CMPA 412 – MIDTERM NOTES

[MRS. JANELYN FLORES RN, MAN]

REORIENTATION PHASE (OPTIONAL)
• Some models include a reorientation phase where
OUTLINE OF THE TOPICS
the client may return for follow-up care or support
I. THERAPEUTIC COMMUNICATION • This phase may re-establish trust and rapport if
II. RESEARCH needed
III. NURSING MANAGEMENT THERAPEUTIC COMMUNICATION IN HEALTHCARE
IV. JURISPRUDENCE • Communication refers to the reciprocal exchange
V. PSYCHIATRIC NURSING of information, ideas, beliefs, attitudes between
WEEK 8 persons or among group of persons. It is goal
THERAPEUTIC COMMUNICATION directed process. In nursing, it is used in nursing
process
PHASES OF THE NURSE-CLIENT RELATIONSHIP COMMUNICATION PROCESS
● The nurse-client relationship is a fundamental aspect
of nursing practice, characterized by a series of phases
that guide the interaction between the nurse and the
client. These phases are essential for building trust,
promoting effective communication, and providing
high-quality care. Understanding and navigating these
phases is crucial for nurses to establish therapeutic
relationships with their clients. Here is an overview of
the phases of the nurse-client relationship: TYPES OF COMMUNICATION
PRE-INTERACTION PHASE Verbal communication
• This phase occurs before the nurse and client meet Non-verbal communication
face-to-face DEFINITION of THERAPEUTIC COMMUNICATION
• The nurse gathers information about the client’s • “In therapeutic communication, the nurse directs
history, condition, and needs the communications towards the patient to
• Initial judgments and assumptions should be identify his current health problem, plan,
suspended to maintain an open mind implement & evaluation the action taken”
ORIENTATION PHASE GOAL OF THERAPEUTIC COMMUNICATION
• This phase marks the first meeting between the • Establish a therapeutic nurse-patient relationship
nurse and client • Identify the most important patient’s needs
• The nurse establishes trust and rapport with the • Assess the patient’s perception of the problem
client • facilitate the patient's expression of emotions
• The nurse and client clarify roles and expectations • implement interventions designed to address the
• Goals for the relationship and client care are set patient’s needs
WORKING PHASE THERAPEUTIC COMMUNICATION TECHNIQEUS
• In this phase, the nurse and client work together to 1) listening
achieve the established goals 2) broad opening
• The nurse provides care, support and education 3) restating
• Communication is on-going and therapeutic 4) clarification
• Problem-solving and decision-making are integral 5) reflection
to this phase 6) humor
TRANSFERENCE PHASE 7) information
• This phase involves the client transferring feelings 8) focusing
and emotions onto the nurse 9) sharing perceptions
• These feelings may be positive or negative and are 10) theme identification
often related to past experiences 11) silence
• The nurse should help the client explore and 12) suggesting
understand these emotions Listening
COUNTERTRANSFERENCE PHASE • it is an active process of receiving information
• Countertransference refers to the nurse’s • response on the part of the nurse such as
emotional response to the client maintaining eye-to-eye contact, nodding,
• The nurse must recognize and manage these gesturing & other form of receptive non-verbal
emotions to ensure they don’t interfere with care communication convey to the patient that he is
• Supervision and self-reflection are essential during being listened to & understood.
this phase BROAD OPENING
TERMINATION PHASE • encouraging the patient to select topics for
• The termination phase occurs when the goals of discussion
the nurse-client relationship have been achieved. • eg: “What are you thinking about?”
• It involves summarizing and evaluating goal RESTATING
attainment • repeating the main thought expressed by the
• The nurse and client say their goodbyes and discuss patient
plans for the future
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 • Eg; “you say that your mother left you when you • *These non-therapeutic techniques should be
were five years old” avoided
CLARIFICATION COMMUNICATION FAILURES
• Attempting to put vague ideas or nuclear thoughts • Failure to perceive the patient as human being
of the patient into words to enhance the nurse’s • Failure to recognize the level of meaning in
understanding or asking the patient to explain communication
what he means. • Failure to listen
• Eg; “I am not sure about what you mean, could you • Failure to interpret with knowledge
tell me about that again?” • Use of close ended question only
REFLECTION • Conflicting verbal non verbal
• Directing back the patient’s ideas, feelings, • Giving false reassurance
questions & content • Changing subject if not comfortable
• Eg; “You are feeling tense & anxious & it is related to WEEK 9
a conversation you had with your husband last INTRODUCTION TO RESEARCH: GENERAL CONCEPTS
night ▪ Research is an organized inquiry carried out to
HUMOR provide information for solving problems
▪ It is the cornerstone of every science.
• The discharge of energy through comic enjoyment
What is Research?
of the imperfect ▪ Re – again
• Eg: “That gives a whole new meaning to the word ▪ Search – find
‘nervous’, said with shared kidding between the ▪ Process – step by step phase, phases
nurse & the patient ▪ Research is the systematic process of collecting
INFORMATION and analyzing information to increase our
understanding of the world in general and of the
• The skill of information giving
phenomenon under study in particular.
• Eg; “I think you need to know more about your Steps in Qualitative Research: THEORY
medications” 1) Acknowledge Social Self
FOCUSING 2) Actual perspective
• Questions or statements that help the patient 3) Design study
expand on a topic of importance 4) Collect data
5) Analyze data
• Eg: “I think that we should talk more about your
6) Interpret data
relationship with your father.” 7) Inform others
SHARING PERCEPTIONS Purpose of Research
• Askin the patient to verify the nurse’s ▪ Explore
understanding of what the patient is thinking or ▪ Describe
feeling ▪ Explain
Characteristics of Research
• Eg; “You are smiling, but I sense that you are really
1) Empirical – research is based on direct
very angry with me”
experience or observation by the researcher
THEME IDENTIFICATION 2) Logical – research is based on valid procedures
• This involving identification of underlying issues or and principles
problems experienced by the patient that emerge 3) Cyclical – research starts with a problem and
repeatedly during the course of the nurse-patient ends with a problem
relationship 4) Analytical – research utilizes proven analytical
procedures in gathering data, whether historical,
• Eg; “I noticed that you said you have been hurt or
descriptive, experimental, and case study.
rejected by a man. Do you think this is an 5) Critical – research exhibits careful and precise
underlying issue?” judgment.
SILENCE 6) Methodical – research is conducted in a
• Lack of verbal communication for a therapeutic methodical manner without bias using
reason systematic method and procedures.
7) Replicability – research design and procedures
• Eg: sitting with a patient & non-verbally
are repeated to enable the researcher to arrive at
communicating interest & involvement valid and conclusive results.
SUGGESTING 8) Intellectual Curiosity – researcher undertakes
• Presentation of alternative ideas for the patient’s deep thinking and inquiry of the things,
consideration relative to problem solving problems, and situations around him
• Eg; “have you thought about responding to your 9) Prudence – researcher is careful to conduct his
study at the right time and at the right place
boss in a different way when he raises that issue
wisely, efficiently, and economically.
with you? You could ask him if a specific problem 10) Healthy Criticism – the researcher is always
has occurred. doubtful as to the truthfulness of the results.
NON-THERAPEUTIC TECHNIQUES 11) Intellectual Honesty – researcher is honest to
• Reassuring collect or gather the data or facts in order to
• Rejecting arrive at honest results.
12) Intellectual Creativity – a resourceful
• Giving approval
investigator always creates new researches.
• Advising Qualities of a Good Researcher
• Defending ▪ Research Oriented
• Requesting ▪ Efficient
• Belittling the feeling of the patient ▪ Scientific
▪ Effective
▪ Active

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 ▪ Resourceful local test result with a state or national
▪ Creative norm.
▪ Honest
▪ Economical
▪ Religious
Types of Research
There are different types of research based on different
aspects such as:
▪ Purpose
▪ Process
▪ Outcome

▪ Descriptive – Educational-Survey Research

Studies
➢ This type of study looks into the
teaching-learning process, the child-
teacher, the learner and the
environment, the attitudes, habits and
other characteristics of the learner, the
techniques and the methods, the
building equipment and materials used,
etc. which all pertain to education. The
goal of this study is to have a total
improvement of the educational system
for the maximum development of the
individual learner.

