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Gerontology Nursing: Schizophrenia

What is Schizophrenia?

People with schizophrenia tend to hear funny voices that do not even exist. Schizophrenia is, therefore “a chronic and disabling brain condition that affects many people” (Birchwood, Spencer, & McGovern, 2000, p. 93). The affected patients believe strongly that other people are manipulating or controlling their minds. Sometimes they think that other individuals are planning to attack them. Some people with the condition “will appear normal until they express their thoughts” (Birchwood et al., 2000, p. 94). This condition makes it impossible for many patients to deal with their problems. Such people cannot have successful careers. This disorder affects many individuals, communities, and families.

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Statistics

According to the World Health Organization (WHO), schizophrenia affects about 1 percent of the human population. The disease affected both women and men. Schizophrenia will occur in 10 percent of individuals whose relatives have been diagnosed with the disorder. Researchers believe that “some genes contribute to the risk of schizophrenia” (Birchwood, 2000, p. 93). The “risk is also higher for identical twins of persons with the disorder” (Birchwood, 2000, p. 93). New studies are being conducted in order to understand the prevalence of this disease.

Signs and Symptoms

Medical practitioners have divided the symptoms of schizophrenia into three unique categories. These categories include cognitive, positive, and negative symptoms. To begin with, positive symptoms are usually unusual and psychotic in nature. According to Mitra (2008, p. 35), “the affected persons tend to lose touch with reality”. These symptoms depend on the kind of medication availed to the targeted patient. Some “hallucinations include things that the individual sees, smells, feels, or hears” (Mitra, 2008, p. 34). The individuals might also portray some dysfunctional ways of interacting with other people. Movement disorders are also common among the affected individuals.

Some negative signs usually affect the normal behaviors of the targeted individual. For example, the affected patient might be unable to complete different activities. The affected individual will lack pleasure in different things. Some patients will be unable to interact with others. The affected persons should get the best support from their guardians and relatives. Cognitive symptoms are usually hard to detect. For instance, some patients will have difficulties whenever completing different chores (Mitra, 2008). Some patients will be unable to make accurate decisions.

Types of Schizophrenia

There are several types of this condition. Mitra (2008) identifies two subtypes of schizophrenia. The first one is the paranoid subtype. This type is characterized by auditory hallucinations. Most of the individuals affected by this type will portray such symptoms until their 40s. A proper management strategy will make it easier for individuals to have good lives. The second type is called disorganized schizophrenia. This “type of schizophrenia is associated with disorganized thought processes” (Birchwood, 2000, p. 94). The affected people might be emotionally disoriented or unstable. They will also be able to complete small tasks such as bathing and dressing. The people might also be unwilling to communicate with others. Medical professionals should consider most of these symptoms to offer the best support (Mitra, 2008).

Risk Factors

Some factors “determine the development and progression of schizophrenia” (Mitra, 2008, p. 36). To begin with, the condition develops from 16 to 40 years of age. The risk also declines with old age. Many men will develop the diseases between 15 and 24 years. The disease will occur in women between 24 and 34 years of age. Intelligent people are “also prone to schizophrenia in comparison with other individuals” (Meiner, 2010, p. 28). Some socioeconomic aspects also promote the development of this condition. It is notable that divorced and unmarried individuals will have higher chances of getting the disease. Poverty, famine, and loneliness can also increase the risks of getting the disease. Studies have also indicated that left-handed people have higher chances of developing this disease. Some “behavioral problems and disorders can also increase the risk of schizophrenia” (Mitra, 2008, p. 36). Individuals with epilepsy have higher chances of developing this disease.

Diagnostic Criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM) IV-TR is used for monitoring the development of schizophrenia. According to the model, doctors should examine the presence of specific symptoms for a period of 1-6 months. The model focuses on the presence of active (or positive) symptoms such as hallucinations and delusions. Doctors should also “monitor some negative symptoms such as lack of motivation, catatonic behavior, and disorganized speech” (Mitra, 2008, p. 34). In the case of a pervasive development disorder, an additional diagnosis is undertaken. Doctors should therefore “monitor the presence of hallucinations and delusions” (Mitra, 2008, p. 35).

