NUR2300 - Nursing priority and chronic health conditions

Running head: NUR2300
Nursing priority and chronic health conditions
Name of the Student
Name of the University
Author Note

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Part A
Evaluation
The research conducted by MacPherson et al., (2013) focused on the fact that the
depression results in significant increase in the rates of mortality among many patients. The
primary objective of the research was to evaluate the effectiveness of acupuncture compared to
counseling approaches, for treating patients who are suffering from this chronic health
conditions. The authors conducted a randomised controlled trial, where 755 patients suffering
from depression were recruited and randomised to three intervention groups namely,
acupuncture, counseling, and usual care. Strength of this research can be attributed to the fact
that both the kinds of intervention were found to significantly reduce the rates of symptoms
associated with depression among the selected participants, thereby confirming the success and
validity of the preventive strategies. Thus, the research findings can be appropriately
implemented by the National Strategic Framework, to eliminate high prevalence of mental
illness, particularly depression in the Australian population.
Part B
Research question
A research question acts as an integral part of a research study, literature review. The
research question given below focused the study, and assisted in determining the search
methodology, thereby acting as a guide for all the stages of search, analysis, and reporting. The
primary areas of concern were related to the high prevalence of mental illness in the target

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population that brings about changes in the emotion, thinking and behaviour of all individuals.
The research question formulated for this study is given below:
What are the possible nursing strategies that can be implemented to reduce high
prevalence of chronic mental illness among patients?
Research topic
Mental disorders, commonly referred to as psychiatric disorder or mental illness are
broadly defines as mental or behavioral patterns that are found to result in the significant distress
among individuals. This in turn contributes to an impairment of personal functioning. The
features associated with mental illness are often relapsing, persistent and remitting. Furthermore,
they are also found to occur as single episodes. The outcome and likely course of common
mental disorders generally vary and are often dependent on a plethora of factors that are related
to the disorder, the individual, or the social environment (Corrigan, Druss & Perlick, 2014).
While some mental disorders are transient, others are chronic in nature. The widely prevalent
chronic mental illnesses are schizophrenia, depression, psychotic disorders, and bipolar affective
disorder. The research was focused on identification of appropriate strategies that can be
implemented across the nation, with the aim of treating the symptoms that are manifested by
individuals, suffering from these chronic mental illnesses. The research topic relates to the
National Strategic Framework for Chronic, an extensive collaboration between the states and
territories and the Commonwealth, and governments. The fact that the framework has been
formulated with the aim of utilizing high level evidences and guidelines that will facilitate the
implementation of coordinated and effective national response to all chronic conditions makes
the research question appropriate in this context. Furthermore, the framework also focuses on the
enforcement of health plans according to the reviews provided by the National Mental Health

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Commission. Thus, evidences collected by use of this research question will enhance the major
attributes of the framework.
Literature review
Schizophrenia refers to a chronic mental illness that is found to affect approximately one
percent of the global population. Patients suffering from schizophrenia manifest symptoms that
include hallucinations, delusions, difficulty with concentration and thinking, and lack of
motivation (Erritty & Wydell, 2013). One research article included in the literature review
focused on the use of group music therapy for reducing psychiatric symptoms related to
schizophrenia and depression among patients suffering from these two chronic mental illnesses
(Lu et al., 2013). Upon implementation of this intervention in the target population, statistically
significant differences were observed in the psychiatric symptoms related to schizophrenia
(p < .05) and depression status (p < .05). Impacts of this intervention in future nursing practice
encompass the fact that group music therapy group improvisations have been recognized as an
essential tool that works with a group of clients who fail to communicate successfully, with the
use of appropriate verbal means. Patients with chronic mental illness demonstrate difficulties in
communication and expression, thereby demonstrating rejection in their relationships. Thus, the
intervention of group music therapy can be put to nursing practice to allow the mentally
disadvantaged patients to display themselves in different context. The nurse will act as the
facilitator or communication bridge, thereby allowing the patients to gain an awareness and
knowledge of their self, and others, which in turn will facilitate the development of relationships
(Solli, Rolvsjord & Borg, 2013). Further benefits of the intervention in nursing practice include
its role in enhancing self-expression and non-verbal communication skills, thereby reinforcing
self-esteem.

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Another article included in the literature review focused on the benefits of Cognitive
Behavioral Social Skills Training (CBSST) as effective psychosocial intervention for older
patients with schizophrenia (Granholm et al., 2013). Upon administration of this group therapy
that involved social skills training, in combination with cognitive behavior therapy, among
veteran and non-veteran clients suffering from the aforementioned chronic mental disorder,
significant improvements were observed in their functional trajectories over time, especially
among the clients who had severe defeatist performance related attitudes. The benefits of this
therapy in the scope of nursing practice can be attributed to the fact that it is imperative for all
nursing professionals to develop approaches that improve behavioral, social, and vocational
functioning (Medalia & Saperstein, 2013). This is an essential goal of treatment for client
suffering from serious mental illness, such as, schizophrenia. The CBSST will target ranges of
multidimensional deficits, which might result in functional disability of the mentally ill patients
(Bellack et al., 2013). Further importance of this evidence can be related to its benefits in
challenging thoughts, and helping in problem solving.
The article that focused on use of counseling and acupuncture for treating the chronic
disorder of depression can also be utilized as essential evidence because the findings that
encompassed reduction of depression symptoms are generalisable to typical settings and patients
(MacPherson et al., 2013). Owing to the cost-effectiveness of the two recognized strategies, both
of them can be effectively implemented by nurses across all healthcare settings, in Australia,
thereby bringing about significant improvements in the persistent low mood and social
withdrawal symptoms that the depression patients suffer from. The interventions will not only
alleviate symptoms of chronic mental illnesses, but will also cure the root cause of the mental
disorder. Furthermore, acupuncture will also provide assistance in correcting imbalance in the