Different types of research coming under the category

purpose are
I. Descriptive research
II. Analytical research
III. Exploratory research
IV. Predictive research
Descriptive Research
▪ It includes fact-finding enquiries of different
kinds such as what, why, when. How and all
▪ The main aim of this research is description of
the characteristics of a phenomena at present
▪ This research has no control over the variable
only have to report what is happening or what
has happened
▪ For description researchers use frequencies,
averages and other statistical calculations
▪ The methods used by this researchers involves
survey method of all kinds including
comparative and correlational method
▪ The periodic table categorizes the elements is an ▪ Descriptive – Psychological Research Studies
example of descriptive research ➢ This study pertains to the behavior of
Method individuals in different situations.
▪ Six steps in conducting descriptive research
1. Identify problem
2. Review literature
3. Select participants and instruments
4. Collect valid and reliable data
5. Analyze data
6. Report conclusions
Types and Actual Studies of Descriptive Research
▪ Descriptive – Normative Survey
➢ The term normative is sometimes used
because survey are frequently made to
ascertain the normal or typical
condition, or practice, or to compare

3|HAZEL A.
 ▪ For a closer look into happenings, behavior,
practice, methods and procedures. Descriptive
research provides essential facts and
understanding about the nature of anything
▪ For the formation of construction of test analysis
of these standardization of tools instruments
used in research
Analytical Research
▪ This research mainly carrying out analysis on a
phenomena and which involves secondary data
▪ The aim of this research is to understand
phenomena by discovering and measuring
causal relations among them
▪ Here the researcher use facts or information’s
readily available to them in order to analyze to
make a critical evaluation of the context
▪ It works within the constraint variables. It also
tries to explain existing state of affairs from
available data
▪ How can the absentee rate among employees be
reduced? It is an example of analytical research.
▪ The researcher has to use facts or information
▪ Descriptive – Social Survey already available & analyze them to make a critical
➢ The purpose of this study is to change for evaluation of the material
the better existing practices of groups ▪ It involves the in-depth study & evaluation of
living a community. It is concerned with available information in an attempt to explain
the formulation of constructive complex phenomenon
programs of social reform and ▪ It concerned with testing hypothesis & specifying
amelioration. A current social problem is & interpreting relationships, by analyzing the
existing in a particular place, and the facts or information already available
aim is to diagnosis the “root causes” of Analytical Method
the ills, utilizing the research approach. ▪ The Analytical Method is a generic process
combining the power of the Scientific method
with the use of formal process to solve any type of
problem. It has nine steps.
STEPS
1. Identify the problem to solve
2. Choose an appropriate process (THE KEY STEP)
3. Use the process to hypothesize analysis or
solution elements
4. Design an experiment(s) to test the hypothesis
5. Perform the experiments
6. Accept, reject, or modify hypothesis
7. Repeat steps 3,4,5, and 6 until hypothesis is
accepted
8. Implement the solution
9. Continuously improve the process as
opportunities arise.
Importance
▪ Use of the analytical method is critical to solving
the sustainability problem because it appears
Ethics of Descriptive Research that current processes are inadequate. They are
▪ Be sure when you describe any particular group intuitive, simple, and based on how activists
of individuals in your population, you should approach everyday problems.
include not only the characteristics which are Conclusion
common to the group but also their unique as In the teaching experiment
well. Failure to include the unique characteristics a) Results show that application of multimedia
of the participant may make the result technology in the teaching of physical education
inconsistent and unreliable has greatly changed the student’s physical source
▪ Bear in mind that seldom in the descriptive of knowledge structure.
method per se used as end in itself. It means that b) Learning ways of cultivating the students’
the primary objective of descriptive methods is to learning ability, habits of lifelong learning has
make use of the results to facilitate predictions or obvious role in promoting;
control of some behaviors. As a researcher, for you c) Network teaching form can make up for the
to plan how your findings can be used as means traditional single teaching content, defect class
to further some ends too little;
▪ Use statistical procedures to assure you of a level d) The network education technology of
of confidence that your results are trustworthy asynchronous nature of teaching and modern
▪ Data should not be manipulated teaching means more optimized teaching mode
▪ Instrument use should be free from cultural bias. has brought inspiration for the school sports
Importance of Descriptive Research exploration, is conducive to the deepening of
▪ For scientific basis of judgement. This means that teaching reform.
descriptive research provide information which Exploratory Research
could be used as basis for important decisions ▪ An exploratory-design is conducted about a
that are to be made. research problem when there are few or now
earlier studies to refer to

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 ▪ The focus is on gaining insights and familiarity for EG6: Coupons in Grocery Stores
later investigation or undertaken when problems ▪ Retailers accumulate huge amounts of data on a
are in preliminary stage of investigation. day-to-day basis
▪ Gathers preliminary information that will help to ▪ Using predictive analytics and data from loyalty
define a problem and suggest a hypothesis cards, computers in real-time crunch terabytes
▪ It commonly uses unstructured interview and terabytes of historical purchases to figure out
▪ It involves generation of new ideas and that favorite ice cream was the one item missing
assumption, development of tentative theories or from shopping basket that week
hypothesis but conclusions cannot be drawn ▪ With bill, a coupon is received for the item that are
even though it provides direction for future most likely to buy next time
research and techniques. ▪ The shift toward contextual marketing and
Types of Exploratory Research retailing is driven by data – big data
▪ Literature Reviews
▪ Experience Surveys
▪ Analysis of Stimulating Examples (i.e., Case
Analyses)
▪ Unstructured Methods (i.e., Pilot Studies)
Conclusion
▪ Exploratory research study which merely leads to
insight or hypothesis, whatever method or
research design outlined above is adopted, the
only thing essential is that it must continue to
remain flexible so that many different facets of a
problem may be considered as and when they
arise and come to the notice of the researcher.
Predictive Research
▪ It studies determine the frequency with which
something occurs or its association with Different types of research coming under the category
something else process are:
▪ In diagnostic research, the researcher must be 1. Qualitative research
able to define clearly, what he wants to measure 2. Quantitative research
and must find adequate method for measuring Qualitative Research
along with clear cut definition off ‘population’ he ▪ It is handled with qualitative phenomena that
wants to study. involves quality or kind
▪ Statistical tools used in this research design ▪ The research designed to find out how people feel
includes regression, linear regression and logistic or what people often think are coming under this
regression research
▪ The major areas in which predictive/diagnostic ▪ It is important in behavioral sciences.
research design used include: business, ▪ Its aim is to discover the underlying motives of
marketing, clinical setting, govt agency and all. human behavior through detailed description
EG1: Match.com ▪ The data is in the form of words, pictures or
▪ Is powered by Synapse algorithm. objects and all
▪ It learns about its users (as Amazon, Netflix, and Research Question Considerations
Pandora) to recommend new products, movies, ▪ Is the question easily and fully researchable?
or songs based on a user’s preferences ▪ What type of information do we need to fully
▪ Excludes certain variables or take a multi- answer the question?
dimensional scoring approach with different ▪ Is the scope of the research question reasonable
weights. ▪ Given scope, is the question too broad or too
EG2: Websites narrow?
EG3: Airlines ▪ Do I have access to the necessary sources?
▪ Customers needs and wants: Techniques Why is all this Important?
➢ Analytical quality control ▪ We can use these same steps when designing a
➢ Reliability modeling new research project for a client
➢ Streamlined services and ▪ Research questions will allow us to be more
➢ Expedited application processing focused on exactly what the client is looking to
For example, predictive modeling assist in: have answered.
▪ Moving from mass marketing to more Now what?
personalized ▪ We have our research question, now what do we
▪ Targeted campaigns and offers do?
▪ Provide insights into where airlines are or are not ▪ The next step is to design a research study that
meeting traveler expectations will answer the necessary question(s)
▪ Pricing products Research Methodology
▪ Managing inventory or staffing ▪ Methods of data collection
▪ Customer and operational data to improve ➢ Interviews (one-on-one, focus groups,
efficiency etc.)
▪ Reduce risk and ➢ Observations
▪ Increase profits ➢ Open-ended survey
EG4: HR ➢ Written documents
Things driving the use of predictive analytics in HR ▪ Analysis: Coding
▪ Getting better at using operational processes and ➢ When coding we focus on whatever is
technology by collecting good-quality data to necessary to answer our research
make better decision-making question
▪ These rich data sources referring to the inclusion ➢ This may require: emotion coding,
of both external and internal data holistic coding, in vivo coding, initial
▪ Vendors of HR solutions are increasingly building coding, etc.
analytics into their core platforms.

