Analysis of Schizophrenia Treatment Strategies and Nursing Role

This report provides an in-depth analysis of treatment strategies for schizophrenia, encompassing both medical and non-medical approaches. The medical strategy focuses on Clozapine, a highly effective antipsychotic, while acknowledging its potential adverse effects like neutropenia and the need for REMS. The report also examines psychoeducation as a non-medical intervention, emphasizing its strength in improving patient outcomes and the importance of family involvement. However, it recognizes the limitations of psychoeducation as a stand-alone treatment, particularly in severe cases. The report further highlights the crucial role of nurses in managing these treatment strategies, including medication monitoring, communication with patients and families, and ensuring safe implementation of medical interventions. The conclusion underscores the importance of a collaborative approach, combining medical and non-medical strategies, for effective schizophrenia management and patient safety.

Schizophrenia

TABLE OF CONTENT
PART B ...........................................................................................................................................1
INTRODUCTION...........................................................................................................................1
Treatment strategies for Schizophrenia ..........................................................................................1
Medical strategy (Clozapine).......................................................................................................1
Non-medical strategy (Psychoeducation)....................................................................................2
Role of nurses in managing and implementing treatment strategies ..............................................3
CONCLUSION ...............................................................................................................................4
REFERENCES................................................................................................................................5

PART B
INTRODUCTION
Schizophrenia is one of the most severe and chronic disorder which requires lifelong
treatment and management. Along with the medical strategies the patients and service users are
also provided non-medical strategies such as psychoeducation. Both the strategies seems to be
effective and their role depending upon the situation of patient (Mohr & et.al., 2018). The nurses
plays an important role in the management of this chronic disorder along with the family
members. This part of the report will analyse the strength and weakness of both types of
treatment strategies. It will also highlight the role of nursing interventions and management in
treatment of Schizophrenia.
Treatment strategies for Schizophrenia
Medical strategy (Clozapine)
Clozapine is known to be highly effective antipsychotic and is preferred medical strategy
for the treatment of schizophrenia. Despite its high effectiveness the drug is only limited to
schizophrenic patients who do not show adequate response to other antipsychotics available for
the disease. According to Porcelli & et.al., (2016) drug requires extensive monitoring on dosage
and impact as it leads to adverse impacts such as myocarditis, neutropenia and agranulocytosis.
The people with treatment resistance schizophrenia shows a significant reduction in the
hospitalization and symptoms with the use of this medical strategy. Clozapine is very helpful and
effective in rebalancing the serotonin and dopamine in the body so that thinking ability,
behaviour and mood can be controlled. The drug seems to be effective in terms of improving
suicidal behaviour, delusions, hallucinations and other critical symptoms of schizophrenia.
Though drug is beneficial but it has serious health implications among patients.
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Clozapine reduces a specific type of while blood cell (neutrophils) in the body which
gives immunity to cells. Thus, with the decrease in the number of neutrophils individuals
becomes more prone to infections leading to deaths and extreme health complexities. Due to this
reason the medical strategy is used in extremely controlled environment and forms the basis of
REMS (Clozapine risk evaluation and mitigation strategy). Contrary to this Kulhara, Grover &
Kate, (2015) states that complications such as myocarditis is very rare and only less than 1%
people may account to risk of developing agranulocytosis due to this medical strategy. Despite
having these serious risk implications the medical strategy is considered as last line treatment for
the schizophrenia patients in vulnerable or severe condition.
Non-medical strategy (Psychoeducation)
Along with the medical strategy another intervention used by the health professionals is
psychoeducation. With this non-medical strategy schizophrenia patients as well as their family
members are provided education and information regarding management of disease. The family
plays an important role in the treatment of mental disorders. As compare to the medical strategies
for schizophrenia one of the key strength of psychoeducation approach is that it provides more
improved health outcomes to the patient. Along with the diagnosis, treatment and adverse impact
of medications the treatment also involves risk assessment for the disease and health outcomes of
the patient.
However, as per the view of Hercelinskyj & Alexander, (2019) the psychoeducation
method suffers from a significant weakness that it cannot be applied stand-alone. This weakness
become more particular among the patients suffering from severe schizophrenia. The people with
