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Schizophrenia Paranoid Type: A Family Assessment
Schizophrenia Paranoid Type: A Family Assessment
Chronic illness is defined as “the irreversible presence, accumulation, or latency of disease states or impairments that involve the total human environment for supportive care and self-care, maintenance of function, and prevention of further disability” (Larsen, 2013a, p. 6). Chronic illness is the “human experience of symptoms and suffering, and refers to how the disease is perceived, lived with, and responded to by individuals, their families, and their healthcare providers” (Larsen, 2013a, p. 4). Furthermore, nurses need to understand the illness experience to provide holistic care (Larsen, 2013a, p. 4). Schizophrenia is a chronic condition categorized as a severe, disabling brain disorder (The National Institute of Mental Health website, 2012, p. 2). The etiology of schizophrenia is thought to be caused by rare genetic mutations with contributing environmental factors, which disrupt brain development (The National Institute of Mental Health website, 2012, p. 6). Schizophrenia occurs in about 1 percent of the general population, occurring in 10 percent of people with first generation relatives with the illness (The National Institute of Mental Health website, 2012, p. 6). The person of an identical twin with schizophrenia has a 40 to 65 percent chance of developing the disorder (The National Institute of Mental Health website, 2012, p. 6). Persons diagnosed with schizophrenia often live in a world of uncertainty and threat due to altered sensory perceptions and false beliefs (Brady & McCain, 2005). Families experience a lifetime of emotional, social, and financial consequences experienced by the individual with schizophrenia (Brady & McCain, 2005). This paper will present an individual’s scenario, an individual developmental assessment, family developmental assessment, and a holistic family assessment using Wong and Eaton’s (2001) tool displayed in Appendix A, and an ecomap in Appendix B. The paper will further discuss aging/geriatric issues and models of care, and nursing roles related to comprehensive individual and family care throughout the continuum of chronic illness. Scenario
Lakisha Simon White is a 34-year-old married black female who was diagnosed with Schizophrenia Paranoid Type at the age of 22. Lakisha was born and raised in Atlantic City, New Jersey. She is currently married to William White, 35-year-old truck driver and has no children. Lakisha states while growing up, she experienced “seeing and talking to people” and having “imaginary friends” that others did not know existed. Lakisha also stated, “I felt like a superhero, only I had the super power”. During her teenage years, Lakisha stated her imaginary friends were replaced with “mean and scary characters”, further stating “they taunted me saying my family was not real” and that she was part of a conspiracy. It was during this time that Lakisha began drinking alcohol and smoking marijuana. At 16 years old, Lakisha states her mother caught her drinking alcohol and became angry, stating she was irresponsible like her father and making up stories and lies. In response, Lakisha unsuccessfully attempted to explain to her mother that the alcohol and marijuana helped to “calm the voices” and made her feel “normal”, to no avail. Lakisha feels high school was difficult by stating “it was a struggle for me to focus” but did graduate. Upon completion of high school, she enrolled at Henry Parker Community College for interior design. It was during this time that she attacked a roommate with a knife stating, “She was the devil and I was God’s messenger”. At this time, the police were notified and Lakisha was hospitalized with the diagnosis of schizophrenia. After four...
References: Brady, N., & McCain, G. C. (2005, January). Living with schizophrenia: A family perspective The Online Journal of Issues in Nursing, 10(1). doi: 10.3912/OJIN.Vol10No01HirshPsy01
Havighurst, R. J. (1972). Developmental tasks and education (3rd. ed.). New York: Longman.
Kirkpatrick, B., Messias, E., Harvey, P. D., Fernandez-Egea, E., & Bowie, C. R. (2007). Is schizophrenia a syndrome of accelerated aging? Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2632500
Larsen, P. D. (2013b). Models of care. In I. M. Lubkin, & P. D. Larsen (Eds.), Chronic illness: Impact and intervention (8th ed., pp. 513-531). Burlington, MA: Jones & Bartlett Learning.
Rosenberg, I., Woo, D., & Roane, D. (2009). The aging patient with chronic schizophrenia. Retrieved from http://www.annalsoflongtermcare.com
The National Institute of Mental Health website
Tormoehlen, K., & Lessick, M. (2011, Dec-Jan). Schizophrenia in women. Nursing for Women’s Health, 14(6), 482-495. doi: 10.1111/j.1751-486X.2010.01595.x
FAMILY ASSESSMENT (Wong & Eaton, 2001)
I. Structural assessment areas (composition; social, cultural, religious, & economic characteristics that influence family’s overall psychologic health)
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