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 ▪ Analysis: Theming ➢ How did the universe begin?
➢ Theming of the data ➢ What are protons, neurons, and
o Reducing data into meaningful electrons composed of?
and manageable groups ➢ How do slime molds reproduce?
o May focus on repeated words ➢ What is the specific genetic code of the
or phrases fruit fly?
o Evidence that answers the Basic Research Steps
research question ▪ Define research problem
▪ Research: Next Steps ▪ Review of literature
➢ Use additional information to support ▪ Formulate hypotheses
your findings ▪ Preparing the research design
➢ The final research presentation can vary ▪ Data collection
based on the needs to the project ▪ Data analysis
➢ In research it is now acceptable to ▪ Interpretation and report writing
submit findings visually, as a poem, a Comparison between Basic and Applied Research
narrative or even a script. Basic Applied
Quantitative Research ▪ Done for the ▪ Testing of
▪ This research is based on the measurements of development of theories and
quantity or amount theories or principle
▪ It can only be expressed in terms of quantity principles
▪ Researcher use tools such as questionnaire or ▪ Domain-driven ▪ Deman-driven
equipment to collect data and all aspect of the intended to lead intended to lead
study are carefully designated before data is theoretical dvpt to solution of
collected specific
▪ Here data is in the form of numbers or statistics problems
and this data is more efficient and able to test. ▪ Focus on making ▪ Designed to
Examples: things better and solve practical
▪ The Impact of COVID-19 to Senior High School creating a more problems of the
Students’ Self-Learning Skills human society modern world
▪ Community Quarantine and Its Impacts on ▪ Done for the ▪ Done to test
Family Relationships intellectual theories in the
Applied Research pleasure of field to achieve
▪ It is defined as a research which is used to answer learning better validity
a specific question, solve a specific problem or to ▪ Mainly concerned ▪ Aims at finding
gain better understanding with a solution for an
▪ It also known as action research generalizations immediate
▪ It aims at finding solution for an immediate and with the problem facing
problem facing in society or an organization formulation of a a society
through systematic inquiry involving practical theory
application of science, based on the level and type ▪ No commercial ▪ There is
of involvement researcher can differ this research value attached to commercial
based on the scope of work. the discoveries value
▪ It is designed to solve problem of modern world that result from ▪ e.g., research to
than acquire knowledge. The main goal of basic research improve
applied scientist is to improve the human agricultural crop
condition for example: treat or cure a specific production
disease.
▪ Analytic ▪ Synthetic
Possible Applied Research Topics
▪ Involves a search ▪ Involves a
▪ Forensic accounting
for enduring or search for
▪ Risk management
general truths pragmatics
▪ Financial criminology
solutions to
▪ Financial integrity
particular
▪ Tax audit
problems
▪ Corporate governance
Some other types of researchers are also there
▪ Financial reporting
▪ One time research/longitudinal research
▪ Financial fraud investigation competency
➢ In this research one group have to
▪ Whistle blowing
studied for long time and it studies
▪ Fraud prevention
different stages in an individual’s life and
▪ CPD training programs for enforcement officers
all
▪ Fraud surveillance
▪ Field setting research/laboratory
Fundamental or Basic or Pure Research
research/simulation research
▪ This research is concerned with generalization
➢ This research is depending upon the
and formulation of theory
environment take into consider for
▪ It is done for the intellectual pleasure on learning
research
and it has no commercial value attached to the
▪ Clinical Research
discoveries that result from basic research
➢ There type of research follows case-
▪ This type of research has limited direct
study method and have an in-depth
applications but in which researcher has careful
approach in order to study causal
control over the research setting
relationships
▪ It involves collection and analysis of data to
▪ Historical Research
develop or enhances theory and have an
➢ In this research, researcher utilizes
understanding of theoretical relationship
historical sources like documents,
between variables.
events and all in order to understand
For example:
past, point of time and all
▪ Basic science investigations probe for answers to
▪ Conceptual Research
questions such as

