Case Study Analysis: Mental Health in Nursing (Semester 2)

This assignment analyzes a case study involving a patient, Peter, diagnosed with generalized anxiety disorder (GAD). The solution explores the nature of GAD, differentiating it from panic disorder and highlighting its prevalence in Australia. It emphasizes the importance of building a therapeutic relationship with the patient, focusing on empathy as a key element. The assignment further details the application of therapeutic communication skills, such as silence, active listening, and observation, to effectively interview and support the patient. Finally, it provides information on the prescribed medication, Paroxetine, including its uses, side effects, and proper administration, ensuring the patient's understanding and safe usage of the medication. The assignment aims to provide comprehensive patient care and improve mental health outcomes.

Mental Health in Nursing
Student's Name:
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Answer 1
In the given scenario, Peter is suffering from distress and worries which can make him sick.
Generalized anxiety disorder is defined as the disorder categorized by chronic anxiety and
concern.
A person with GAD may have physical signs such as muscle tension, chronic headaches,
irritability, fatigue and sleeping issues. GAD is the long-term disorder which causes the
individual to feel nervous about a varied problems and conditions (Stein & Sareen, 2015). In the
given case, Peter with GAD feels anxious most of his time and often struggle to evoke the last
time he feels relaxed. GAD can be caused due to several reasons such as a person having a
history of stressful experiences, painful health condition, over activity in the areas of brain and
imbalance of the brain.
GAD is quite different from Panic disorder in many ways. Panic disorder means an anxiety
disorder categorized by repetitive variations of extreme fear that complemented by various
symptoms like chest pain, abdominal distress, sweaty palms, and dizziness. Both the anxiety
disorders share common symptoms like excessive worrying that shows the mental health
condition of the person. Both the disorders are prevalent in the population of Australia. It is
found that panic disorder affects 2.3% males, 2.9% females and 2.6% other persons while
generalized anxiety disorder affects 2.0% males, 3.5% females and 2.7% other persons in
Australia (Mennin, Fresco, Ritter & Heimberg, 2015). Therefore, it can be said that GAD affects
the population more than the panic disorder. Individuals with GAD are unable to accomplish
their normal actions for 6.3 days and with panic disorder for 5.9 days as estimated by the health
government in Australia. Australian women are affected more than men by a generalized anxiety
disorder. It is analyzed that about 14% of the adult population in Australia are affected by
anxiety disorders every year (Reifels, Mills, Dückers & O'Donnell, 2017). GAD and panic
disorder may vary in terms of severity as well as complexity. GAD is identified when an
individual finds it hard to control anxiety for more days, whereas panic disorder is diagnosed
when the person worries about future attacks and change his behavior to ignore them.

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In conclusion, GAD is such an anxiety disorder that affects the person more than that of panic
disorder. The symptoms as identified in Peter, shows that he has both GAD and panic disorder.
Hence, he should take psychological therapies and medication to treat anxiety disorder.
Answer 2
The main purpose is to develop a therapeutic relationship with the patient as he suffers from an
anxiety disorder. Empathy presented by the nurses to create a therapeutic relationship with the
patient.
A therapeutic relationship is close contact between health care practitioner and the patient in
therapy (Majumder, Vostanis, Karim & O'Reilly, 2019). This relationship is essential for the
assist the persons in therapy to change their life for better. The therapists are motivated to
represent empathy in building a good therapeutic relationship with the patient. Similarly, as a
therapist, I need to show empathy to establish a therapeutic relationship with Peter. Empathy
plays a vital role in creating the relationship because it is an essential step in the recovery process
of the patient. Empathy assists me in developing a great level of trust with Peter, a greater level
of feeling secure and happy and self-understanding for Peter. Empathy is considered as a
significant feature of the therapeutic relationship and helps the therapists in therapy process
(Percy & Richardson, 2018). With the help of empathy, I can not only understand what Peter
says in the therapy session but also understand what Peter is not communicating to me.
Being high empathetic, I can help Peter in treatment and obtain a high level of understanding of
past and present experiences. I can sense the emotion of Peter through active listening as well as
concentration. Empathy enables me to understand both voiced and non-voiced signals of the
patient and assess the internal condition of Peter. Empathy also assists the therapists in building
emotional bonds which is crucial for therapeutic relationship (Williams, Brown, McKenna,
Beovich & Etherington, 2017). Establishing a relationship with Peter can encourage him to take
actions in the treatment process and improve his life. Empathetic attitude helps the therapists to
ask open questions, encourage discussion, listen to the patient actively and eliminate negative
emotions. Empathy assists in establishing a therapeutic relationship with Peter by allowing the
therapist to feel the situation and understand the sense of being closely. The relationship based
on empathy shows the quality of care given to the individual for treating the mental health