the early stages of the disease can be treated effectively and their hospitalization events can be
reduced greatly by only psychoeducation. However, with the increasing severity the treatment
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tends to act as only supporting strategy instead of leading treatment method. It has been analysed
that most of the individuals observe deteriorating condition and clinical outcomes in case of
schizophrenia. The main rationale for such outcomes is that patient and their family members
does not understand the severity of mental illness and importance of treatment strategies.
Another advantage of this treatment approach is that along with the patient other carers
are also included in the care plan and interventions so that improved care outcomes are received
at the earliest and with better support. For the safety of patients it has been mandatory that both
medical and non-medical treatment approaches are works or applied in collaboration. It has been
also evaluated that many patients and their family members are not aware of informed about the
side effects of taking Clozapine (Mohr & et.al., 2018).
One of the limitation or weakness of this treatment approach is that with schizophrenia
patients most of the health professionals as well as family members used to prefer only
medications or medical treatment. The psychoeducation approach is not given priority by the
professionals and thus there are higher vulnerabilities that patient and carers remain unaware of
the other complications related to schizophrenia treatment strategies. In addition to this the non-
medical treatment strategies are not accessible to all patients or vulnerable groups. In comparison
to medical strategies psychoeducation facilities are usually not available within health care
environment.
Role of nurses in managing and implementing treatment strategies
From the above discussion it has been analysed that quality care and treatment services
can be provided to schizophrenia patients through various treatment choices. The nurses play an
important role in the management and care of schizophrenia patients. The role of nurses is
inevitable in both types of treatment interventions. There is vast range of side effects associated
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with the use of Clozapine. Thus, it is mandatory that these adverse impacts must be taken into
consideration (Mwebe, 2018) . It is the responsibility of the nurses along with the general
practitioners that they regulate and monitor the dosage of Clozapine or other psychotic drugs
used for the patients of schizophrenia.
One of the critical aspect which affects the quality of care and patient safety is effective
communication and coordination with the other team members. There are several factors or the
situations which can affect the thinking process of patients and the hospitalization events. Nurses
must have good communication with the patients and their family members so that significant
risk factors and adverse medication impacts can be analysed and identified at the earliest. The
use of medical strategies requires additional care and prevention to avoid the adverse impacts.
For example Clozapine is highly reactive with other drugs and thus nurses must assure that the
nursing interventions used by them is safe for the patient. For this purpose the nurses must also
communicate and works in collaboration with multidisciplinary teams comprising nutritionist
and psychologists.
Another important role-played by nurses is to ensure the safe implementation of medical
strategies. It is the responsibility of the registered nurses to follow the safe practices of
medications such as right dosage, time and type of medication suitable for the particular patient.
Nurses also monitor the vital symptoms and assessment so that white blood cell count and
psychological status of the patient can be measured and patient safety can be assured (Porcelli &
et.al., 2016). It has been also analysed that nurses acts as an intermediator between family
members and schizophrenic patients. The psychoeducation provided by nurses along with the
drug administration enhances the treatment effectiveness for the disease.
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CONCLUSION
It can be concluded form the above study that patients suffering from Schizophrenia can
be provided effective treatment only when medical and non-medical strategies are applied in
collaboration. It has been also analysed that intake of Clozapine is associated with several critical
risk factors which cannot be neglected from the safety perspective of patient. Thus, the drug
must be administered carefully under appropriate clinical governance. On the other hand non-
medical strategy also cannot be considered as self-sufficient treatment strategy for the severe
illness. Thus, for the quality of services both nurses must play an active role and must apply both
of these treatment strategies.
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REFERENCES
Books and Journals
Hercelinskyj, G. J., & Alexander, L. (2019). Mental Health Nursing: Applying Theory to
Practice. Cengage AU.
Kulhara, P., Grover, S., & Kate, N. (2015). Schizophrenia: Indian Research: II—Treatment
Issues. In Developments in Psychiatry in India (pp. 173-200). Springer, New Delhi.
Mohr, P. & et.al., (2018). Value of schizophrenia treatment I: The patient journey. European
Psychiatry. 53. 107-115.
Mwebe, H. (2018). Psychopharmacology: A mental health professionals guide to commonly used
medications. Critical Publishing.
Porcelli, S. & et.al., (2016). Clinical factors related to schizophrenia relapse. International
journal of psychiatry in clinical practice. 20(2). 54-69.
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