Understanding Schizophrenia

This assignment delves into the complexities of schizophrenia, covering its characteristics, cognitive impairments, and impact on patients' lives. It emphasizes the role of nursing in providing effective care, including pharmacological interventions, psychotherapeutic approaches, and supportive measures for individuals with schizophrenia.

1Running head: MENTAL HEALTH
Mental Health
Name of student:
Name of university:
Author note:

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MENTAL HEALTH
Part A
1.
Schizophrenia is a severe and chronic mental disorder in which the patients exhibit
abnormal social behaviour with an inability to differentiate between real and unreal. The
thought process and feelings of the individual are modified to the extent that the patient is left
disabled. Common symptoms of the disease include unclear and confused thinking, false
beliefs, hallucinations, movement disorders, reduced social engagement and inability to
express emotions. Individuals with schizophrenia might be suffering from additional health
and mental well-being complications such as substance-use disorders, anxiety and depression.
Further, a patient with schizophrenia has a poor executive functioning and challenges in
paying attention (Bentall, 2013).
As opined by Frith (2014) a combination of environment and genetic factors are
responsible for the development of schizophrenia. Individuals who have a family history of
the disease have 80% more chances of developing the disease. The greatest risk factor for
developing schizophrenia is having a first-degree relative with the disease. The key
environmental factors that are related to the development of schizophrenia are drug use,
prenatal stressors and the living environment. The environmental factors mainly are exposure
to the virus, psychosocial factors and malnutrition before birth. Research indicates in certain
sections of the population, development of the disease is related to intestinal tract
dysfunction. Late adolescence and early adulthood are the time frames when the onset of
schizophrenia is more likely. Thus, the critical years of an individual’s vocational and social
development are the time of onset of the disease. In 23% of women and 40% of men
diagnosed with the disease, the condition manifests before the age of 19. However, for men,
the onset is earlier than women (Sekar et al., 2016).

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2.
An individual suffering from schizophrenia might be requiring lifelong treatment even
after the major symptoms subside. Management and treatment of schizophrenia are
multidimensional and include medication management, psychological treatment, physical
therapy and education. The first line of medication used for the disease is antipsychotic drugs.
Such form of medication is useful for reducing the positive symptoms of psychosis in around
two weeks. Some of the commonly used medications include chlorpromazine, haloperidol,
perphenazine and fluphenazine. These are first-generation antipsychotic drugs that might
have potential side effects involving neurologic system. Second-generation medications are
preferred as they pose a lower risk of serious side effects, and such medications include
Aripiprazole, Brexpiprazole, Lurasidone, and Cariprazine (Stuart, 2014).
Psychological interventions have also been prominent in managing schizophrenia.
After psychosis records, social and psychological interventions are necessary. These include
individual therapy, family therapy, social skills training and vocational rehabilitation. These
interventions act to normalise the well being and quality of life of the individuals and focuses
on improvement of social communication. For patients not responding to drug therapy,
electroconvulsive therapy (ECT) may be considered. Electroconvulsive therapy (ECT) is a
process in which low doses of electric currents are passed through the brain of the patient that
brings in bouts of brief seizure. Changes are brought in the brain chemistry so that the
symptoms of the disease can be reversed. Research has pointed out that exercise therapy for
schizophrenia holds much potential to improve quality of life of a patient. Physical activity
and exercise are done on a regular basis improve mental health as well as physical health
(Fortinash & Worret, 2014).