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Interventions: Pharmacological and Non-pharmacological

It is agreeable that the leading causes of schizophrenia are not known. However, some pharmacological interventions are used to eliminate most of the symptoms associated with schizophrenia. Some antipsychotic medications have been widely used to treat the disease. Some of these medications include “Haloperidol, Chlorpromazine, Fluphenazine, and Perphernazine” (Mitra, 2008, p. 33). Clozaril is also used to treat different symptoms such as hallucinations. Most of these drugs produce a wide range of side effects. The “common side effects of most of these antipsychotics include blurred vision, skin rashes, drowsiness, and rapid heartbeat” (Mitra, 2008, p. 37). According to Mitra (2008 p. 37), “continued use of these drugs will result in a condition called Tardive Dyskinesia”. These drugs are necessary because schizophrenia requires long-term management.

Some non-pharmacological methods can make it easier for many people to achieve their goals. Some of these therapies will reduce the period of hospitalization. Some illness management skills (IMSs) will ensure more people achieve their potentials. An integrated approach will combine therapy and medicine. Guardians should ensure every schizophrenic patient does not take any addictive drug. Rehabilitation is another powerful practice that can support the needs of many people. The strategy includes training and continued counseling. Cognitive behavioral therapy is effective because it re-patterns the behaviors of the affected individuals (Meiner, 2010). Societies should form self-help groups to support every person with the disease. The approach will eventually produce the best outcomes.

Other Considerations in the Management of Schizophrenia

Nursing should always be “an evidence-based practice aimed at producing the best health outcomes” (Fawcett, 2003, p. 45). Schizophrenia is one of the chronic conditions affecting mankind. That being the case, nurses should use different theories and evidence-based practices in order to support their patients (Meiner, 2010). To begin with, self help groups and family interventions can support the needs of many schizophrenic individuals. The individuals will learn how to live with the disease and focus on their goals.

According to Martha Rogers, nurses “should focus on the unitary human being” (Fawcett, 2003, p. 49). Medical practitioners should “use the best health outcomes even when there is a presence of a disease” (Fawcett, 2003, p. 48). Nurses should undertake more studies in order to address the needs of many schizophrenic patients. Nurses should “also identify the clinical problems associated with schizophrenia” (Fawcett, 2003, p. 48). This knowledge will also encourage more nurses to identify new practices in order to assist the targeted patients.

The Use of Evidence-Based Practices

An evidence-based practice focuses on the key issues associated with different medical problems. Nurses will examine the best treatment methods that can be used to deal with schizophrenia. This approach will ensure more nurses support the targeted patients. They will also “examine the cultural backgrounds of different patients in order to re-pattern their associations with the surrounding environment” (Fawcett, 2003, p. 45). Such nurses will also “treat the practice as a science and art” (Fawcett, 2003, p. 48). They will also develop new philosophies that can address the health needs of many schizophrenic people.

Medical practitioners should begin by understanding the types and symptoms exhibited by different patients. The practitioners will also identify the right therapies and medications that can produce the best outcomes. They will also use various training sessions and strategies to support the needs of the targeted patients. These practices will ensure more schizophrenic patients manage their lives. The above nursing skills will ensure more patients manage their families. Family education and continued behavioral therapies will ensure the targeted individuals achieve their goals. Nurses should mentor different families in order to support their patients. Such families should also “get the best services and support for their patients” (Meiner, 2010, p. 47). These evidence-based practices will ensure more societies support every person with schizophrenia.

Reference List

Birchwood, M., Spencer, E., & McGovern, D. (2000). Schizophrenia: Early Warning Signs. Advances in Psychiatric Treatment, 6(1), 93-101.

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Fawcett, J. (2003). The Nurse Theorists: 21st Century Updates – Martha E. Rogers. Nursing Science Quarterly, 16(1), 44-51.

Meiner, S. (2010). Gerontology Nursing. Maryland Heights, MO: Mosby.

Mitra, J. (2008). Management of Negative Symptoms in Schizophrenia: Looking Positively. Delhi Psychiatry, 11(1), 32-38.

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