Description: Using recent and relevant research you are to write an essay that analyses a case study in order to discuss appropriate biopsychosocial assessment and nursing management or interventions relevant to that case. Instructions: 1) Select a case study from those provided below. 2) Use recent literature to support your discussion: 2.1) Describe the components of a biopsychosocial assessment that will identify relevant factors that may assist in the diagnosis of a mental health issue. 2.2) Discuss biopsychosocial assessment for the selected disorder. 2.3) Discuss nursing management or nursing interventions appropriate for your selected case study and consider any ethical implications of these interventions.
Ensure that you use scholarly literature1 (digitised readings, research articles, relevant Government reports and text books) that has been published within the last 5 years. Provide a clear introduction and conclusion to your paper. You may use headings to organise your work if you wish. Write in the third person. Use academic language2 throughout. Refer to the marking guidelines when writing your assignment. This will assist you in calculating the weightings of the sections for your assignment. State your word count (excluding your reference list) on the Title page and Assignment Coversheet.
1 Scholarly or peer-reviewed journal articles are written by scholars or professionals who are experts in their fields, as opposed to literature such as magazine articles, which reflect the tastes of the general public and are often meant as entertainment. 2 Everyday language is predominantly subjective. It is mainly used to express opinions based on personal preference or belief rather than evidence. Written academic English is formal. It avoids colloquialisms and slang, which may be subject to local and social variations. Formal language is more precise and stable, and therefore more suitable for the expression of complex ideas and the development of reasoned argumentation.
Case 1: First episode psychosis John is an 18-year-old student. He lives with his mother Anne, who is 50 years old, and his stepfather Greg, who is 53 years old. Anne was remarried 9 years ago. John is the youngest of three children and he is the only child to still live in the family home with his parents.
John is now in Grade 12. He liked to socialise with friends and was fun-loving. In the past seven months he started to have changes in behaviours and appearance. John was disruptive and started to talk and laugh inappropriately in class. He also became isolated and did not want to join in any activities at school. He used to receive good grades but since the beginning of the year he started to lose his concentration and attention. His school performance became poor and he was frequently tardy. John had finally stopped going to school over the last two months. John has a history of drug abuse. He started to use marijuana when he was in Grade 9 because the group of friends he was hanging out with also used drugs. John uses amphetamines on a regular basis. He occasionally drinks alcohol and smokes cigarettes.
John was brought to a mental health unit by his parents after he had been noted wandering around the house and talking to himself for over a week. This is his first admission. On admission, John appears suspicious and has unkempt hygiene. He stated he heard voices from a group of two men and a woman. The voices kept telling him that he was “no good” and “everybody hated” him. Sometimes they told him to kill himself and sometimes to kill older people. John also believes that he has special powers and he is a spy working for the government. John is argumentative and sometimes becomes aggressive. He has a history of aggression and violence.
John’s mother told the admitting nurse that John’s father has schizophrenia and he was abusive to her and the children. They divorced when John was 8 years old. After the divorce, John’s family relocated to different cities. John also had to move to different schools, so he did not have any close friends.
Case 2: Eating disorder Charlie is a 19-year-old girl. She is a second year university student. Charlie shares a flat with two other students who have always been very supportive of her. Jo, one of Charlie’s flatmates, has contacted Charlie’s parents and expressed concern over Charlie’s appearance and behaviours. Charlie used to go out and have dinner together with her flatmates. She started to isolate herself about four months ago. She spends much of her time alone in her room. Charlie eats very little throughout the day and takes laxatives on a daily basis. After eating, Charlie immediately goes to the toilet and spends at least half an hour in the bathroom. Charlie has lost 10 kilograms in the last three months and her menstrual periods have ceased. Charlie is pale and thin. Her hair is dry and brittle. Though it is summer, she is wearing several layers of clothing.
Charlie is the youngest daughter of Pam, who is a registered nurse, and Jack, who is a dentist. Both parents work full time and lead busy lives. Charlie always sets high standards for herself. She feels that she needs to be as perfect as her parents. She describes her parents as overprotective and controlling. Charlie has a brother who is working in a well-paid company.
Charlie was taken to see the family doctor who has referred her to the Eating Disorders Unit in Brisbane. Charlie’s family reports that Charlie was a high achiever at school. The nurse interviews Charlie and although she is pleasant the nurse gains little information as Charlie is guarded and reluctant to talk about her eating. Charlie, however, says she is “too fat” and believes that she needs to lose more weight to be more attractive. Charlie feels worthless. She believes she is not as smart as her brother and this has made her parents do not care much about her. Charlie sometimes has self-harm urges. She feels that it is the only time she can control herself.
Charlie is admitted to the unit and is prescribed multivitamins, antidepressants, and anxiolytic medication.
Case 3: Depression
Amy is a 75-year old woman. She has been diagnosed as having depression for ten years. She started to feel depressed after she was diagnosed with diabetes and hypertension. She felt more depressed after the loss of her husband three years ago. She was hardly eating anything and wasn’t sleeping. She felt like she had no one to talk to. After the death of her husband, Amy moved to a retirement village. Amy manages her medications by herself. Sometimes she forgets to take her medications.
Amy has two daughters. They live in another city, about one hour’s drive from her home. They visit her almost every month. Amy is a quiet but caring person. She likes to keep things to herself. Amy has similar characters to her mother who also had depression and passed away fifteen years ago.
Amy was brought to a mental health hospital by Sue, one of Amy’s daughters, after the retirement village manager contacted her. This is her fourth admission to the hospital. Over a period of two weeks, Amy has experienced a loss of interest in her activities and sleep disturbance. Amy was restless at night and she found it hard to fall asleep. Over the past two weeks, Amy has felt increasingly tired and fatigued, resulting in her not wanting to get out of bed. Amy has lost her appetite. She has lost six kilograms in the past two months. Amy expresses feelings of worthlessness, helplessness, and hopelessness. She feels she is a burden for her daughters. Amy reports a low mood and states “If I were gone, things would be easier for my daughters”.
The doctor prescribes Amy another group of antidepressants. While she is in an inpatient unit, she attends cognitive behavioural therapy as well as art and craft group activities.