Depression is the most common but serious mental illness, which is characteristic by a persistent feeling of sadness and a loss of interest in activities that a person normally enjoy. It is determined as a person’s inability to do daily activities, normally for 14 days (World health organization, 2018). Depression seems to affect everyone equally but females are more likely to be depressed than man. This mental health issue is not the new concept for the world; it has been affecting people for many years. Nearly 300 million people of all age groups suffer from depression. It ranked as the single largest contributor to the international disability. It is the major contributor to death by suicides and accounts for nearly 800000 deaths per year. Sign and symptoms if this disorder includes depressed mood, reduced interest, weight loss, insomnia, fatigue, feeling worthlessness, impaired ability to think, and loos of energy. In this essay report, the topics like assessment, recovery concepts, the role of nurses to reduce the issues, essential therapeutic relationship and treatment strategies, intervention, the role of the nurses working with the multidisciplinary team and client participation will be included.
Assessing a patient with depression is quite difficult as most of the patient mention low mood as the symptom of their physical health issues. Assessing the sign and symptoms is the major contributor to provide a better health care and treatment to the patient with depression, the nursing assessment should include assessing general appearance and motor behaviors, mood and affects, the thought process and content, judgement and insight, roles and relationship of the person with others. They should also use a depression rating scale or tools like Hamilton depression rating scale and Patient health Questionnaires-9 (PHQ-9). Hamilton Depression Rating Scale is the multiple item questionnaires use to indicate depression, it was designed for adults. The patients are rated by the clinicians on seventeen to twenty-nine items scored on two different point scale; 3 points or 5 point scale. The original scale had only 17 items but the new version contains 29 items. According to Olden, Rosenfeld, Pessin, and Breitbart (2008), the Hamilton Depression Rating Scale is highly reliable and has concurrent validity with the diagnosis of depression. PHQ-9 tool also has a tremendous option for researches and providers due to its brief nature and easy scoring method (Richardson, McCauley, Grossman, McCarty, Richards, Russo, & Katon, 2010).
According to Vittengl, Clark, and Jarrett (2009), in clinical medicine area, the term recovery has connoted the act of gaining the normal psychological health like before. Remission is the related word that indicated a provisional abatement of the indicators of depression. If the sternness of the symptoms diminish below the threshold when it is used for defining the onset, recovery occurs.
Meaning of remission term matches the old scientific concept of rehabilitation, the intermediate stage of reintegration after the health issue (Novick, Montgomery, Vorstenbosch, Moneta, Dueñas, & Haro, 2017). Therefore, one of the significant dimensions in the procedure of trajectory needs of severals longitudinal contemplations of the development of the disease, residual and encircling prodromal indicators. Recovery is not just about curing the symptoms associated with the disorder but also achieving the complete mental health and returning the patient to his or her normal condition. According to a study published by Stotland (2012), treatment of this health issues considers adequate and successful when the patient’s function and the mood seemed to be better after the treatment than before. The only measure of health improvement was that the patient reports of function and the reduction in symptoms. In spite of the specific objective, the very core of all psychiatric nursing treatment approaches is the therapeutic nurse-client relationship. For creating a reliable and confidential boundary, the process starts with defining a relationship of understanding between the client and nurse, where the nurse in entering in to a relation with the client (Fonagy & Allison, 2014). One of the major truth is also that the therapeutic can not heal disorders relating to the strong biochemical and genetic components. However, with the help of therapeutic nurse-client relationship, various emotional issues like low self-esteem can be enhanced (Sucala, Schnur, Constantino, Miller, Brackman, & Montgomery, 2012).
It takes time for creating a relation or alliance with the client. Those individuals who are more expertise in this field also help in improving the skills in this area. Except for the mutual frustrations, nothing much will happen if the user does not involve with the therapeutic alliance (Zuroff,s Kelly, Leybman, Blatt, & Wampold, 2010). The relationship of the therapeutic consisting various principles relating to the mental health nursing is more clearly explained unlike the relationship of client and nurse. There are various specific goals and functions in the nurse and client relationship of the therapeutic – creating communication of the distressing feelings and thoughts, take activites relating to the daily living by assisting the clients and making client believe in the self-defeating behaviour (Arnow et al., 2013).