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Townsend and Morgan (2017) highlighted that patient education plays an imperative
role in managing the disease. Coping is challenging and thus support, and education drives
better ability to deal with the condition. Education is effective in motivating the individual to
adhere to the treatment plan. Further, the family members can better understand the disease
and be more caring and compassionate towards the patient. Since management of
schizophrenia is an ongoing process, support and proper education enable a person to be
more conscientious of his responsibilities.
3.
The role of the nurse in managing and caring for a patient suffering from
schizophrenia is of importance since a nurse spends the maximum time with the patient
among the different care professional. The care delivered by a nurse focuses on six
fundamental aspects; reduction of psychotic symptoms, prevention fo recurrence of acute
episodes, meeting psychosocial and physical needs, helping the patient fain optimal
functioning and increasing compliance to a treatment plan (Varcarolis, 2016). A nurse is
required to build a trusted relationship wth the patient through effective communication.
Appropriate verbal and non-verbal cues are to be used to make the patient feel respected and
valued. A sense of hope for potential improvement is to be instilled that acts as the
motivational factor (Videbeck, 2013). A nurse is to ensure that a safe environment is created
for optimal treatment. Further, a nurse must encourage the involvement of patient’s family
members in the treatment process.
4.
Symptoms of schizophrenia have a drastic negative impact on the lives of individuals
living with it, and the life-altering affects are prominent for social life as well as professional
life. Behaviours of the disease severely affect social, and home life since individuals are

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withdrawn from the social relationships. Exhibiting undesirable mood behaviour makes
interpersonal relationships to suffer. A person is likely to enable to take part in family life
adequately. The family members are required to deliver care to the patient in a continuous
process, and this is often challenging. Further, schizophrenic patients often face the social
stigma that excludes them from social life. The patients are subject formal and informal
discrimination at different levels (Domenech et al., 2017).
In this regard Brissos et al., (2016) state that the early symptoms of schizophrenia
result in poor performance in academics. A child suffering from schizophrenia is pushed
away from the social circle, and he is not interested in taking part in activities. The cognitive
impairment suffered due to the disease makes thinking process challenging, thereby resulting
in poor grades for the child. The symptoms of the disease get pronounced as an individual
gets older. For an adult, the most prominent symptoms that interfere daily functioning at
workplace includes unusual posture, muscle immobility, disorganised behaviour,
hallucinations and repetition of speech. Since working under normal environment is difficult
for a patient with this disease, individuals find it difficult to get employed.
Part B
1.
Carrying out the gallbladder surgery for the patient would be challenging since
symptoms of schizophrenia might be interfering with the treatment and recovery process of
the patient. Conversely, the gallbladder surgery might impact the patient pre-existing illness
of schizophrenia. According to Heng and Tan (2016) patients undergoing surgery who are
living with schizophrenia suffer postoperative complications that are more adverse. The risk

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of mortality is three times more than patient who does not suffer from such mental illness.
Hassidim et al., (2017) pinpointed that diverse range of behavioural symptoms might occur
after a crucial surgery. These include hallucinations, impulsivity, depression and psychosis.
For a patient suffering from schizophrenia, his symptoms would get aggravated due to the
gallbladder surgery. Psychoses commonly occur postoperatively and is a substantial
morbidity. Though the exact cause of postoperative psychoses is not identified yet, the
outcomes are noteworthy. Patients become perplexed, confused and disorganised due to
surgery that augments the preexisting symptoms of the schizophrenia. Further, the patient
might have auditory and visual hallucinations with a paranoid perspective postoperatively
due to medications, which again is linked to schizophrenia.
As stated by Liao et al., (2013) prevalence of schizophrenia would have a negative
impact on the surgery process for the patient. The main concern is the administration of
anaesthesia. Anaesthesiologists would be confronted with difficulties while communicating
with a schizophrenia patient. Moreover, a patient with the disease might be suffering from
abnormalities of the cardiovascular, immune and endocrine system. The adverse response
that a patient might be demonstrating against anaesthesia includes hypotension, arrhythmias,
hyperpyrexia, prolonged narcosis, post-operative confusion and post-operative ileus. Patient
suffering from chronic psychoses lack pain sensitivity in addition to autonomic nervous
dysfunction and water intoxication. These alterations influence outcomes post operatively.
2.
Psychiatric patients, such as those suffering from schizophrenia, are at more risk of
suffering perioperative complications due to impairment in the ability to respond
appropriately to biological stress. The complications that commonly occur are related to
antipsychotic health behaviours and physical disorders. It is the responsibility of the

