Schizophrenia is a group of mental disorders characterized by psychotic features, the inability to trust others, and unordered thought processes. The client also withdraws from reality, shows regressive behavior, has ineffective communication and a reversely impaired inter-personal relationship. Typical onset occurs in early adulthood with diagnosis based on observation and the patient’s experiences.
Types of Schizophrenia
- Disorganized or Hebephrenic Schizophrenia. There is severe and pronounced mental incapacity. The client manifests a flat affect and peculiar behavior. Social withdrawal and delusions are common.
- Catatonic Schizophrenia. The client has catatonic stupor wherein he manifests waxy flexibility, withdrawal, distorted reality, and ambivalence.
- Paranoid Schizophrenia. The patient undergoes delusions as compensatory mechanism and hallucinations.
- Undifferentiated Schizophrenia. There are mixed symptoms. The client also manifests a flat affect. Factors: severe emotional problem, chronic insecurity or a total failure in inter-personal relationships, difficulty in restoration of integrity and personality.
Delusion
Delusions are false beliefs considered to be true even though there is sufficient evidence on the contrary. The client also believes the certain events, situations, or actions are directly related to self. Types of Delusions:- Delusions of Grandeur. The client believes that one is powerful and an important person or being.
- Delusions of Persecution. The client believes that he is being singled-out for harm by others.
- Delusions of Jealousy. The client believes that he’s partner is going out with another person.
Assessment for Schizophrenia
- 4 A’s
- Affect. If client manifests flat or blunted it is considered inappropriate.
- Associative looseness. The client’s verbalization is disorganized.
- Ambivalence. The client has two conflicting emotions.
- Autism. Thoughts on self, extreme withdrawal, and the inability to relate to the outside world.
- Ability to perform Activities of Daily Living (ADLs). Clients with Schizophrenia have difficulties in performing self-care activities. Also, client have nutritional deficit.
- Aggression
- Suicidal Potential
- Any changes in thoughts or feelings.
- Disturbances in inter-personal relationships.
Nursing Diagnosis for Clients with Schizophrenia
- Anxiety related to disturbed thought processes.
- Impaired verbal communication related to inappropriate use of words.
- Ineffective family coping related to ambivalent family relationships.
- Sensory perceptual alterations related to misinterpretation of stimuli.
Nursing Care for Clients with Schizophrenia
- Encourage the client to follow drug regimen.
- Observe adverse drug reactions especially major tranquilizers.
- Encourage the development of interpersonal relationships.
- Encourage the client towards presentation to reality.
- Accept the level of functioning.
- Respect the patient as a human being with dignity and worth.
