P1 – Clinical Report
Demographics:
According to the case scenario, Mr. x is a 23-year-old male who was born on the 20th of October 1998. He is an unmarried person but due to educational purposes, he has to stay away from his parents (case study). He frequently visits his parents as well as his grandparents. He is not having such a significant personal friend; however, all his support lies with his parents as well as some social content. His hobby is playing tennis, however after getting admitted to the hospital, reasonable rapport with staff and peers in the ward. Mr. X has 3 members from his maternal family, who are grandparents and aunty. However, 4 members are there who belong to Mr. X’s paternal family who is grandparents and 2 uncles.
Referred by and referred for:
As per the case study, client interviews are often carried out in the unit of “Ministry of Health for accessing the mental state of the patient. In this regard, a psychiatrist and clinical director of mental health services checked the condition of Mr. x on 7th September 2017 and got referred to National Women’s Hospital (case study).
Presenting problems:
Mr. X is having several kinds of issues such as Schizophrenia is defined by out-of-body experiences or ideas, disorganized speech or behaviour, and diminished engagement in daily tasks. Concentration and memory issues may also be present. Furthermore, other factors are also associated with the patient’s condition such as overweight, constipation, Perforated eardrum 2018, and Facial acne (case study). Lack of motivation, Change in sleep patterns, Delusions, and Slow movement is also found within the patient (Wu et al. 2019).
MSE:
● Mr x unduly suspicious of the examiner and socially be awkward
● “tic” type movement disorder and some OCD rituals/behaviour (Tulacı, 2018)
● Expressing a variety of odd beliefs or delusions
● Diagnosis of Autistic Spectrum Disorder (Petty et al. 2018)
● Having a flat affect that is little range of expressed emotion
● Continues to present with intermittent auditory hallucinations
Predisposing:
It has been identified from the research that a combination of physical, genetic, psychological and environmental factors can make a person more likely to develop the condition of schizophrenia. The actual aetiology of schizophrenia is unknown, although genetics, environment and chemistry, as well as changes in brain structure, may all have a part (Mitra et al. 2020). Schizophrenia is characterised by seemingly unreal ideas or experiences, disordered language or behaviour, and a reduction in everyday activities involvement.
Precipitating:
There are several precipitating factors of schizophrenia such as having a family history of schizophrenia (Hume et al. 2020). It has also been identified that some pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development and schizophrenia. Childhood trauma, Structural changes in the brain, and Chemical changes in the brain are also observed as precipitating factors of schizophrenia. Previous drug use also led individuals towards precipitating factors of schizophrenia (Gillespie et al. 2017).
Protective factors:
Protective variables are family support, adherence to antipsychotic medication, work, and religion (Durgoji et al. 2019). Participants proposed that to assist prevent relapse, mental health psycho-education workshops and community home visits by mental health nurses be strengthened. Treatment normally lasts a lifetime and usually consists of a combination of drugs, counselling, and coordinated speciality care services.
Tests/Results:
It has been identified that several testing such as Cognitive testing, Personality testing open-ended or projective testing such as the Rorschach (inkblot) test are associated with diagnosing schizophrenia. Although there is no particular laboratory testing for schizophrenia, your doctor may use a variety of diagnostic procedures to rule out physical disease as the origin of your symptoms, such as MRI or CT scans or blood tests (DeLisi, 2017).
Current Risks/mitigation:
Several current risks are associated with the respective disease. Having a family history of schizophrenia are also a current risk within Mr x. Mr X’s brain is still developing, so this is very crucial. Avoid any circumstances that are harsh or upsetting the patient along with getting help if the patient is in an abusive relationship or going through a traumatic experience (Coulon et al. 2020). Maintaining strong social bonds can be done for mitigating the issues earlier along with learning how to cope with stress. Planning of stress management along with including risk mitigation strategies are also key factors of the mitigation plan of the disease.
P2: Goals and Integrated Care Plan or Inpatient Care Plan or Transfer Care Plan
Minimum 3 short term goals
● Regular exercise and yoga
● Having healthy foods rich with fibres for dealing with constipation
● Taking medications (Benson et al. 2020)
Minimum 3 long term goals
● Regular practice of yoga for dealing with facial expressions, weight losing, and other risk factors of the disease (Te Pou, 2009)
● Control disturbed behaviour and reduce the severity of psychosis
● To effectively manage signs and symptoms at the lowest possible dose
Goal Strategy (intervention/action/clinician) Review meeting/time Expected Outcome
Regular exercise and yoga The patient can rise early in the morning and do some exercises as well as yoga for the purpose of dealing with brain-related issues, along with enhancing memory. Every after 1 week the doctors, who have prescribed yoga and exercise should be making an appointment for checking the recovery. Reduced weight, overcoming stress and brain development.
Having healthy foods rich with fibres for dealing with constipation
Consumption of health foods especially high fibre food Appointment with a nutritionist for checking the recovery Reduced issue of constipation Taking medications
Intake of prescribed medications by the doctors Twice a month Instant recovery of breathing and mental illness
Regular practice of yoga for dealing with facial expressions, weight losing, and other risk factors of the disease Yoga is found to be one of the best medications for schizophrenia in terms of dealing with all its symptoms Once in a month Reduced symptoms of schizophrenia
Control disturbed behaviour and reduce the severity of psychosis Antipsychotics are the most common type of medication prescribed by doctors to treat psychotic illnesses. These medications are successful in controlling the most problematic symptoms of psychotic illnesses, such as delusions, hallucinations, and cognitive difficulties, even though they aren’t cures (Shim, 2009). Once in a month Reduced disturbed behaviour and reducing the severity of psychosis
To effectively manage signs and symptoms at the lowest possible dose Antipsychotic medicine, Anti-Tremor
Once in a month Antipsychotic reduces or improve the symptoms of some mental illnesses. Anti-Tremor is useful for tremors, shaking, and unsteadiness is all things that this medication can help with.P2.2 Provide details about plans for ongoing monitoring of the goals and interviews
First of all, the patient should be taken to a psychiatrist so that he can suggest some medications for immediate response to the ongoing disease. Furthermore, the patient should also visit a general physician who can check any general disability caused by the respective disease and suggest some relief and medications for the recovery. Yoga specialist doctors are also one of the most important doctors for recovery of the disease, forgetting the long-term solution of the disease (Ministry of Health, 2019). Moreover, the patient should only take such food that is suggested by nutrition. In this regard, all the goals can be fulfilled with the help of the suggested plans. The patient is also recommended for following all the medications as well as all treatments proposed by the doctors along with a regular check-up as per the doctor’s direction. They should also be an agent of mental Health services who can take the recovery position and condition of the patient on a weekly basis.
P2.3 Description of patient and family/carer education
It has been observed that Mr X is only close to the family and social friends who are related to family members. In this regard, it is necessary for Mr X in order to do proper support that can help the patient in terms of a proper recovery (Dunn & Marshall, 2015). It is recommended for the family members of the patient to consult with the doctor in such a manner that the doctor can illustrate the supportive factors that can be provided to the patient at the time of their need and overcoming with mental illness.