Treatment of depression can be successful with the help of various modern therapies. It is mandatory for the depressed people to contact the GP, which refer them to mental health professionals so that the issue can be resolved. Kind of severity and depression leads to a specific type of the treatment. With the help of Antidepressant drugs, the patient can easily be retrieved from the various types of anxiety, appetite and thus restore the normal sleeping patterns. With the help of modifications of the activity relating to the neurotransmitter pathways, this can be work. There is a huge list of the various categories of the antidepressants like SSRI, SNRI, tricyclic, phenelzine and tranylcypromine. (Menza, et al., 2009).
One of the safe and highly effective treatments for the severe depression is the Electroconvulsive therapy (ECT). There are various misconceptions are there in the use of this therapy due to the inaccurate descriptions in the media (Kato, 2009). In the process of throughout monitoring and recovery, short acting anesthesia can be used along with the muscle relaxants and oxygen (Perrin et al., 2012). The objective here is to enhance in mood and reduction of symptoms relating to psychotic so that to induce a highly modified seizure. The reason is that it has a positive impact on the levels of neurotransmitters. For those people who have at high risk of suicide or there is severity in the illness, ECT may be perceived as lifesaving (Tendolkar et al., 2013).
Nursing interventions are the primary or initial interventions that a patient received from the health care system. Nursing interventions play a critical and vital role to achieve the health goals already set for the patient with depression. Nurse’s interventions should be provided to the patient according to the nursing diagnosis. In case of risk of suicide a nurse should create a safe environment for the patient, he or she keeps close observation and make a frequent round in irregular intervals. A nurse should make a verbal conversation in order to reduce the suicidal thoughts form the person. If the patient developed symptoms like social isolation, a nurse should show the unconditional positive regard, they should recognize and reinforces the interaction positively with others (Pinto-Foltz, & Logsdon, 2009). Patient with depression often face insomnia, in this case, a nurse should log total sleeping time in every shift, and he or she should assist the patient to maintain the healthy sleeping habits. If necessary the patient should be administered sleep medicines. Another psychological issue that might occur in case of depression is low self-esteem. In this case, a nurse should spend time with the patient, focus on the patient’s strength and accomplishment that are forgotten by her or him. The person should be encouraged to participate in group activities and other areas of their life that were once interesting to them. Imbalanced nutrition is the most important issues that should be noticed by the nurses at the higher priority (Richards & Hamers, 2009). The dietician and the nurses should work together and cooperate with each other to monitor the healthy nutrition intake in the patient with depression. The body weight should be monitored by making a meal schedule and staying with the patient during meal time (Jefferies, Johnson, & Ravens, 2011). A nurse can educate and motivate the patient to increase the responsibility for them. In case of hopelessness, the nurse should identify stressors in the patient to express and explore feeling and their perception that may develop the expression of hope. According to Kang, Choi, and Ryu (2009), Complicated grieving can also be seen in case of depressed mood, in this scenario a nurse should develop the trusting alliance with the patient and encourage them to express their anger and motivate them for physical activates to emotional discharge. A nurse can use the touch method while talking with the patient to make them believe that somebody care for them and they are not alone (Konnert, Dobson, & Stelmach, 2009).
Multidisciplinary team must include psychologists, social workers, secretaries at medical place, and psychiatrists (Bosch et al, 2009). Every different profession consists of different area of expertise so they can solve the mental health condition with their necessary skill sets. (Leontjevas, Gerritsen, Smalbrugge, Teerenstra, Vernooij-Dassen and Koopmans, 2013). In addition, the individual needs of each patient are best suited with the patient care plan as discussed by the team of Multidisciplinary. A nurse has an important role in a multidisciplinary team cares for the person with depression. Establish the supportive role of the patient’s environment through their counselling by the multidisciplinary therapeutic team.
