Schizophrenia Nursing Interventions & Diagnosis

Hello students; welcome to another fantastic post. In this blog post, we will explore these strategies so nurses can better understand how to provide effective management of Schizophrenia through a nursing approach.

What is Schizophrenia?

Schizophrenia is a complex and severe mental disorder that affects how a person thinks, feels, and behaves. It can cause disturbances in thinking, behavior, emotions, perceptions, and relationships. Schizophrenia can be accompanied by other mental health disorders such as depression or anxiety.

How common is this condition?

Here are some statics data about how common Schizophrenia is worldwide:

• New cases: Each year, an estimated 2.77 million people are diagnosed with Schizophrenia worldwide.
• Average number of cases: There are currently 22.1 million cases (or 221 out of every 100,000 persons).
• The lifetime risk of developing it: The probability of suffering from Schizophrenia at some point in life is approximately 0.85% globally (or 850 out of every 100,000 persons).

What are the different types of Schizophrenia?

• Paranoid Schizophrenia: This type of schizophrenia is characterized by delusions or fixed false beliefs and hallucinations.
• Undifferentiated Schizophrenia: The type this Schizophrenia is characterized by positive symptoms (mainly delusions, hallucinations, and disorganized speech) without any dominant features.
• Catatonic Schizophrenia: This type of Schizophrenia is marked by disturbances in movement (i.e., psychomotor retardation).
• Residual Schizophrenia: This type of Schizophrenia is characterized by milder symptoms, including social withdrawal, flat affect, and reduced speech.
• Disorganized Schizophrenia: It is characterized by disorganized speech and behavior and flat affect.
• Schizoaffective disorder:  This type of Schizophrenia is characterized by a combination of symptoms from both psychotic and mood disorders.

What are the Symptoms of Schizophrenia?

The four primary symptoms of Schizophrenia are:

• Delusions – false beliefs firmly held despite clear evidence to the contrary.
• Hallucinations – Hearing, seeing, or feeling things that aren’t real.
• Disorganized thinking and behavior – Difficulties performing daily activities, disordered communication, and erratic behaviors.
• Thought disorder includes difficulty organizing thoughts, formulating ideas, and finding words to express them.
• Movement disorder: includes repetition of purposeless movements, agitation, and catatonia.
• Negative symptoms – reduced and flattened emotions, decreased motivation, reduced ability to experience pleasure, lack of energy.
• Cognitive symptoms: These involve impaired memory, concentration, and attention.

Are there other Possible Symptoms?

People with Schizophrenia often experience the following:

• Depression, anxiety, and suicidal thoughts.
• Feeling suspicious, paranoid, or afraid frequently.
• Not caring about their hygiene and appearance.
• Using nicotine, alcohol, prescription medications, or recreational drugs, often to “self-medicate” their symptoms.

What are the Risk Factors for Schizophrenia?

Risk factors for Schizophrenia include:

•  Genetics – having a close relative with the disorder
• Exposure to viruses during prenatal development
• Stressful life situations
• Substance abuse or exposure

What is Disorganized Speech?

You will need to learn about the various speech patterns of people with Schizophrenia, as it will be tested in your exams and will help create care plans.

• Word salad: when a person strings together unrelated words and phrases that don’t make sense.
• Tangentiality: when an individual answers a question by going off on a tangent or talking about something completely different than the topic at hand.
• Clang associations: using rhyming words or words with similar sounds instead of related ideas or thoughts.
• Neologisms: making up words or phrases that have no meaning to anyone else.
• Echolalia: repeating words or phrases that another person has just said.
• Pressured speech: talking very rapidly and uncontrollably.

What is Disorganized Thinking?

Patients with Schizophrenia may demonstrate disorganized thinking in several ways:

• Loose associations: jumbled and incoherent thinking, with frequent changes in topic
• Tangentiality: unfocused ideas that never return to the main point
• Circumstantiality: a meandering discussion that eventually comes back to the original concept
• Thought blocking: abrupt ending of thought processes, shown as an interruption in speech.
• Concrete thinking: thoughts confined only to tangible objects and events, with no capacity to generalize, conceptualize or idealize.

What are all the different types of Delusions and Hallucinations?

Delusions 

• Persecutory: an individual’s belief that others are out to harm them. It is often referred to as paranoid delusion.
• Grandiose delusion: An exaggerated sense of the individual’s importance.
• Somatic delusion: Conviction of having a severe medical problem or physical defect when none exists.
• Jealous delusions: Paitaient believes that their partner is being unfaithful with no evidence of infidelity.
• Religious delusions: The user is talking about individuals with a religious misconception, like thinking they are a saint or deity.
• Erotomanic delusions: The conviction that another is in love with them.
• Delusion: Delusion of control is the belief that another person, group, or an external force controls their behavior, thoughts, or feelings.
• Mixed delusions: If more than one type of delusion is present.

Hallucinations 

• Visual: Vivid hallucinations range from animals and religious figures to other people; they may or may not be perceived as frightening, and the individual may also be unaware that they’re hallucinating.
• Auditory: More than 70% of patients with Schizophrenia may experience hearing one or multiple voices, which could be forceful or indistinct whispers or constant hums.
• Tactile: The perceives physical sensations despite no external cause for such stimulation.
• Gustatory: Tasting a specific quality such as chemicals, a horrible taste, or a mixture despite no oral stimulus.
• Command: Auditory in nature and instructs the patient to take action, which could range from innocuous to dangerous.

How is Schizophrenia Diagnosed?

