is usually described as euthymic or dysphoric, or normal (meaning depression). However, psychiatric professionals should be cautious not to confuse the terms because they have different definitions and are affected by a variety of factors.
While the MSE is a valuable clinical tool, it can be difficult to interpret based on subjective patient reports. It is therefore beneficial to ask patients how they have been feeling over the last few weeks, as opposed to relying on physician observation only. A recent study found that a significant percentage of symptoms, which includes those that fall under the same disorder category, vary between assessment tools. This could be due to the different emphasis on emotional or cognitive symptoms, as well as differences between the time intervals and frequency of the reporting of symptoms.
It is possible that the MSE relies on self-reports which could be susceptible to bias. For example, a patient who reports a headache and anxiety is likely to report less than someone who has only an occasional headache. Patients tend to minimize negative feelings while exaggerating positive feelings.
The affect and mood of a person directly affect the content of thoughts which influences the way people make decisions, their interpersonal behavior and physical functioning. They can be affected by fatigue, stress and social interactions. In actual fact positive moods have been proven to boost the ability to think and be creative. A negative mood can lead to confusion and reduce concentration. Therefore, a careful and thorough mental health evaluation needs to consider the patient's mood and affect as in addition to the underlying causes.
Thought content
One of the most crucial aspects of a mental state exam is assessing how a patient thinks. Evaluation of thought process and content. The term "thought process" refers to the logic, organization and coherence of a patient's thought processes. Normal thought processes are logical and goal-oriented. Thought processing can be altered in several mental health conditions. Examples include hallucinations and delusions as well as loose associations.
A mental state examination also assesses the quality of insight and judgement. Insight is being able to recognize problems. Judgment is the ability to make a well-considered choice after receiving information. Both are affected by a variety of mental health issues such as schizophrenia and depression. If a patient suffers from impaired judgment or insight in any way, they are at greater risk of harming themselves or others. If they are in danger, their rational judgement would suggest leaving the home immediately. A patient with impaired judgment might suggest that they remain in the building to try to put out the flame.
The content of a patient's thoughts encompasses their subject matter, themes and beliefs. Examiners will comment on the clarity, relevance and the content of the thoughts of the patient. They will take note of any thoughts that are tangential or circumstantial, and whether the patient has flights of ideas (digressions from the topic of conversation). They will also make comments on the speed at which someone is thinking, for example, if they seem to be faster or slower.
It is also important to determine whether the patient's mood is in line with their surroundings. For example, a patient who is depressed could hear voices that are angry and threatening, while those suffering from schizophrenia may be able to imagine the sound of a calm and soothing voice. The patient should also be asked about any homicidal or suicidal ideation. Although they are not common, they can be life threatening and should be considered in every mental health assessment.
Watching
Nurses' observation skills are essential to a mental health assessment. They involve a thorough evaluation of behavior, appearance as well as any unusual beliefs or perceptions (such delusions or hallucinations) and mood cognition (including memory, attention, orientation). The nursing mental status exam also includes the observation of motility. This includes any physical movement like eating, drinking, or brushing your teeth.
The Observation element of the mental health examination is a key component of determining whether or not the patient is posing the risk to themselves or others. This is determined by assessing whether or not the patient appears to be moving deliberately in a way that suggests that they may be threatening to harm themselves or anyone else.
In addition, a comprehensive thought content assessment is made by observing the patient throughout the interview and identifying their thoughts and concerns. It is crucial to determine if a patient is having suicidal or homicidal ideas and to determine if they're experiencing thoughts of suicide or delusions.
Global assessment of functioning (GAF) which is an assessment of functioning in numerical form, ranging from 0 to 100, combines the ability of the person to function in daily life and their capability of dealing with stressors. The GAF is an important component of the mental health exam and assists in guiding treatment decisions.
It is important to understand that observing the behaviour of a patient can cause anxiety. Therefore, it is essential that the procedure is conducted in a manner that doesn't cause or make the patient feel uncomfortable. It is also vital that the patient is fully informed about the purpose of the observation and the length of time it will last.
Nursing observation is a crucial ability that should be a central part of any nursing program. However, it should be kept in mind that patients could be dissatisfied with the quality of observation. If they are unable to reach an agreement with staff then they should have access to an advocate service that can represent their interests and assist their discussions on their care. This should be a fundamental part of the local policy and practice, including the involvement of user groups to ensure that patients are included in the creation of written information and staff training for this aspect of clinical governance.
Questioning
Many people have a hard to discuss their mental health issues However, loved ones can often notice the signs that something is not right. They can also encourage the person to seek an assessment. These tests can be extremely broad and cover a variety of topics including appearance, mood as well as memory, thought process and more. In addition to these tests, the mental health professional will also ask the individual questions about their personal life, such as what has been going on recently and what their emotions have been like.
The test consists of an evaluation of the cognitive capacity that examines a person's ability to think clearly and remember information. The person may be required to complete simple tasks such as focusing on a list or objects, remembering lists, or solving math questions. The test can be used to test the ability of the person's judgement and to make good choices. The assessment determines a patient's perception, which is their knowledge of their illness and how it affects them.
The attitude of the patient towards others, himself and the illness is also an important aspect of a mental assessment. The patient's voice, facial expression and body language may convey hostility, anger, depression or a sense of helplessness. It is important to check whether the patient seems to be asking for help or accepting their condition.
In more serious situations an assessment of mental health might include an examination of the patient's mental state, which could involve hallucinations (false sensory perceptions without real stimuli) or illusions (misperceptions of real stimuli). It is important to note the presence of these conditions as they can be extremely dangerous and even life-threatening.
A mental health assessment must be holistic and focus on the person's interactions with their social world. A health professional can use photographs, music, art, or any other assessment tool to gain a better understanding of the individual. They should also talk about the challenges that led the person to seek help, and assure them there is nothing wrong with seeing a mental healthcare professional.