6|HAZEL A.
 ➢ This research is completely based on support to nursing staff, fostering a positive
some abstract ideas or theory work environment, and resolving conflicts
▪ Empirical Research when they arise.
➢ It is completely based on experiences or
10. Data Management: Collecting and
observations
TERMS AND CONCEPT OF RESEARCH analyzing data related to patient care, staff
1) The faces and places of research performance and department operations
2) The building blocks of research to male informed decisions.
a. Phenomenon, Concepts, and Constructs HENRI FAYOL’S PRINCIPLES OF MANAGEMENT
b. Theories and conceptual models Henri Fayol
c. Variables ▪ He was born in 1841 in Istanbul and died in1925.
d. Conceptual and operational definition ▪ French mining engineer and director of mines who
e. Data developed a general theory of business
3) Relationships administration.
WEEK 10 ▪ He and his colleagues developed this theory
NURSING MANAGEMENT independently of scientific management.
What is Nursing Management? ▪ He is known as the “Father of Modern Management
▪ Nursing management refers to the leadership and Theories”.
administrative activities that are involved in Principles of Management
overseeing and coordinating nursing care within a ▪ Principles of Management are universally
healthcare setting. This management role is applicable rules or recommendations that guide
typically carried out by registered nurses or nurse the behaviour or decision-making of a manager.
managers, who are responsible for ensuring the Importance of Modern Management Theory
delivery of high-quality patient care and the ▪ Fayol’s 14 Principles of Management
efficient operation of nursing departments or units. ➢ One of the earliest theories of
Nursing management encompasses a wide range management to be created.
of responsibilities, including: ➢ It incorporated proven principles,
1. Staffing and Scheduling: Nurse managers elements, procedures and techniques
are responsible for assigning nursing staff based on his practical experience.
to various shifts, ensuring adequate 1. Division of ▪ Jobs are segmented into
staffing levels, and creating schedules that Labor smaller bits, which are to be
meet patient care needs while adhering to assigned to be individual
labor regulations. workers in accordance with
their area of specialization.
2. Budgeting and Resource Allocation:
➢ Specializations
Managing budgets for nursing quicken the rate of
departments, allocating resources and completion of task,
controlling costs to ensure that the unit increase productivity
operates within financial constraints. and permits large-
3. Quality Assurance: Overseeing the scale production at
implementation of quality improvement minimal cost.
➢ Division of labor and
initiatives, monitoring patient outcomes
specialization
and ensuring adherence to best practices produces more and
and regulatory standards. better work with the
4. Training and Development: Providing same effort.
ongoing education and training for nursing 2. Authority ▪ Authority is the right to give
staff to keep them updated on the latest and orders and the power to exact
healthcare practices and technologies. Responsibility obedience.
▪ Authority is required to
5. Patient Care Coordination: Coordinating
control the behavior of
patient care plans and collaborating with organizational members.
other healthcare professionals to ensure ➢ Appropriate sanction
that patients receive comprehensive and is needed to
effective care. discourage poor
6. Policy and Procedure Development: performance and
encourage good job
Developing and implementing nursing
performance each
policies and procedures that comply with member of the
regulatory guidelines and best practices. organization should
7. Risk Management: Identifying and be given enough
mitigating risks to patient safety and the authority to enable
healthcare organization, such as him carry out the
preventing medical errors and promoting assigned job
responsibility.
infection control.
3. Discipline ▪ Obedience and respect within
8. Communication: Facilitating effective an organization are absolutely
communication among nursing staff, essential.
patients, families and other members of the ▪ Good discipline requires
healthcare team. managers to apply sanctions
9. Leadership and Team Management: whenever violations become
Providing leadership, guidance and apparent.

7|HAZEL A.
 ▪ Disobedience should be NURSING LEADERSHIP THEORIES
discouraged through Transformational Leadership Theory
imposition of penalties. ▪ Transformational leadership is centered on
▪ Discipline, especially self- inspiring and motivating followers to achieve their
discipline is a crucial
potential. Nursing leaders using this theory focus
determinant of effective job
performance within an on developing a shared vision, fostering innovation
organization. and empowering their teams to provide high-
4. Unity of ▪ An employee should receive quality care.
Command orders from only one superior. Transactional Leadership Theory
➢ This is one way to ▪ Transactional leadership is based on a system of
minimize confusion,
rewards and punishments. Leaders set clear
conflict and
expectations and provide rewards for meeting
indiscipline within
an organization. those expectations. In healthcare, this approach
5. Unity of ▪ Organizational activities must can be useful for ensuring compliance with
Direction have one central authority protocols and procedures.
and one plan of action. Servant Leadership Theory
➢ An organization is ▪ Servant leadership emphasizes serving and
more effective when prioritizing the needs of others, especially patients
every member
and healthcare team members. Nurse leaders
within it work toward
the accomplishment adopting this theory are attentive, empathetic and
of a common dedicated to supporting the well-being of their
objective. team and patients.
➢ Unity of direction Situational Leadership Theory
implies unity of ▪ Situational leadership suggests that the most
purpose.
effective leadership style varies depending on the
6. ▪ The interest of one employee
specific situation and the needs of the team.
Subordination or group of employees are
of Individual subordinate to the interests Nursing leaders must adapt their leadership style to
Interest to and goals of the organization. suit the circumstances and the competence and
General commitment of their team members.
Interest Laissez-Faire Leadership Theory
7. ▪ The pay/salary of employees ▪ Laissez-faire leadership involves a hands-off
Remuneration should be very approach, allowing team members considerable
commensurate to the work
autonomy in decision-making. In nursing, this style
they do in an organization to
create a good measure of can work when team members are highly skilled
satisfaction. and self-motivated.
8. ▪ Centralization means Path-Goal Theory
Centralization concentration of authority at ▪ It focuses on how leaders can clarify paths to
the top of the administrative achieving goals and remove obstacles for their
system. team. Nursing leaders may provide guidance,
▪ Decentralization means
support, and resources to help team members
dispersal of authority among
the lower levels of the achieve optimal patient outcomes.
administrative system. Contingency Theory
9. Scalar Chain ▪ Scalar chain refers to the ▪ Contingency theory proposes that effective
number of levels in the leadership depends on various factors, including
hierarchy from the ultimate the leader’s personality, the characteristics of the
authority to the lowest level followers, and the situational context. Nursing
in the organization.
leaders must adjust their leadership style
10. Order ▪ There should be a systematic
order of function for every accordingly.
material and personnel in an Authentic Leadership Theory
organization. ▪ Authentic leadership emphasizes self-awareness,
11. Equity ▪ This implies that justice, transparency, and ethical behaviour. Authentic
fairness, compassion and nursing leaders strive to be genuine and consistent
cordiality based on in their interactions with both their team and
predetermined norms should
patients
dominate the activities of an
organization. Quantum Leadership Theory
12. Stability of ▪ Employee turnover should be ▪ Quantum leadership is an evolving concept that
Tenure of reduced to ensure incorporates elements of chaos and complexity
Personnel effectiveness and efficiency. theories. It emphasizes the dynamic and
13. Initiative ▪ Employee need to be unpredictable nature of healthcare, where nurse
motivated to put forward leaders must be adaptable, innovative, and
their ideas or suggestions
responsive to change.
and execute them.
IMPORTANT
14. Esprit de ▪ French term for “Team
▪ These nursing leadership theories offer a range of
Corps Spirit”.
approaches and strategies for nurse leaders to employ,
▪ “United we stand, divided we
depending on their individual style, the healthcare
fall.” environment, and the needs of their team and patients.
Effective nursing leadership requires the ability to draw