Your healthcare provider can diagnose schizophrenia or related disorders by asking questions, listening to the symptoms you describe, and observing your behavior. They may also ask additional questions to rule out other causes of the condition. They then compare their findings against the criteria for a diagnosis of Schizophrenia as outlined in the DSM-5. These criteria involve:

• Having at least two of five main symptoms: delusions, hallucinations, disorganized or incoherent speech, disorganized or strange behavior, and negative symptoms.
• Duration of symptoms and effects. These symptoms persist for at least one month, and the condition’s effects (whether or not they fit the criteria for the symptoms mentioned above) for at least six months.
• Social or occupational dysfunction. Disruption of your ability to work or maintain relationships due to the condition’s effects.

How is Schizophrenia Treated?

Schizophrenia is typically treated with medications, therapy, and other supportive services. Medications may include antipsychotics, antidepressants, mood stabilizers, and other drugs. Treatment can involve individual therapy, family therapy, cognitive behavioral therapy (CBT), and other forms of psychotherapy to help the person understand and manage their condition. 

Additional supportive services may include case management, housing support, employment assistance, drug and alcohol treatment programs, and more. Working with a mental health professional is important to find the right combination of treatments for you or your loved one.

What are some tips for living with Schizophrenia?

Living with Schizophrenia can be challenging, but many tips can help make it easier.

• Develop a daily routine to keep yourself on track
• Practice relaxation techniques such as deep breathing or mindfulness
• Stay organized and avoid procrastination
• Create a healthy lifestyle with proper nutrition and exercise
• Connect with others who understand what you’re going through
• Reach out for help when you need it, and don’t be afraid to ask for support
• Seek professional help from a mental health provider if necessary
• Take care of yourself and practice self-compassion.

By following these tips, you can take control of your life and manage the symptoms of Schizophrenia more effectively.

Schizophrenia Nursing Process

Here are the nursing responsibilities for taking care of patients with Schizophrenia:

Nursing Assessment

• Recognize Schizophrenia
• Monitor for signs and symptoms of the disorder.
• Assess compliance with medications and therapy sessions.
• Evaluate patients’ understanding of illness control strategies and how they impact their daily life and activities.
• Provide emotional support, education about the condition, symptom management techniques, help with coping skills, assess the risk of self-harm or violence, and provide safety.
• Encourage patients to participate in social activities and reunite with family and friends.
• Monitor for signs of suicidal ideation and risk of self-harm.

Schizophrenia Nursing Diagnoses

• Impaired Physical Mobility: Due to a depressed frame of mind and reluctance to start moving.
• Decreased Social: Interaction due to problems with thinking processes and communication.
• Reduced Cardiac Output: Caused by the effects of drugs that lower blood pressure when standing.
• Risk of Suicide due to impulsiveness and significant alterations in behavior.
• Risk of Injury triggered by hallucinations and delusions.
• Risk of Imbalanced Nutrition below body requirements due to neglecting oneself and refusing to care for oneself.

Nursing Care for Schizophrenia

• Reduce the severity of psychotic symptoms
• Prevent the recurrence of acute episodes
• Meet patient’s physical and psychosocial needs
• Help patient gain optimum level of functioning
• Increase the client’s compliance with the treatment and nursing plan

Nursing interventions for Schizophrenia:

• Monitoring the patient’s progress, including side effects of medications.
• Educating the patient and family about the condition.
• Teaching relaxation techniques or other coping skills to reduce stress and anxiety.4-Providing respite services for caregivers.
• Encouraging social activities and involvement.
• Assisting with symptom management techniques and compliance with treatment plans.
• Referring the patient for psychiatric and psychological evaluation when necessary.
• Providing support to families and caregivers of patients living with Schizophrenia.
• Encouraging healthy lifestyle choices, including proper nutrition, exercise, sleep hygiene, and stress reduction strategies.
• Monitoring for suicidal ideation and signs of self-harm or violence.
• Observing for signs of relapse or exacerbation of symptoms.
• Assessing the environment in which the patient lives to ensure safety measures are in place.
• Providing psychosocial support to the patient and their family.
• Encouraging adherence to treatments such as medications, therapy, and other supportive services.
• Educating the public about Schizophrenia to eliminate stigma and create awareness.

What Lifestyle Changes Can Someone with Schizophrenia Make?

Someone with Schizophrenia can make several lifestyle changes to help them manage their condition and improve their overall quality of life. These include:

• Practicing relaxation techniques such as deep breathing or mindfulness exercises regularly
• Eating a healthy diet that is rich in lean proteins, complex carbohydrates, fruits, vegetables, and healthy fats
• Exercising regularly to help relieve stress and anxiety
• Engaging in meaningful activities like hobbies, social activities, and other leisure activities
• Getting enough sleep and following good sleep hygiene practices
• Limiting or avoiding the use of alcohol and drugs
• Seeking professional help from a mental health provider when necessary.

By making these lifestyle changes, someone with Schizophrenia can better manage their condition and gain more control over their life. With the proper support, tools, and resources, living with Schizophrenia is possible.

Final Words

Schizophrenia is a severe mental health condition that can be difficult to manage, but with the proper treatment and support, someone living with Schizophrenia can lead a fulfilling life. Mental health professionals can provide the necessary treatment and support to help individuals better manage their condition.

Schizophrenia nursing interventions and lifestyle changes can also help individuals with Schizophrenia better manage their condition. From monitoring progress and educating the patient and family about the situation to assisting with symptom management techniques, there are many ways for nurses to support those living with Schizophrenia.

By following these tips and working closely with a mental health provider, you or your loved one can find the right combination of treatments that will work best for them. With proper care and support, those living with Schizophrenia can lead fulfilling lives.

References

• https://en.wikipedia.org/wiki/Schizophrenia
• https://www.nimh.nih.gov/health/topics/schizophrenia#:~:text=What%20is%20schizophrenia%3F,for%20their%20family%20and%20friends.
• https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443
• https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia
• https://www.nhs.uk/mental-health/conditions/schizophrenia/overview/