Nursing Plan of Care for Schizoaffective Disorder: A Case Study

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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NURSING
Plan of care
The case study is about Miss B, a 23 years old female who had been admitted in
South Australia, due to her maniac relapse of the schizoaffective disorder. On diagnosis, she
had been diagnosed with both bipolar disorder (BD) and schizoaffective disorder.
Schizoaffective disorder is a chronic mental condition that is primarily characterized by
Schizophrenic symptoms like delusions or hallucinations like mania and depression.
Considering the environment
Considering the environment, in which Miss B had been living, it is known that the
Miss B had a prolonged disabling disorder, which affected her social functioning at all the
level. Miss. B was on disability support pension, and was living with her female friend Miss.
R, for approximately 6 months. Miss. B’s current partner Mr. T is supportive in B’s care, but
they continuously feel problem with a permanent housing issue, as none Miss B and Mr. T
have stable income. It is evident from the case study that the patient had no permanent home.
According to Rezansoff et al., (2016), treatment of psychotic disorders becomes a significant
challenge to the one that does not have proper housing facilities. There had been
experimental trials that have investigated the effect of the housing on adherence among the
patients suffering from Schizophrenia.
Hence, one of the intervention is to refer the patient to some organization that can
give the some housing support. Congregate style housing support can be provided by
organization for the adults with psychotic disorders.

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NURSING
The priorities of care
The main priorities of care that can be decided for the Miss. B are to reduce her
paranoid beliefs and delusions that the people are watching her and wanted to kill her. Other
clinical priorities of Miss. B is the treat for the mood disturbance and sleep disturbances.
Treatment for Schizoaffective disorder involves Medication, psychotherapy, skill training.
Another important clinical priority for Miss. B is the prolonged intake of the cannabis on both
the physical and psychosocial health of the patient. A bio-psychosocial model of care should
be used to empower Miss B. The patient should be encouraged to adhere to the medication
regimen and thus decreasing the rate of relapse and contributing to a higher quality of life.
Decision regarding the initiation, titration and switching medicines involves ongoing
discussions during clinical consultations.
Psychosocial aspect of care
Establishing a therapeutic relationship with the patient is one of the prime intervention
while treating a patient with mental health disorders. A therapeutic relationship can be
defined as an interaction between two people, where collaboration between both the patient
and the nurse leads to a curative situation, with the promotion of the growth and the
prevention of the disease. In order to care for the patients, the nurses requires being highly
competent and developing understanding and empathy for the patient (Kvrgic eta l., 2013). It
is necessary to see beyond the symptoms, that there is a person who is in terrible mental
suffering or who is in extreme despair and might be entertaining suicidal thoughts.
Psychosocial interventions plays an important role in the rehabilitation and the
treatment of the patient with Schizophrenia. As per the studies, in addition to
pharmacotherapy, the patients also require the problem specific psychosocial treatment,
family psychoeducation , access to counselling of the crisis, easy availability of the inpatients

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NURSING
psychiatric care and supervised arrangements of residual lighting arrangements (Bartoli et al.,
2015). According to Mahone, Maphis, and Snow, (2016), some of the psychosocial treatment
approaches would be –
Either social skills training- Education can be provided to the patient individually or in
groups, that involves systematic teaching of the patient behaviour.
Family psych education- Working with the families might have positive implication on the
Schizophrenic patients. A collaborative ad a respectful relationship with the family,
providing information about the condition of the patient and teaching the family about less
stressful strategies for communicating and solving the problems. It is revealed from the case
scenario, that Mr. T provides support to Miss S. Hence, Mr. T should be educated about
psychosocial treatment.
Cognitive therapy- Self-talking, rational analysis has been found to be reduce distress in
patients suffering from hallucinations and delusions (Pfennig et al., 2014).
Cognitive rehabilitation- Efforts can be given to increase memory capacitation, attention and
high levels of problems. Cognitive behavioural therapy would include emphasis on normal
process of dealing with the adversities, use of the stimulation, role-playing and over learning.
The coping training skills would begin with external verbalization that diminishes as the
procedure is internalized.
Specific nursing Interventions
Nursing assessment of a person suffering from Schizophrenia is a complex process in
most of the cases that requires a collection of data from several sources, as the acute phase of
patients with psychotic disorder rarely gives reliable information (Hutton & Taylor, 2014). It
is evident from the case study that the patient had been suffering from delusions. Hence, in