8|HAZEL A.
 from multiple theories and apply them in a flexible and PLANNING Planning
context-specific manner. ▪ GULLICK- “Planning is working
NURSING LEADERSHIP STYLES out in broad outline the things
Key Nursing Leadership Styles that need to be done and the
▪ Transformational Leadership methods for doing them to
▪ Servant Leadership accomplish the purpose set for
the enterprise”
▪ Autocratic Leadership
▪ KOONTZ - ”Planning is deciding
▪ Laissez-Faire Leadership in advance – what to do, when to
▪ Democratic Leadership do & how to do. It bridges the gap
▪ Transactional Leadership from where we want to be”.
▪ Situational Leadership 3 Basic Steps in Planning
▪ Charismatic Leadership 1. Formulating Objectives – states
precisely what results are to be
▪ Authentic Leadership
accomplished and when
▪ Visionary Leadership 2. Taking action – follows pre-
IMPORTANT determined plans of actions to
▪ Effective nurse leaders often incorporate elements from fulfill the objective
multiple leadership styles to adapt to the unique needs 3. Analyzing results – measures the
and challenges of their teams and healthcare settings. results achieved against the
The most successful leaders are those who can flexibly original goal
switch between styles and focus on the best approach
ORGANIZING Organizing
for a given situation or group of individuals.
▪ It is the establishment of a formal
structure of authority through
MANAGEMENT which the work subdivisions are
▪ “Management is an art of getting things done arranged, defined, and
through and with the people in formally organized coordinated for the defined
groups. It is an art of creating an environment in objective.
which people can perform and individuals can ▪ In organizing, structures are
cooperate towards attainment of group goals.” created, relationships are
established and resources are
Harold Koontz
allocated for the accomplishment
▪ “Management is an art of knowing what to do, of activities.
when to do and see that it is done in the best and ▪ According to Henry Fayol, “To
cheapest way”. – F.W Taylor organize a business is to provide it
▪ “Management is a distinct process consisting of with everything useful or its
planning, organizing, actuating and controlling, functioning i.e. raw material, tools,
performed to determine and accomplish stated capital and personnel’s”
Organizing as a process involves:
objective by the use of human beings and other
1. Identification of activities
resources”. George R. Terry 2. Classification of grouping of
MANAGEMENT AS A PROCESS activities
11. Management is a ▪ Concerned with developing 3. Assignment of duties
social process relationship among people 4. Delegation of authority and
12. Management is ▪ Undertake the job of creation of responsibility
an integrated bringing together human 5. Coordinating authority and
process physical and financial responsibility relationships
resources so as to achieve STAFFING ▪ The whole personnel action of
organizational purpose bringing in and training the staff
13. Management is a ▪ Concerned with constantly and maintaining favorable
continuous identifying the problem and conditions of work. It is also
process solving them by taking known as Human Resource
adequate steps Management
14. Management is ▪ All managerial ▪ Koonttz & O’Donell, “Managerial
an iterative functions are contained function of staffing involves
process within each other (?) manning the organization
joke di ko alam putol structure through proper and
kasi HAHAHA effective selection, appraisal &
development of personnel to fill
MANAGEMENT FUNCTIONS the roles designed into the
George Terry ▪ “There are four fundamental structure”.
functions of management i.e. Staffing Involves:
planning, organizing, actuating ▪ Manpower Planning
and controlling” ▪ Recruitment, selection &
Henry Fayol ▪ “To manage is to forecast and placement
plan, to organize, to command, & ▪ Training & development
to control” ▪ Remuneration
▪ Performances appraisal
Koontz and ▪ Planning, Organizing, Staffing,
▪ Promotions & transfer
O’Donnel Directing and Controlling
DIRECTING ▪ Directing is a part of
POSDCoRB
managerial function which
Luther Gullick coined the keyword ‘POSDCoRB’ which
actuates the organizational
formulates the responsibility of a chief executive or
methods to work efficiently
administrator. It is developed as a means to structure and
for achievement of
analyze management activities and sets a new paradigm
organizational purposes.
in Public Administration

9|HAZEL A.
 ▪ It is considered life-spark of ▪ Evaluator should be trained to carry out the
the enterprise which sets in performance appraisal process
motion the action of people ▪ Performance appraisal should focus on employee
because planning, organizing behaviour and results rather than on personal traits
and staffing are the mere
or characteristics.
preparations for doing the
work. It involves guiding and OBJECTIVES OF APPRAISAL
motivating other people to ▪ Appraisal should be in writing and carried at least
work for a common once a year.
Elements of Directing: ▪ The performance appraisal information should be
1. Supervision – implies shared with the employee.
overseeing the work of
▪ Employee should have the opportunity to respond
subordinates by their
superiors. in writing to the appraisal.
2. Motivation – inspiring, ▪ Employees should have a mechanism to appeal the
stimulating or encouraging results of the performance appraisal.
the subordinates with zeal to ▪ Manager should have adequate opportunity to
work. observe the employees.
3. Leadership – the process by ▪ Anectodal notes on the employee’s performance
which manager guides and
should be kept during the entire evaluation period.
influences the work
subordinates in desired ▪ Evaluator should be trained to carry out the
direction. performance appraisal process.
4. Communication – process of ▪ Performance appraisal should focus on employee
passing information, behaviour and results rather than on personal traits
experience, opinion from one or characteristics.
person to another
QUALITY CONTROL
COORDINATING
▪ Quality control is the traditional way of managing
REPORTING
quality.
BUDGETING
▪ Quality control is concerned with checking and
COMMUNICATING reviewing work that has been done.
▪ Communication is necessary for the exchange of ▪ For example, this would include lots of inspection,
facts, opinions, ideas and information between testing and sampling.
individual and departments. ▪ Quality control is mainly about “detecting”
▪ In an organisation, communication is useful for defective output – rather than preventing it. Quality
giving information, guidance and instructions. control can also be a very expensive process. Hence,
▪ Managers should be good communicators. in recent years, businesses have focused on quality
▪ They have to use major portion of their time on management and quality assurance.
communication in order to direct, motivate and co- 7 Basic Tools of Quality Control
1. Check ▪ is a form used to collect data
ordinate activities of their subordinates.
sheet in real time at the location
▪ People think and act collectively through where the data are
communication. generated. The data it
▪ According to Louis Allen, "Communication involves captures can be quantitative
a systematic and continuing process of telling, or qualitative. When the
listening and understanding". information is quantitative,
Controlling the check sheet is
sometimes called a tally
Controlling involves three broad aspects:
sheet.
▪ (a) establishing standards of performance, 2. Control ▪ Also known as Shewhart
▪ (b) measuring work in progress and interpreting Chart charts or process- behavior
results achieved, and charts, in statistical process
▪ (c) taking corrective actions, if required. control are tools used to
▪ Managers have to exercise effective control in order determine if a
to bring success to a business plan. manufacturing or business
process is in a state of
▪ Controlling is a continuous activity of a supervisory
statistical control.
nature. 3. Histogram ▪ is a graphical representation
DEFINITION OF PERFORMANCE APPRAISAL showing a visual impression
▪ According to Edwin B. Flippo, “Performance of the distribution of data
appraisal is a systematic, periodic and so far as 4. Ishikawa ▪ Common uses of the
humanly possible, an impartial rating of an Diagram Ishikawa diagram are
employee’s excellence in matters pertaining to his product design and quality
defect prevention, to identify
present job and to his potentialities for a better job.”
potential factors causing an
OBJECTIVES OF APPRAISAL overall effect. Each cause or
▪ To determine the effectiveness of employees on reason for imperfection is a
their present jobs so as to decide their benefits. source of variation. Causes
▪ To identify the shortcomings of employees so as to are usually grouped into
overcome them through systematic guidance and major categories to identify
training. these sources of variation.
▪ To find out their potential for promotion and
advancement.

