The Activities on these Portfolio Pages correspond with the learning objectives of the Guided Learning unit published in Nursing Times 105: 20 (26 May, 2009) and 105: 21 (2 June, 2009). The full reference list for this unit follows Activity 4.
Before starting to work through these Activities, save this document onto your computer, then print the completed work for your professional portfolio. Alternatively, simply print the pages if you prefer to work on paper, using extra sheets as necessary.
Recording your continuing professional education
To make your work count as part of your five days’ CPD for each registration period, make a note in the box below of the date and the total number of hours you spent on reading the unit and any other relevant material, and working through the Activities.
Hours: / Date:11
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults 1
nice guidance on schizophrenia in adultsACTIVITY 1
Learning objective: Understand the implications of the updated NICE guideline on promoting access for and engagement of people from black and minority ethnic groups.
Activity: Marek Wysocki* has been referred to a community mental health team by his university GP following concerns raised by his tutors, peers and university counsellor. Mr. Wysocki is an overseas student from Poland and has come to the UK to undertake postgraduate study for 18 months. He has recently stopped eating and is worried about being poisoned and persecuted by secret police. He keeps himself awake at night worrying that his perpetrators may come for him. He has begun to speak less English and has retreated to his mother tongue over the last few weeks. He is very isolated in the UK as he has no family or friends nearby.
What considerations do you have when planning and conducting a comprehensive assessment with Mr Wysocki? What measures will you take to help engage and support him?
RESPONSEBegin your response here.
11
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults 1
nice guidance on schizophrenia in adults11
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults 1
nice guidance on schizophrenia in adultsACTIVITY 2
Learning objective: Be familiar with the main principles of promoting early detection, comprehensive assessment and starting drug treatment in schizophrenia.
Activity: Caroline Watson’s* GP has referred her to an early intervention service (EIS) after detecting some symptoms suggestive of first-episode psychosis. About a month ago her GP initiated a low dose of a second-generation antipsychotic. While Miss Watson has found the drug has some calming effects, she complains of weight gain and feeling tired and sedated.
In your capacity as a nurse/care coordinator of the EIS, how will you explain to Miss Watson the proposed assessment process? Which other professionals might you involve in this comprehensive assessment process? How will you approach her concerns regarding the side-effects of the medication?
rESPONSEBegin your response here.
3
Nursing Times Portfolio Pages: Unit Title
nice guidance on schizophrenia in adults3
Nursing Times Portfolio Pages: Unit Title
nice guidance on schizophrenia in adults3
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults
nice guidance on schizophrenia in adultsACTIVITY 3
3
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults
nice guidance on schizophrenia in adultsLearning objective: Identify the evidence-based psychosocial interventions for people with schizophrenia and their families/carers for acute episodes.
Activity: Dennis Elliott*, aged 29, has had positive psychotic symptoms which resulted in a recent referral for a six-week period of intensive support from a crisis resolution and home treatment team. This is his third relapse in the last 18 months. Despite this he settles quite quickly after each acute episode and responds well to medication; he usually stops his medication within a few weeks. He also has negative symptoms (he lacks interest and motivation even for daily activities).
Mr Elliott has isolated himself from friends and peers, worrying that others may look down on him. He lives with his parents and frequently argues with them whenever they try to remind him of his medication and when discussing job opportunities.
What are the evidence-based psychological interventions that Mr Elliott and/or his parents could benefit from? Who can provide them? What are the principles in delivering the identified interventions?
3
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults
nice guidance on schizophrenia in adultsRESPONSE
Begin your response here.
3
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults
nice guidance on schizophrenia in adults3
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults
nice guidance on schizophrenia in adultsACTIVITY 4
Learning objective: Describe the social interventions to optimise clients’ recovery.
Activity: Following some psychological and social interventions involving Mr Elliott and his parents, he is regularly attending some further short activity sessions in the local day hospital and feels motivated to re-establish some routines for himself. However, as Mr Elliott’s care coordinator, you are aware that some further occupational activities will need to be identified and planned for him to optimise his recovery.
What social interventions and opportunities will be suitable for this client? How will you ascertain Mr Elliott’s needs, strengths and aspirations? Apart from the services available from NHS and statutory agencies, what other opportunities and support are suitable for him?
*All clients’ names have been changed
RESPONSEBegin your response here.
5
Nursing Times Portfolio Pages: Unit Title
nice guidance on schizophrenia in adults5
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults 5
nice guidance on schizophrenia in adults5
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults 5
nice guidance on schizophrenia in adultsFULL REFERENCE LIST
Department of Health (2008) Refocusing the Care Programme Approach: Policy and Positive Practice Guidance. London: DH. http://tinyurl.com/refocus-careprogramme
Kirkbride, J.B. et al (2006) Heterogeneity in incidence rates of schizophrenia and other psychotic syndromes: findings from the 3-center AeSOP study. Archives of General Psychiatry; 63: 250–258.
NICE (2009) Schizophrenia (Update). Core Interventions in the Treatment and Management of Schizophrenia in Adults in Primary and Secondary Care (Update). London: NICE. http://www.nice.org.uk/CG082
NICE (2008) Lipid Modification. Cardiovascular Risk Assessment and the Modification of Blood Lipids for the Primary and Secondary Prevention of Cardiovascular Disease. London: NICE. http://www.nice.org.uk/CG067
NICE (2005) Violence: The Short-term Management of Disturbed/Violent Behaviour in Inpatient Psychiatric Settings and Emergency Departments. London: NICE. http://www.nice.org.uk/CG25
NICE (2004) Self-harm: The Short-term Physical and Psychological Management and Secondary Prevention of Self-harm in Primary and Secondary Care. London: NICE. http://www.nice.org.uk/guidance/CG16
Singleton, N. et al (2000) Psychiatric Morbidity Among Adults Living in Private Households, 2000. London: HMSO. http://tinyurl.com/psychiatric-morbidity
5
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults 5
nice guidance on schizophrenia in adults5
Nursing Times Portfolio Pages: NICE guidance on schizophrenia in adults 5