Various types of people having mental illnesses or disorder are cared for by the mental nurses working in a highly specialised field. The main area of focus is the personal recovery and overcoming the symptoms of the illness. Supporting the consumer families and protecting the right of the consumers are also their major accountabilities. As the care is made of diverse range of people having disorder and mental illness including depression, this creates various opportunities for the nurses (Gaul et al., 2011).
Mental health nurses are a part of a multi-disciplinary team including psychologists, social workers and GPs. In the planning and caring of the people having mental illness and disorder, mental nurses play a significant role. Patient personality and his communication skills are the strength and main tool as a mental health nurse. It is compulsory for a better care that the nurse should focus on caring the people with warm behaviour. Fighting this and supporting the individual and their families compact with the compound nature of mental illness and disorder is the main part of the mental health nurse’s role (De Man?van Ginkel, Gooskens, Schuurmans, Lindeman, Hafsteinsdottir, & Rehabilitation Guideline Stroke Working Group, 2010).
According to Jungbluth and Shirk (2009), including the patient and their families in decision-making for the treatment process of the patient is a proven idea for achieving good health outcomes. Client-centered therapy is known as person-centered therapy The therapist not focuses on giving the detailed interpreting at the time of client-centred therapy. In spite, they will provide support and respect which will help the nurse to solve the solutions to the patient’s issues and feel them empowered. This will also make the nurses self-reliant and aware of the empathic relationships (Bohart, & Tallman, 2010). During client-centered therapy, the therapist does not subject the patient’s feelings and behaviors to analytic interpretation. Participation of the patient in the treatment process might help the nurses and health practitioners to achieve the good health recovery. Including the family member may help the treatment to boost recovery. A patient with depression might feel low or alone and he or she should be given time to meet with their families so that they can recover fast various it has conducted on involving the family members and friends in the treatment proves (Graven, Brock, Hill & Joubert, 2011). Most them have found that this can be a good idea to develop must the patient and their families related to the treatment process and the health care system as various patient families seemed to feel unsafe when it some to the health of their loved ones. According to a study conducted among 761 patients by Bolkan et al. (2013) in multivariate regression analyses, lower depression severity and better medication adherence over time were significantly linked to higher satisfaction with limited efforts by clinicians to involve families in care. This method of therapy is meant to be adapted to each patient (Tandon, Perry, Mendelson, Kemp, & Leis, 2011).
Depression is considered as the most common but severe mental illness, which is often characterized by a persistent feeling of depression and loss in favorite activities or interest. It is determined as the inability to do the daily tasks. The epidemiological data has shown that nearly 800,000 people suffer died per year due to suicides. Nursing assessment should include assessing sign and symptoms, mood and affects judgment and insights. He or she should use the Hamilton depression rating scale and patient health questionnaires to assess the patient health condition. The recovery concept in the treatment of the patient with depression is gaining and returning the patients previous health conditions. Recovery can be achieved when the patient becomes healthy like before. It is important for the nurse to make therapeutic relationships with the patients, so that their health can be recover at a fast pace. It helps the patient to express their thoughts and feeling with the nurses. Treatment strategies for depression include medication and ECT. An antidepressant may help the patient to relieve with depression and restoring sleeping patterns and appetite. Electroconvulsive therapy is considered as the safe and highly effective approach to treat most severe forms of depression. In this health condition, nursing interventions can be proved to be beneficial for the creation of safer environment, weight monitoring, encouragement of the patient to perform physical activities so that they can be motivated to take responsibilities. In a multidisciplinary team, a nurse plays a key important role. They establish the supportive role of the patient’s environment through their counseling by the multidisciplinary therapeutic team and report the coercing clinicians regarding the patient’s health condition. Client participation in the treatment decision can help the nurses to develop trust in the patient for the nurses and the healthcare system.