10 | H A Z E L A .
 5. Pareto ▪ is a type of chart that contains ▪ The goal of nursing is optimum client wellness and
Chart both bars and a line graph, the maximum level of functioning. The nursing
where individual values are interventions are evidence-based and stem from
represented in descending their core knowledge. The professional nurse must
order by bars, and the
appreciate the role of informatics.
cumulative total is
represented by the line. ▪ Philosophy of nursing includes beliefs and values
6. Scatter ▪ is a type of mathematical with regard to man in general and specifically man
diagram diagram using Cartesian as the learner, teacher, nurse, client and the beliefs
coordinates to display values about health, illness, society, nursing and learning,
for two variables for a set of etc. It includes:
data.
➢ Spiritual: Religion should serve as the
7. Flow chart ▪ is a type of diagram that
primary integrating factor
represents an algorithm or
process, showing the steps as ➢ Moral: Nurse has to develop right
boxes of various kinds, and conscience
their order by connecting ➢ Intellectual: To provide a systematic
them with arrows development and training and for
JURISPRUDENCE fulfilment of nursing function
Nursing definition: ➢ Functional needs: Nurse must be able to
▪ Virginia Henderson defined nursing in functional function as a mature, self-dependent and
terms: "The unique function of the nurse is to assist responsible individual and must be able to
the individual, sick or well, in the performance of relate well to other people.
those activities contributing to health or its ➢ Physical: To promote harmonious
recovery (or to a peaceful death) that he would development, physical needs to preserve
perform unaided if he had the necessary strength, essentials of health.
will or knowledge. And to do this in such a way as ➢ Social: Nursing is linked with social culture,
to help him gain independence as rapidly as in which nursing activities are carried out.
possible." Qualities of Professional Nurse
Profession ▪ Truthfulness, loyalty & honesty
▪ is a calling that requires special knowledge, skill ▪ Love for the fellowmen
and preparation. ▪ Empathy
▪ An occupation with ethical components, that is ▪ Hamor
devoted to the promotion of human & social ▪ Caring
welfare. ▪ Kindness
Basic Nursing Principles: ▪ Commitment
▪ Safety ▪ Morality
▪ Therapeutic effectiveness ▪ Compassion, generosity
▪ Comfort ▪ Courage
▪ Use of resources ▪ Acceptance, assertiveness Punctuality
▪ Good workmanship ▪ Fairness
▪ Individuality ▪ Self-esteem and tolerance
Concept of nursing: ▪ Appreciation
▪ The tasks of nursing are: ▪ Creativity
- (a) to promote health ▪ Imagination
- (b) to prevent disease ▪ Confidence
- (c) to help ill-person to healing (to assist healing) ▪ Accountability
- (d) to assist the dying patient to pass away with ▪ Authenticity
quietude, peace, and dignity (to case suffering) ▪ Alertness
- (e) The client is a holistic human being, including ▪ Intelligence
suffering person and healthy person. ▪ Efficiency
▪ 6) The working place is not only in the hospital, but ▪ Self-discipline
also in family, community and whole society. ▪ Openness
▪ 7) Nursing is not only a science, but also an art. ▪ Independent
▪ 8) The nursing science attaches importance to ELEMENTS:
human being's living environment and the 1. Accountability: service involves intellectual
interrelation between human being and its activities individual responsibilities
environment. 2. Autonomy: practitioners are relatively independent
▪ 9) The nursing science is a gradually perfect and & control their own policies & activities
developing science. 3. Altruism: practitioners are motivated by service &
Philosophy of Nursing: consider their work as an important component of
▪ Nursing is viewed as both an art and a science, their lives
reflecting upon the concepts of the nursing. 4. Association: there is an organisation that
Nursing is an applied discipline which expresses encourages & supports high standards of practice
itself in practice and has its foundation rooted in ETHICAL ISSUES
scientific/empirical knowledge, theory and ▪ Practitioner-Assisted Suicide (PAS)
research. Nursing is also expressed as a caring, ▪ Refusal to treat
therapeutic and teaching discipline. ▪ Genetic research

11 | H A Z E L A .
 ▪ Right to refuse treatment Flight Nursing
▪ Do not resuscitate (DNR) orders ▪ one field of nursing that is considered peculiar only
RA NO. 9173 to the military and to the Air Force is flight nursing
▪ THE PHILIPPINE NURSING ACT OF 2002 or aero-space nursing. A flight nurse is responsible
ARTICLE 1 – TITLE for patients, military or otherwise, who have been
SECTION 1. TITLE evacuated from battle areas to the nearest
▪ This Act shall be known as the “Philippine Nursing installation for treatment.
Act of 2002” Advance Practice Nursing
SECTION 15. RATINGS ▪ An umbrella term for nurses who have specialized
▪ In order to pass the examination: education and experience beyond the basic
▪ A general average of at least 75% with a nursing program. This field covers the roles of the
rating of not below 60& in any subject clinical nurse specialist.
Section 16. Oath Independent nursing Practice
▪ All passers in the examination shall be required to ▪ Nurse is self-employed and provides professional
take an oath of profession before the Board or any nursing services to clients and their families.
government official authorized to administer oaths CONTRACT
prior to entering upon the nursing practice WHAT IS A CONTRACT?
Section 17. ▪ Contract may be defined as a legally binding
▪ Issuance of Certificate of agreement that recognizes and governs the rights
Registration/Professional License and and duties of the parties to the agreement.
Professional Identification Card ▪ A contract is an agreement between two or more
Section 18. Fees for Examination and Registration competent persons, on sufficient consideration
▪ Applicants for licensure and for registration shall ay (remuneration), to do or not to some lawful act.
the prescribed fees set by Commission TYPES OF CONTRACT
Section 19. Automatic Registration of Nurses 1) Verbal contract
▪ All nurses whose names appear at the roster of 2) Written contract
nurses shall be automatically or ipso facto WRITTEN CONTRACTS
registered as nurses under this Act upon its ▪ This is an agreement made on printed document
effectivity. that has been signed by parties to a contract
Section 20. Registration by Reciprocity ▪ Written contracts provide more certainty for parties
▪ A certificate of registration/professional license may than verbal contracts
be issued without examination to nurses registered ▪ Written contracts help prevent misunderstandings
under the laws of a foreign state or country. by stating clear terms of the agreement
NURSING PROFESSIONS ▪ An example of a written contract in nursing is a
Occupational health nursing or industrial nursing contract between a nurse and a client before care
▪ In 1958 industrial nurses in the United States is commenced.
elected to call themselves occupational health VERBAL CONTRACTS
nurses to reflect the broader and changing scope of ▪ Verbal contract is a contract in which the terms are
practice within the specialty. The practice focuses agreed by spoken communication
on promotion, protection, and supervision of ▪ A verbal contract has no legal document binding it
workers health within the context of a safe and however has been discussed and agreed upon by
healthy worker environment. it is autonomous and the parties involved
Occupational health nurses make independent ▪ An oral contract is equally binding as a written
nursing judgement in providing health services. contract
Nursing Education ▪ However it is difficult to prove an oral contract in a
▪ Career opportunities in nursing education are court of law
better today than ever before. There is a chronic Changing/Amending a Contract
teacher shortage in all nursing education ▪ A written contract cannot be changed legally by an
programs. Nurses who like to consider teaching as oral agreement
their field expertise. ▪ If two people want to change some aspects of a
▪ is an interesting, important, and challenging field written contract, the change must be written into
and the opportunities for well-prepared nursing the contract.
educator are numerous Expressed VS. Implied Contracts
Military Nursing ▪ A contract is expressed when two parties discuss
▪ The Nurse Corps (NC) and agree orally or in writing to its terms. For
▪ History: example a contract between a nurse and an
→ Military nursing in the Philippines may employer
said to have begun in the time of "Tandang ▪ A contract is implied when it has not been explicitly
Sora" during the katipunan revolution in agreed upon by the parties but considered to exists
1890. Commonwealth Act No. 1 "National by the law. For example, in a contractual
Defense Act" relationships between a nurse and a client, the
o Provided for the establishment of client expects that the nurse has the competence
a medical service in the to meet his/her needs
Philippine army. However, the ▪ Likewise, in a contract between the nurse and the
component corps was not agency the hospital is expected to provide the
specified.

