Scribd
Upload
67 views

12 Psychiatric

Adult patients face major changes when hospitalized including changes to body image, confronting mortality, increased dependency, and adjusting to physiological changes. They may also grieve losses of functions, body parts, or lifestyle. How patients cope ranges along a continuum from approach styles where they actively engage in treatment, to avoidant styles using denial. Common reactions to hospitalization include anger at feeling powerless, agitation from helplessness, and withdrawal which risks patients being overlooked. Nurses should support patients' coping abilities, help them learn new skills, and provide consistency, education, pain control and family inclusion to better address these reactions.

Uploaded by

amal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
67 views

12 Psychiatric

Adult patients face major changes when hospitalized including changes to body image, confronting mortality, increased dependency, and adjusting to physiological changes. They may also grieve losses of functions, body parts, or lifestyle. How patients cope ranges along a continuum from approach styles where they actively engage in treatment, to avoidant styles using denial. Common reactions to hospitalization include anger at feeling powerless, agitation from helplessness, and withdrawal which risks patients being overlooked. Nurses should support patients' coping abilities, help them learn new skills, and provide consistency, education, pain control and family inclusion to better address these reactions.

Uploaded by

amal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 28

12

Adult reactions to illness


and hospitalization

Associate Prof. dr. Yosr elmasri


Lecture objectives:-
At the end of this lecture the students will be aware of :

Major changes facing the ill adult.


Coping to major changes facing the ill adult.
Major categories of reaction to hospitalization
Major changes facing the ill adult.
1. Change in body image
2. Reality of their own mortality
3. Dealing with an altered level of dependency
4. Adjusting to physiological changes
5. Grieving for their losses (body function, body part, life
style, …)
6. Illness occurs with other stressors
1- Change in body image
ill hospitalized adults are often confronted with
a change in body image. This is obvious in
surgical patients who suffer an incision and
often removal of a body part.
EX.

o IV replace drinking liquids or a catheter may


replace the customary trip to the bathroom.
o Cardiac patients may experience their illness
as having “something wrong” with the core
of their physical being .
2-Reality of their own mortality
Hospitalization viewed as a place people go to die.

o Furthermore, a hospitalized patient today is


surrounded by seriously ill individuals.
o The atmosphere may be tense, the staff very
busy and the collection of technology exciting
and frightening.
3- Dealing with an altered level of dependency
In the hospital, the client’s may feel more
dependent, less in control, more anxious, or less
decisive,………
They must resign to nurses, and other hospital
personnel for the most basic daily functions
(hygiene, eating, ambulation and elimination…..)
These changes are a serious challenge to an
individual’s self-esteem
4. Adjusting to physiological changes

include dietary, exercise, stress or movement


reduction, medication use, amputation, ……..
Non-compliance can be an huge problem for the newly
diagnosed with chronic disease.
The individual can use non-compliance as a way to
express their anger and frustration.
5- Grieving for their losses

This grief may be expressed in an overt and direct


manner. They may also experience guilt.
6- Illness occurs with other stressors

For example:
o financial stressors are prevalent in
today’s economic climate; these may be
severely complicated by reduced
income and increased health care
costs.
o Marital and familial stressors exist in many
families ( such as shift of roles )

o The individual may experience depression


, anxiety and feelings of helplessness
Coping to major changes facing
the ill adult.
Generally, people react negatively to the signs of
even a minor illness. they may feel resentful, angry,
disappointed or frustrated.
Coping is usually a learned
response pattern to stressful events/illness which the
individual has developed through a trial and error process
over their life span, As such, coping is a process rather
than an event.
In a very broad terms, the ranges of coping styles
cover a continuum from approach coping style at
one end through avoidant coping style at the other.

Approach Mix Avoidant


coping coping coping
style skills style
Individuals with an approach coping style
force into the recommended therapy and actively
fight to regain their health, Such patients want
very detailed information ; they wish to be totally
engaged in all information and education; they
wish to be totally engaged in all aspects of
evaluation and treatment; they set goals and follow
through.
Regain a sense of control both through
understanding, involvement and through self
management (relaxation, seeks support and help,
verbalizes feelings, etc…..).

Additionally, they seeking compensation,


involvement in social events, and maintenance of
independence.
At the other end of the spectrum are adults whose
Avoidant coping style . These individuals
utilize denial, repression, projection and other
strategies which used as a passive coping
behavior to minimizes the seriousness and
perception of threat from their illness.
Patient also delaying decisions, non-
compliance with treatment, withdrawing
from supports and significant others,
maintenance of unrealistic hope or
abuse of substances including alcohol,
drugs and nicotine.
Between the two extremes are individuals who
mix coping skills from both ends of the
spectrum. The majority of people fall in the
mid range on this continuum. It may be
difficult initially to accurately assess which
coping style predominates in an individual
However, it is important for the nurse to
identify an hospitalized individual’s coping
style.
Medical staff must:
o accept and support a patients coping abilities.
o facilitate learning new coping skills
o refer the individual to resources which can assist
them to expand their coping list during their
recovery.
o The initial goals of coping strategies
include minimizing uncomfortable
emotional responses such as anxiety,
fear, guilt, etc; enhancement of self-
esteem; maintenance of
positive/supportive relationships; and
generation of hope.
Major categories of reaction
to hospitalization
1- The angry individual
o When a patient feels powerless, they may relate
in an angry manner with staff in an unconscious
attempt to externalize their uncomfortable inner
experience.

o Their angry style may also be an indirect


expression that others are responsible for their
internal discomfort.
Such patients may be loud, demanding, rude,
time consuming and very frustrating to staff.

Successful interventions include acknowledging the


patient’s individuality and unique situation;
keeping them informed; responding to their
realistic needs while setting firm limits .
2- The agitated, hypervigilant individual

The hypervigilance and agitation is


often a response to the individuals
feeling of helplessness or to attempt
to regain a sense of control
Successful interventions might include consistency
in staff assignment; suggesting relaxation
interventions, such as deep breathing, hot
shower, diversion (reading, etc.); providing
patient teaching while a family member is
present and providing the patient with adequate
pain control.
3- The withdrawn individual
This type of reaction is serious for a number
of reasons.
o A withdrawn patient can “lost in the cracks.”
o He/she may not receive the appropriate
assessment and intervention
o Can be ignored emotionally and even physically
in a busy practice setting.
For more information...........
- American Holistic Nurses Association. (2000). AHNA standards of
holistic nursing practice. Flagstaff, AZ: Author, available at
http://www.ahna.org
- American Holistic Nurses Association. (2003). AHNA standards of
advanced holistic nursing practice for graduate prepared nurses.
Flagstaff, AZ: Author available at http://www.ahna.org
- http://en.wikipedia.org/wiki/Wiki and Further reading
- https://scholar.google.com/schhp?hl=ar ( ‫ الباحث العلمي‬Google -
Google Scholar)
Thanks
Associate Prof. dr. Yosr elmasri

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy