A Person-Centered Approach to Managing Depression in Pregnant Teen

This case study focuses on Janice, a 17-year-old pregnant Aboriginal woman experiencing depression. The case details her socio-demographic background, including a history of substance abuse, type 2 diabetes, and psychological problems. The presenting issues include worries about financial stability and the high suicide rates in her community, leading to a provisional diagnosis of Depression DSM-5. A person-centered care plan is proposed, emphasizing the patient's strengths, addressing barriers like financial issues and suicide risks, and setting short-term objectives such as stress reduction and family support. Interventions include self-care, psychotherapy, and potentially antidepressants. A formulation matrix is used to analyze predisposing, precipitating, perpetuating, and protective factors related to Janice's biological, psychological, and social circumstances. Desklib offers a wealth of similar case studies and resources for students.

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

2NURSING ASSIGNMENT
Socio demographics
The socio-demographic data as obtained from the given case study shows the
following:
Name of the patient: Janice
Gender- Female
Age- 17 years
Current health status- 20 weeks pregnant
Origin- Aboriginal community
Past drug history- petrol sniffing and drinking alcohol from 10 years of age
Past medical history- Type 2 diabetes, psychological problems which needed mental health
care.
Education- Left school at 14 years of age
Marital status- not married, lives with partner
Family income- Below average
Primary carer- Grandmother
Presenting issues and provision diagnosis
The presenting issues for Janice includes being worried about her baby as there she
and her partner are facing financial crisis, therefore she is worried that how will they take
care of the baby financially. Janice also seems to be worried due to the increased number of
suicides taking place in their community. She also got very emotional after her cousin had
hanged himself almost 3 months ago. She also reported that her family has gone through lot

3NURSING ASSIGNMENT
of bad luck which makes her quite sad because of which sometimes it is even difficult for her
to get out of bed. Most of times she stays aloof and the family can even recognise her on
some occasions. The issues also stated that she has been previously treated by a psychologist
and a traditional healer for mental health, however now she doesn’t want to see anyone
regarding this issue. She showed symptoms like headaches, lack of concentration, continuous
feeling of tiredness along with aches and pains.
The provision diagnosis in the case of Janice is Depression DSM-5. The diagnostic
criteria for DSM-5 includes depressed mood along with loss of interest or pleasure which are
evidently shown by Janice. She also shows a decrease in appetite as well as slowing down of
thought and reduced physical movement according to the diagnostic criteria of DSM-5 (Stein
et al., 2014). Often there are feelings of guilt along with worthlessness. She also finds it
difficult to concentrate or think clearly almost every day.
Person Centred Care Plan for Depression
Goal/s: To manage depression for the patient before the birth of the child so that it
does not affect the pregnancy of the patient.

4NURSING ASSIGNMENT
Strengths to draw upon:
The strengths include support
received from the partner and her
grandmother. She now wants to improve in
her studies so that she can learn to read
books for her baby. Although she has been
away from her family for a long times, she
now wants to meet her mother and is
anxious to see her again.
Barriers which interfere:
The barriers are the prevailing risks
of depression like the high rates of suicides
in the community. Additionally there are
financial issues.

5NURSING ASSIGNMENT
Short term objectives:
Short terms objectives include making her feel relaxed and avoid getting stressed
out regarding the prevailing situation. She needs to be more near the contact of her family
so that she can enjoy her life and her pregnancy. The patient should be kept away from
disturbing situations (Rai et al., 2013).
Interventions and action steps:
Self-care is an important intervention that needs to be implemented like
maintaining a diet or losing some weight because of the prevalence of type 2 diabetes
(Thombs et al., 2014). Support from the primary carer is essential for the well-being of the
patient. Implementation of psychotherapy is recommended as a first-line treatment. Taking
of anti-depressants might also be recommended which needs to be decided by the
physician (Talley, 2013).

6NURSING ASSIGNMENT
Formulation matrix
The formulation matrix helps to provide individualised care to the individualised care
to the individuals who required mental health care (Bragazzi & Del Puente, 2014). The
matrix addresses the precipitating factors along with the perpetuating factors, predisposing
factors and the protective factors that is related to the biological, psychological and the social
factors of the patient (Jorge et al., 2015).

7NURSING ASSIGNMENT
Precipitating
factors
(immediate
factors that have
caused the
presenting
issue/s)
Predisposing
factors
(factors in the
person's history
that makes them
more susceptible
to the presenting
issue/s)
Perpetuating
factors
(factors that are
causing the
person's
presenting
issue/s to
continue or
worsen)
Protective
factors
(factors that
provide
resilience and
strength and
help to
mitigate the
presenting
issue/s)
Biological
factors
Pregnancy
Past drug use as
a child
Type 2 diabetes Presence of
the baby
Psychological
factors Guilt for death of
cousin, feeling of
lingering bad
luck in the
Brought up in
foster homes
Death of the
cousin who
hanged himself
Support from
partner and
grandmother

8NURSING ASSIGNMENT
family
Social factors
Distance from
parents ,
Financial
conditions ,
suicides in the
community
Abused in the
foster homes.
No such
relationship with
the parents
Poor financial
condition of the
family
Proper self-
care

9NURSING ASSIGNMENT
References
Bragazzi, N. L., & Del Puente, G. (2014). A proposal for including nomophobia in the new
DSM-V. Psychology research and behavior management, 7, 155.
Jorge, M. S. B., Diniz, A. M., Lima, L. L. D., & Penha, J. C. D. (2015). Matrix support,
individual therapeutic project and prodution in mental health care. Texto & Contexto-
Enfermagem, 24(1), 112-120.
Rai, D., Lee, B. K., Dalman, C., Golding, J., Lewis, G., & Magnusson, C. (2013). Parental
depression, maternal antidepressant use during pregnancy, and risk of autism
spectrum disorders: population based case-control study. Bmj, 346, f2059.
Stein, D. J., McLaughlin, K. A., Koenen, K. C., Atwoli, L., Friedman, M. J., Hill, E. D., ... &
Alonso, J. (2014). DSM‐5 and ICD‐11 definitions of posttraumatic stress disorder:
Investigating “narrow” and “broad” approaches. Depression and anxiety, 31(6), 494-
505.
Talley, L. (2013). Stress management in pregnancy. International Journal of Childbirth
Education, 28(1).

10NURSING ASSIGNMENT
Thombs, B. D., Arthurs, E., Coronado-Montoya, S., Roseman, M., Delisle, V. C., Leavens,
A., ... & Coyne, J. C. (2014). Depression screening and patient outcomes in pregnancy
or postpartum: a systematic review. Journal of Psychosomatic Research, 76(6), 433-
446.