12 | H A Z E L A .
 necessary supplies and equipment needed to • Medication Management: Psychotropic
provide competent nursing care. medications, such as antidepressants and
ELEMENTS OF A CONTRACT antipsychotics, are prescribed and monitored by
▪ Legal capacity: People entering into a contract mental health nurses to manage symptoms.
must have the legal capacity to do so. Some people • Electroconvulsive Therapy (ECT): In severe cases of
not free to go into a valid contract include depression or other mental illnesses, ECT may be
▪ Mentally ill people, Minors, Prisoners e.t.c considered. It involves controlled electrical
▪ Consent: There must be consent of each of the stimulation to induce a seizure, which can help
parties to a contract in order for the contract to be alleviate symptoms.
genuine. DEPRESSION
▪ Offer and acceptance: a contract is formed when an What is Depression?
offer by one party is accepted by the other party • Everyone occasionally feels blue or sad. But these
▪ Intent: The parties to the agreement must intend to feelings are usually short-lived and pass within a
enter into a legally binding agreement couple of days. When you have depression, it
▪ Consideration: This is the price paid for a promise interferes with daily life and causes pain for both
made by one party to the other party. you and those who care about you. Depression is a
MENTAL HEALTH NURSING common but serious illness.
Definition: DEFINITION
• Mental health nursing, also known as psychiatric • Depression is a common mental disorder that
nursing, is a specialized field of nursing that focuses presents with depressed mood, loss of interest or
on the care and treatment of individuals with pleasure, feelings of guild or low-self-worth,
mental health disorders. It involves providing disturbed sleep or appetite, low energy, and poor
holistic care that addresses the physical, emotional, concentration
and social aspects of a patient's well-being. Signs and Symptoms
Holistic Care: • Persistent sad, anxious, or “empty” feelings
• Mental health nursing goes beyond addressing • Feelings of hopelessness or pessimism
symptoms; it considers the person as a whole. For • Feelings of guilt, worthlessness, or helplessness
example, a patient with depression may receive • Irritability, restlessness
therapy and medication, but mental health nurses • Loss of interest in activities or hobbies once
also assess their social support, coping skills, and pleasurable, including sex
lifestyle factors. • Fatigue and decreased energy
Role of a Mental Health Nurse What are the different forms of depression?
• Assessment: Mental health nurses conduct There are several forms of depressive disorders.
thorough assessments to understand a patient's 1. Major depressive disorder, or major depression
mental state. They use tools like the Mental Status 2. Dysthymic disorder, or dysthymia
Examination to assess mood, cognition, and 3. Minor depression
behavior. → Psychotic depression,
• Care Planning: Based on assessments, mental → Postpartum depression
health nurses develop individualized care plans. → Seasonal affective disorder (SAD)
These plans outline goals, interventions, and 4. Bipolar disorder
expected outcomes. For example, a care plan for a Diagnosis
patient with schizophrenia might include • History collection
medication management, psychoeducation, and • Mental Status Examination
social skills training. • ICD -10 Criteria
• Advocacy: Mental health nurses often advocate for The International Classification of Diseases (ICD) is a globally
their patients' rights and needs. This may involve used medical classification used in epidemiology, health
ensuring access to appropriate treatment, management and for clinical purposes. The ICD is
addressing stigma, or helping patients maintained by the World Health Organization (WHO), which
communicate their preferences to the healthcare is the directing and coordinating authority for health within
team. the United Nations System. The ICD is originally designed as
Assessment Process: a health care classification system, providing a system of
• Mental health nurses use a structured process to diagnostic codes for classifying diseases, including nuanced
assess patients, including history taking, classifications of a wide variety of signs, symptoms,
observation, and standardized assessment tools. abnormal findings, complaints, social circumstances, and
Diagnosis Process external causes of injury or disease. This system is designed
• Accurate diagnosis guides treatment decisions. to map health conditions to corresponding generic
Misdiagnosis can lead to ineffective or even harmful categories together with specific variations, assigning for
interventions. For instance, mistaking bipolar these a designated code, up to six characters long. Thus,
disorder for unipolar depression can result in major categories are designed to include a set of similar
incorrect medication choices diseases.
Therapeutic Interventions
• Psychotherapy: Mental health nurses often engage ANTI DEPRESSANTS
in talk therapy with patients. Cognitive-behavioral • Selective serotonin reuptake inhibitors (SSRIs).
therapy (CBT) is one example, which helps patients Fluoxetine (Prozac), escitalopram sertraline (Zoloft),
identify and change negative thought patterns. (Lexapro), paroxetine (Paxil), and citalopram