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anaesthesiologist to be aware of the techniques to manage the perioperative course of
medication management (Fatemi, 2015). Proper diagnosis, awareness and understanding of
the psychotic symptoms of schizophrenia emerging after surgery are crucial for better
delivery of care. Adequate treatment is also enabled by these factors. It is very important that
health care professionals are educated adequately to monitor patients for under dosing of
drugs, overdosing and interactions between medications. This is vital since a number of
anaesthetics, analgesics and psychotropic medications for schizophrenic patients interact with
each other and prevent the sutibale postoperative outcomes (Frese, 2016).
Morrison et al., (2014) explained that if antipsychotic drugs are used preoperatively
for schizophrenic patients, then they become more vulnerable to the hypotensive action that is
brought about by the general anaesthesia. In contrast, if antipsychotic drugs are discontinued,
chances of suffering episodes of psychotic symptoms like agitation and hallucinations is
more. Thus the patient undergoing gallbladder surgery needs to be given the antipsychotics
pre-operatively so that there is no abrupt withdrawal, leading to recurrence of symptoms of
psychoses.
3.
Hollis et al., (2015) consider that if there is suitable preoperative assessment and
prevention of symptoms of psychoses, then the risk of suffering poor outcomes is reduced to
a considerable extent. It is imperative to include psychiatrists in the care plan for a
schizophrenia patient post operatively. A psychiatrist would work as an integrated surgical
healthcare team member for providing knowledge for patients with mental illness.
Frese (2016) have highlighted that patients who have a history of psychiatrist
disorders such as schizophrenia are at increased risk of facing challenges to cope with the
health-related demands surgery brings in. Patients undergoing surgery are exhausted and have

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a stressful time. Professional help would be required during the postoperative coping time. A
therapist might be included in the care plan for the patient for administration of Cognitive
behaviour therapy (CBT). CBT has been indicated to be effective for treating symptoms of
schizophrenia postoperatively. The therapeutic technique is outlined on the basis of
fundamental principles of CBT. Relationships are established between actions, feelings and
thoughts in an accepting and collaborative atmosphere.
Family support is fundamental for caring for patients with schizophrenia post
operatively (Duckworth & Halpern, 2014). The family members are to be involved in the care
process of the patient after he has undergone gallbladder surgery. The adaptation process of
the patient is enhanced by the family members who act as the first line of support for the
patient. Patients with schizophrenia might be having disrupted and dysfunctional family
dynamics that make it difficult to cope up with the surgical process. In such cases, other
individuals who might be in a position to provide support are to be contacted.
4.
It is important that a healthcare professional, about to care for a schizophrenia patient
post operatively, is well educated and informed about the key implications of the patient
condition so that there is no compromise with the quality of care process delivered (Degnan
et al., 2017). The staff member needs to understand that schizophrenia has phases and
patterns that are predictable. It is, therefore, easier to understand the difficulties a patient is
suffering from due to the disorder at a particular point in time. Patience and understanding are
of utmost importance while caring for a schizophrenia patient post operatively. It is essential
to communicate in a proper manner with the patient so that a respectful and trusted bond is
established between the patient and the carer. Communication needs to be effective through
different verbal and nonverbal cues. It is important to show empathy and respect while caring

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for such patients. If a patient feels valued and loved, it is likely that challenges in caring for
him would be diminished (Fortinash & Worret, 2014).
Townsend and Morgan (2017) in this context that stated that since communication
might be difficult, it is important that the care professional orients the patient to the present
reality by using the name of the patient and validating conversations engaged in. In addition,
one must also decode the conversation by apprehending the needs of the patient. The care
giver must take the responsibility of understanding the detailed needs of the patient. The
patient thereby understands that he is beign cared for adequately and does not show any
inappropriate behaviour. Since the patient might be exhibiting literal thinking, it is significant
not to use abstract phases. Participating in different forms of activities along with the patient,
if possible, would also be advantageous.

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