References
Arnow, B. A., Steidtmann, D., Blasey, C., Manber, R., Constantino, M. J., Klein, D. N., & Kocsis, J. H. (2013). The relationship between the therapeutic alliance and treatment outcome in two distinct psychotherapies for chronic depression. Journal of Consulting and Clinical Psychology, 81(4), 627.
Bohart, A. C., & Tallman, K. (2010). Clients: The neglected common factor in psychotherapy. The heart and soul of change: Delivering what works in therapy, 2, 83-111.
Bolkan, C. R., Bonner, L. M., Campbell, D. G., Lanto, A., Zivin, K., Chaney, E., & Rubenstein, L. V. (2013). Family involvement, medication adherence, and depression outcomes among patients in veterans affairs primary care. Psychiatric Services, 64(5), 472-478.
Bosch, M., Faber, M. J., Cruijsberg, J., Voerman, G. E., Leatherman, S., Grol, R. P., & Wensing, M. (2009). The effectiveness of patient care teams and the role of clinical expertise and coordination. Medical Care Research and Review, 66(6_suppl), 5S-35S.
De Man?van Ginkel, J. M., Gooskens, F., Schuurmans, M. J., Lindeman, E., Hafsteinsdottir, T. B., & Rehabilitation Guideline Stroke Working Group. (2010). A systematic review of therapeutic interventions for poststroke depression and the role of nurses. Journal of clinical nursing, 19(23?24), 3274-3290.
Fonagy, P., & Allison, E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, 51(3), 372.
Gaul, C., Visscher, C. M., Bhola, R., Sorbi, M. J., Galli, F., Rasmussen, A. V., & Jensen, R. (2011). Team players against a headache: multidisciplinary treatment of primary headaches and medication overuse headache. The journal of a headache and pain, 12(5), 511-519.
Graven, C., Brock, K., Hill, K., & Joubert, L. (2011). Are rehabilitation and/or care coordination interventions delivered in the community effective in reducing depression, facilitating participation and improving quality of life after stroke?. Disability and rehabilitation, 33(17-18), 1501-1520.
Jefferies, D., Johnson, M., & Ravens, J. (2011). Nurturing and nourishing: the nurses’ role in nutritional care. Journal of Clinical Nursing, 20(3?4), 317-330.
Jungbluth, N. J., & Shirk, S. R. (2009). Therapist strategies for building involvement in cognitive–behavioral therapy for adolescent depression. Journal of Consulting and Clinical Psychology, 77(6), 1179.
Kang, Y. S., Choi, S. Y., & Ryu, E. (2009). The effectiveness of a stress coping program based on mindfulness meditation on the stress, anxiety, and depression experienced by nursing students in Korea. Nurse education today, 29(5), 538-543.
Kato, N. (2009). Neurophysiological mechanisms of electroconvulsive therapy for depression. Neuroscience research, 64(1), 3-11.
Konnert, C., Dobson, K., & Stelmach, L. (2009). The prevention of depression in nursing home residents: A randomized clinical trial of cognitive–behavioral therapy. Aging and Mental Health, 13(2), 288-299.
Leontjevas, R., Gerritsen, D. L., Smalbrugge, M., Teerenstra, S., Vernooij-Dassen, M. J., & Koopmans, R. T. (2013). A structural multidisciplinary approach to depression management in nursing-home residents: a multicentre, stepped-wedge cluster-randomized trial. The Lancet, 381(9885), 2255-2264.
Menza, M., Dobkin, R. D., Marin, H., Mark, M. H., Gara, M., Buyske, S., … & Dicke, A. (2009). A controlled trial of antidepressants in patients with Parkinson disease and depression. Neurology, 72(10), 886-892.