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internal environment of the body (Engel et al., 2014). Nursing professionals who adopt methods
of counseling for treating the patients having chronic mental disorders will help the latter
improve their communication and interpersonal skills. The intervention will also prove beneficial
in increasing self-esteem and self-acceptance among the patients (Draguns, 2013). Moreover, the
patients will also gain the ability to alter or modify changes and self-defeating habits and
behaviour. This in turn will result in better management and expression of emotions that will
provide the much needed relief from depression.
Another article included in the search focused on investigating the role of Dialectical
behavior therapy (DBT) in treating high suicide risk patients suffering from Borderline
Personality Disorder (Linehan et al., 2015). Following recruitment of the patients, and
administration of this intervention for a specified time period, greater improvements were
observed in the rates of nonsuicidal self-injury and depression among the participants.
Furthermore, the therapy was also found to be effective in reducing depression symptoms
associated with suicidal ideations, among the patients. Effectiveness of this therapy lies in the
fact that Dialectical behavior therapy (DBT) has proved effective in providing the clients with
skills for managing painful emotions and decreasing conflicts in relationships. DBT specifically
focuses on delivery of therapeutic skills in four major areas: (1) mindfulness focuses on the
improvement of an individual's ability for accepting and being present at the current moment; (2)
distress tolerance is aimed towards increasing the tolerance of an individual for negative
emotions, rather than making him/her attempt escaping from it; (3) emotion regulation
encompasses several strategies that change and manage intense emotions, which lead to the
development of a range of problems in the person’s life; and (4) interpersonal effectiveness that
involves several techniques to allow a person better communicate with the people surrounding

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him/her, in a way, which is assertive, and helps to maintain self-respect, and strengthen
relationships (Miller, Carnesale & Courtney, 2014).
Recommendations
Research studies conducted over the past decade suggests that the most prevalent chronic
mental illnesses such as, depression, schizophrenia, and personality disorders are preventable
(Kazdin & Rabbitt, 2013). Thus, there is a need to adopt methods that allow the nursing
professionals, and psychiatrists in averting the symptoms associated with such disorders. The
presence of one or several risks factors increases the likelihood of an individual to get affected
by mental disorders, which in turn will create adverse health outcomes. Thus, efforts must be
taken to conduct studies that thoroughly recognize the social, genetic and interpersonal risk
factors that might make a person more susceptible to get affected by these chronic health
conditions. There is a need for all healthcare organizations to abide by or show adherence to the
National health policies that have been formulated by the Australian government, to effectively
manage the high prevalence of mental illness. Conducting clinical trials will also form an
essential part of the research and will act as the heart of medical advances, the results of which
can be adopted by the National Strategic Framework, detect, and prevent chronic mental
illnesses.

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References
Bellack, A. S., Mueser, K. T., Gingerich, S., & Agresta, J. (2013). Social skills training for
schizophrenia: A step-by-step guide. Guilford Publications.
Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on
seeking and participating in mental health care. Psychological Science in the Public
Interest, 15(2), 37-70.
Draguns, J. G. (2013). Cross-cultural counseling and psychotherapy: History, issues, current
status. Cross-Cultural Counseling and Psychotherapy: Pergamon General Psychology
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Engel, C. C., Cordova, E. H., Benedek, D. M., Liu, X., Gore, K. L., Goertz, C., ... & Ursano, R.
J. (2014). Randomized effectiveness trial of a brief course of acupuncture for
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Erritty, P., & Wydell, T. N. (2013). Are lay people good at recognising the symptoms of
schizophrenia?. PLoS One, 8(1), e52913.
Granholm, E., Holden, J., Link, P. C., McQuaid, J. R., & Jeste, D. V. (2013). Randomized
controlled trial of cognitive behavioral social skills training for older consumers with
schizophrenia: defeatist performance attitudes and functional outcome. The American
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Kazdin, A. E., & Rabbitt, S. M. (2013). Novel models for delivering mental health services and
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Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., ... &
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Lu, S. F., Lo, C. H. K., Sung, H. C., Hsieh, T. C., Yu, S. C., & Chang, S. C. (2013). Effects of
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controlled trial. PLoS medicine, 10(9), e1001518.
Medalia, A., & Saperstein, A. M. (2013). Does cognitive remediation for schizophrenia improve
functional outcomes?. Current opinion in psychiatry, 26(2), 151-157.
Miller, A. L., Carnesale, M. T., & Courtney, E. A. (2014). Dialectical behavior therapy.
In Handbook of Borderline Personality Disorder in Children and Adolescents (pp. 385-
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Solli, H. P., Rolvsjord, R., & Borg, M. (2013). Toward understanding music therapy as a
recovery-oriented practice within mental health care: A meta-synthesis of service users'
experiences. Journal of Music Therapy, 50(4), 244-273.