13 | H A Z E L A .
 (Celexa) are some of the most commonly compulsions. They are severe enough to be time
prescribed SSRIs for depression. consuming, or cause marked distress or significant
• Tricyclics are older antidepressants. Tricyclics are impairment in functioning.
powerful, but they are not used as much today • Obsessions are recurrent intrusive ideas, thoughts,
because their potential side effects are more images or impulses that cause significant anxiety or
serious. distress.
→ Examples: Imipramine and Nortriptyline POST-TRAUMATIC STRESS DISORDER (PTSD)
ANXIETY DISORDERS • It is an anxiety disorder produced by exposure to a
• Anxiety disorders are a group of disorders in which severe traumatic event (e.g., war, violent assault,
anxiety is the major element. rape, explosion, torture, natural disasters, etc.,) that
• They are the most prevalent group of psychiatric involves threat of death, serious injury, or personal
disorders. safety
• Anxiety is a feeling of apprehension caused by • It may result from witnessing the traumatic event
anticipation of an ill-defined threat or danger that being inflicted on somebody else
is not realistically based. CLINICAL FEATURES:
GENERALISED ANXIETY DISORDER 1) Persistent re-experiencing of the trauma
• Onset, Course & Prognosis: 2) Efforts to avoid recollecting the trauma
• Patients come to clinicians usually in their early 20's 3) Hyperarousal
• Course is chronic, but symptoms may decline with MANAGEMENT OF ANXIETY DISORDERS
age • Behavioral Therapy
• Secondary depression is common → Techniques used include exposure
• Prognosis is variable with treatment techniques (systematic desensitization,
graded exposure and flooding), response
THE PANIC ATTACK prevention and stop-thought techniques
CLINICAL FEATURES (for OCD), and relaxation techniques
• Recurrent spontaneous or unexpected panic • Cognitive-Behavioral Therapy
attacks, i.e acute episodes of intense anxiety → It can help in correcting the maladaptive
• It may be associated with agoraphobia (about 1/3 of cognitive schemata operating in anxiety
patients) disorders, e.g., irrational fears of physical
• Diagnosis of panic disorders is made of the attacks or psychological danger (generalize
are repeated (4 attacks in a month), or if the patient anxiety) or catastrophic fear of immediate
become concerned about having additional physical or mental disaster (panic)
attacks (anticipatory anxiety) • Psychodynamic (insight-oriented) therapy
• A panic attack is a discrete period of intense anxiety → It can be helpful with selected patients
not related to any particular situation or → Its goal is to develop insight into
circumstances. intrapsychic conflicts or personality
• lt develops abruptly, reaches the peak over 10 deficits which underlie symptom
minutes, and lasts for a limited time (5-30 minutes). formation with subsequent positive
• During the attack there is a mixture of physical and changes
psychological symptoms. SCHIZOPHRENIA
PHOBIC DISORDERS • Schizophrenia literally means “Fragmented Mind”
• Phobia is fear related to a particular object or • Schizophrenia is one of the most complex, chronic
situations and challenging of psychiatric disorders that
• A phobic disorder is diagnosed if the experienced affects how a person thinks, feels, behaves
fear is intense or causes the patient to avoid the • It represents a heterogenous syndrome of
phobic object in a manner that (limits his activities disorganized thoughts, delusions, hallucinations,
and impairs his functioning) and impaired psychosocial functioning
1)AGORAPHOBIA
CLINICAL FEATURES:
• Its name came from Agora = Market
• It is intense irrational fear of being in open places,
outside home alone, in a crowd or generally in
places or situations in which escape is perceived by
the patient as difficult or embarrassing
2 SOCIAL PHOBIA 1) Viral Infections and Immune Disorders:
Clinical Features → Schizophrenia may be triggered by
• There is intense irrational fear of scrutiny (i.e., being environmental events, such as viral
critically observed) by other people in social or infections or immune disorders. For
performance situations. instance, babies whose mothers get the
• The person fears that he will act in a way that will flu while they are pregnant are at higher
be humiliating or embarrassing (i.e., fear of risk of developing schizophrenia later in
negative evaluation). life. People who are hospitalized for severe
3 OBSESSIVE-COMPULSIVE DISORDER infections are also at higher risk.
Clinical Features 2) Genetics (Heredity):
• It is an anxiety disorder in which the patient → Scientists recognize that the disorder
experiences recurrent obsessions and/or tends to run in families and that a person
14 | H A Z E L A .
 inherits a tendency to develop the disease.
• CATATONIA Purposeless
Similar to some other genetically-related
abnormal motor activity
illnesses, schizophrenia may appear when
or aggressive behavior
the body undergoes hormonal and
physical changes.
• Cognitive Symptoms
→ The risk of developing schizophrenia is
→ POOR EXECUTIVE
increases to approximately 10% if a first-
FUNCTIONING:
degree relative has the illness and to 3% if
Unability to
a second-degree relative has the illness. If
understand
both parents have schizophrenia, the risk
information to
of producing a schizophrenic offspring
make decisions
increases to approx 40%
→ POOR WORKING
MEMORY:
TYPES
Unability to use
• Paranoid schizophrenia
information
→ Common form of schizophrenia
immediately after
→ Prominent hallucinations and/or delusions
learning
→ May develop at a later age than other
types of schizophrenia
→ Speech and emotions may be unaffected ADVERSE EFFECTS
→ At risk for suicidal or violent behavior 1) SEDATION
under influence of delusions → Although sedation is most commonly
• Hebephrenic / Disorganized schizophrenia associated with chlorpromazine and
→ Behaviour is disorganised and without clozapine, it is primarily related to dosage
purpose with other antipsychotics.
→ Thoughts are disorganised, difficult to 2) AUTONOMIC SIDE EFFECTS
understand by others → Some antipsychotic drugs are associated
→ Pranks, giggling, health complaints, with changes to the QT interval measured
grimacing and mannerisms are common on the elecrocardiogram (ECG) and, if
→ Delusions and hallucinations are fleeting given in high doses, may increase the risk
→ Usually develops between 15-25 of sudden cardiac death due to a
• Catatonic schizophrenia adrenergic blockage.
→ Rarer than other types → Anticholinergic side effects such as dry
→ At risk for malnutrition, exhaustion or self- mouth, constipation, blurred vision are
injury particularly associated with piperidine
→ Unusual movements, often switching phenothiazines.
between extremes of over- activity and → Postural hypotension, palpitation,
stillness inhibition of ejaculation and
→ Unable to talk (Catatonia) photosensitivity are associated with the
• Undifferentiated schizophrenia aliphatic phenothiazines.
→ Some characteristics of paranoid, BIPOLAR DISORDER
hebephrenic or catatonic schizophrenia, Symptoms
but does not obviously fit one of these • People with bipolar disorder experience unusually
types intense emotional states that occur in distinct
• Residual schizophrenia periods called "mood episodes" An overly joyful or
→ Past History of psychosis but only having overexcited state is called a manic episode, and an
negative symptoms extremely sad or hopeless state is called a
SIGNS & SYMPTOMS depressive episode.
• Sometimes, a mood episode includes symptoms of
POSITIVE SYMPTOMS NEGATIVE SYMPTOMS both mania and depression. This s called a mixed
state.
• DELUSION: False beliefs • FLAT EFFECT: Reduced
• In addition to mania and depression, bipolar
that are not based in expression of emotions
disorder can cause a range of moods, as shown on
reality via facial expression or
the scale.
• HALLUCINATION: voice tone
• A person having a hypomanic episode may feel very
Involving seeing or • ALOGIA: Reduced speech
good, be highly productive, function well, and may
hearing things that don't • AVOLITION: Inability to not feel that anything is wrong even as family and
exist begin & sustain activities friends he mood swings. Without proper treatment,
• DISORGANIZED SPEECH • ANHEDONIA: Inability to however, people with may develop severe mania or
& THINKING Effective experience pleasure depression.
communication can be • ASOCIALITY: Withdrawal
impaired and answers to from social contacts
questions may be • Reluctance to perform
partially or completely everyday tasks
unrelated

15 | H A Z E L A .
 • Electroconvulsive Therapy (ECT)
SYMPTOMS OF MANIA OR SYMPTOMS OF
A MANIC EPISODE DEPRESSION OR A → it is a medical procedure that uses
DEPRESSIVE EPISODE electrical currents to induce controlled
seizures in the brain
BEHAVIORAL CHANGES BEHAVIORAL CHANGES → For cases in which medication and/or
• Talking very fast, • Feeling tired or psychotherapy does not work,
jumping from one “slowed down” electroconvulsive therapy (ECT) may be
idea to another, • Having problems useful.
having racing concentrating,
→ ECT is used to treat severe psychiatric
thoughts remembering,
• Being easily and making disorders:
distracted decisions ➢ Major depressive disorder
• Increasing goal- • Being restless or ➢ Bipolar disorder
directed activities, irritable ➢ Schizophrenia
such as talking on • Changing eating, ➢ Catatonia
new projects sleeping, or other ➢ Severe anxiety disorders
• Being restless habits
➢ In some neurological conditions,
• Sleeping little • Thinking of death
• Having an or suicide, or such as Parkinson’s disease.
unrealistic belief in attempting
one’s abilities suicide
• Behaving
impulsively and
taking part in a lot
of pleasurable,
high-risk
behaviors, such as
spending sprees,
impulsive sex, and
impulsive
business
investments.

TYPES OF BIPOLAR

● BIPOLAR 1 DISORDER • Is mainly defined by

manic or mixed episodes
that last at least seven (7)
days, or by manic
symptoms that are so
severe that the person
needs immediate
hospital care. Usually, the
person also has
depressive episodes,
typically lasting at least
two weeks. The
symptoms of mania or
depression must be a
major change from the
person’s normal behavior

BIPOLAR II DISORDER • Is defined by a pattern of

depressive episodes
shifting back and forth
with hypomanic
episodes, but no full-
blown manic or mixed
episodes
TREATMENTS
• Mood stabilizing medications are usually the first
choice to treat bipolar disorder
→ Lithium, Depakote
• Atypical antipsychotic medications are called
“atypical” to set them apart from earlier
medications, which are called “conventional” or
“first-generation” antipsychotics
→ Zyprexa, Abilify, Seroquel, Risperdal,
Geodon
• Antidepressant medications
→ Prozac, Paxil, Zoloft, Wellbutrin

16 | H A Z E L A .