Novick, D., Montgomery, W., Vorstenbosch, E., Moneta, M. V., Dueñas, H., & Haro, J. M. (2017). Recovery in patients with the major depressive disorder (MDD): results of a 6-month, multinational, observational study. Patient preference and adherence, 11, 1859.
Olden, M., Rosenfeld, B., Pessin, H., & Breitbart, W. (2009). Measuring depression at the end of life: is the Hamilton Depression Rating Scale a valid instrument?. Assessment, 16(1), 43-54.
Perrin, J. S., Merz, S., Bennett, D. M., Currie, J., Steele, D. J., Reid, I. C., & Schwarzbauer, C. (2012). Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder. Proceedings of the National Academy of Sciences, 109(14), 5464-5468.
Pinto-Foltz, M. D., & Logsdon, M. C. (2009). Reducing stigma related to mental disorders: initiatives, interventions, and recommendations for nursing. Archives of Psychiatric Nursing, 23(1), 32-40.
Richards, D. A., & Hamers, J. P. (2009). RCTs in complex nursing interventions and laboratory experimental studies. International journal of nursing studies, 46(4), 588-592.
Richardson, L. P., McCauley, E., Grossman, D. C., McCarty, C. A., Richards, J., Russo, J. E., & Katon, W. (2010). Evaluation of the Patient Health Questionnaire-9 Item for detecting major depression among adolescents. Pediatrics, peds-2010.
Stotland, N. L. (2012). Recovery from depression. Psychiatric Clinics, 35(1), 37-49.
Sucala, M., Schnur, J. B., Constantino, M. J., Miller, S. J., Brackman, E. H., & Montgomery, G. H. (2012). The therapeutic relationship in e-therapy for mental health: a systematic review. Journal of medical Internet research, 14(4).
Tandon, S. D., Perry, D. F., Mendelson, T., Kemp, K., & Leis, J. A. (2011). Preventing perinatal depression in low-income home visiting clients: A randomized controlled trial. Journal of consulting and clinical psychology, 79(5), 707.
Tendolkar, I., van Beek, M., van Oostrom, I., Mulder, M., Janzing, J., Voshaar, R. O., & van Eijndhoven, P. (2013). Electroconvulsive therapy increases hippocampal and amygdala volume in therapy-refractory depression: a longitudinal pilot study. Psychiatry Research: Neuroimaging, 214(3), 197-203.
Vittengl, J. R., Clark, L. A., & Jarrett, R. B. (2009). Continuation-phase cognitive therapy’s effects on remission and recovery from depression. Journal of Consulting and Clinical Psychology, 77(2), 367.
Zuroff, D. C., Kelly, A. C., Leybman, M. J., Blatt, S. J., & Wampold, B. E. (2010). Between?therapist and within?therapist differences in the quality of the therapeutic relationship: effects on maladjustment and self?critical perfectionism. Journal of Clinical Psychology, 66(7), 681-697.
Essay Writing Service Features
Our Experience
No matter how complex your assignment is, we can find the right professional for your specific task. Contact Essay is an essay writing company that hires only the smartest minds to help you with your projects. Our expertise allows us to provide students with high-quality academic writing, editing & proofreading services.
Free Features
Free revision policy
$10Free bibliography & reference
$8Free title page
$8Free formatting
$8How Our Essay Writing Service Works
First, you will need to complete an order form. It's not difficult but, in case there is anything you find not to be clear, you may always call us so that we can guide you through it. On the order form, you will need to include some basic information concerning your order: subject, topic, number of pages, etc. We also encourage our clients to upload any relevant information or sources that will help.
Complete the order form
Once we have all the information and instructions that we need, we select the most suitable writer for your assignment. While everything seems to be clear, the writer, who has complete knowledge of the subject, may need clarification from you. It is at that point that you would receive a call or email from us.
Writer’s assignment
As soon as the writer has finished, it will be delivered both to the website and to your email address so that you will not miss it. If your deadline is close at hand, we will place a call to you to make sure that you receive the paper on time.
Completing the order and download