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condition. I can fully engage emotionally with the expression of the patient, along with support
Peter to manage his feelings.
In conclusion, empathy is a significant part in creating a therapeutic relationship with the patients
that helps the therapists to understand feelings as well as emotions to treat the problem.
Answer 3
Communication refers to the process of interaction between two persons to send or receive
messages. Communication skills are essential for nurses or therapists to communicate with the
patient effectively.
There are various communication skills or techniques that can be used by the nurses while
interviewing a patient in therapy. The nurses must have effective communication skills to
identify the needs as well as issues of the patients. I would use therapeutic communication skills
to interview Peter as it prioritize the mental well-being of the person, which are as follows:
Silence – It is the communication skill that allows the patient to take control of the discussion if
he wishes (Martin & Chanda, 2016). This communication skills would be used to interview Peter
because it helps him to gather his thoughts and recognize mental disorders.
Active listening – It is an essential skill of communication that allows the nurses to listen to the
patient carefully and understands both verbal and non-verbal communication (MacLean, Kelly,
Geddes & Della, 2017). Active listening would be used to interview Peter because it helps me to
observe his non-verbal behavior, understand his message, detect false messages and give
feedback regarding him.
Make observations – It is the other skill that helps in observing the behavior of the patients to
draw attention to those areas that create the problem. I would use the communication skill for
communicating with Peter because it assists me in observing his behavior, performance and
appearance.
Focusing – Focusing is the communication skill that helps the nurses to focus on the
conversation that takes place with the patients. The rationale behind using this skill is that Peter

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may mention something in the conversation that seems to be important. Thus, I can focus on his
statement and prompt him to discuss further.
Seek clarification – It assists the nurses to seek clarification for the confusing statement. By
using this skill, I can ask feedback on the accuracy of the statement. It also provides an
opportunity to correct misperceptions and promote mutual understanding between the patient and
the nurse.
Providing recognition – Recognition acknowledges the behavior of the patient and helps in
highlighting it. The rationale behind using this skill is that it indicates awareness of both Peter
and me and acknowledge his behavior.
Finally, therapeutic communication skills such as silence, active licensing, clarification,
observation and recognition will be used in the interview because it promotes quality care for the
patient.
Answer 4
I noted that Peter was commenced on Paroxetine 20mg PO daily and thus, it is required to
provide relevant information to Peter regarding the medication.
Paroxetine is the medicine used for treating depression, anxiety disorders and panic attacks
(Kapil et al., 2015). It enhances the person's mood, appetite, sleep and energy level and decreases
anxiety or fear. The medicine maximizes the amount of serotonin that produces by the body to
release in the brain as serotonin assists with anxiety and stress. It also contains various side
effects, such as to cause drowsiness, sleepiness, weakness, nausea, and dizziness (Eyre et al.,
2017). It may also make the person unable to making decisions and thinking quickly. If Peter
finds that the effects are severe, then he should go to the doctor. It is also harmful to Peter if he
uses this medicine with other medications as it prevents the medication from working well. Peter
should administer paroxetine once daily in the morning while having food. He can increase the
dose by 10mg if he finds insufficient response after a few weeks.
In the end, Peter needs to have all the information about the medicine for preventing the side-
effects and improve his mental health.

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References
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Kapil, R. P., Friedman, K., Cipriano, A., Michels, G., Shet, M., Mondal, S. A., & Harris, S. C.
(2015). Effects of paroxetine, a CYP2D6 inhibitor, on the pharmacokinetic properties of
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MacLean, S., Kelly, M., Geddes, F., & Della, P. (2017). Use of simulated patients to develop
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Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. New England Journal of
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Williams, B., Brown, T., McKenna, L., Beovich, B., & Etherington, J. (2017). Attachment and
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