RESUMEN
BACKGROUND AND PURPOSE: Although the prevalence of dissociative disorders (DDs) is up to 10 percent of the general population, psychiatric-mental health (PMH) registered nurses lack education on how to care for individuals diagnosed with these disorders. METHOD: Sixty-two PMH nurse educators completed an anonymous online survey about their perceptions of teaching DDs to nursing students. Braun and Clarke's six-phase framework was used to conduct an inductive, reflexive thematic analysis of the data. RESULTS: Three primary themes were identified: lack of resources, differing opinions on the value of teaching DDs, and stigma. CONCLUSION: Though roughly 75 percent of participants reported that they teach DDs to their nursing students, they endorsed concerning misperceptions about the diagnoses. By failing to properly educate future PMH RNs about DDs, individuals with DDs are at risk of receiving inadequate and inappropriate nursing care and experiencing poor outcomes.
Asunto(s)
Trastornos Disociativos , Docentes de Enfermería , Enfermería Psiquiátrica , Humanos , Docentes de Enfermería/psicología , Enfermería Psiquiátrica/educación , Femenino , Trastornos Disociativos/enfermería , Adulto , Masculino , Encuestas y Cuestionarios , Persona de Mediana Edad , Actitud del Personal de Salud , Bachillerato en Enfermería , Estudiantes de Enfermería/psicologíaRESUMEN
For professionals confronted with intrafamily violence, being aware of the phenomena of the hold of the perpetrator and understanding its devastating psychotraumatic mechanisms are key to being able to provide better protection, information and care to the victims. Their behaviour, which seems paradoxical, arouses doubts and sometimes even brings into question the victims, when they are actually suffering from traumatic dissociation and memory of the violence.
Asunto(s)
Trastornos Disociativos/enfermería , Trastornos Disociativos/psicología , Violencia Doméstica/psicología , Rol de la Enfermera/psicología , Relaciones Enfermero-Paciente , Trastornos por Estrés Postraumático/enfermería , Trastornos por Estrés Postraumático/psicología , Adulto , Niño , Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/psicología , Trastornos Disociativos/diagnóstico , Dominación-Subordinación , Femenino , Humanos , Masculino , Recuerdo Mental , Maltrato Conyugal/diagnóstico , Maltrato Conyugal/psicología , Trastornos por Estrés Postraumático/diagnósticoRESUMEN
A person having suffered traumatic life events may find relief in the formation of symptoms. Anorexia can therefore be envisaged as a way of facing up to the trauma, both as a means of positioning oneself, as well as a solution for relieving the traumatic suffering. However, giving up these symptoms is sometimes difficult, as the case of Léa demonstrates.
Asunto(s)
Anorexia Nerviosa/enfermería , Incesto/psicología , Acontecimientos que Cambian la Vida , Adaptación Psicológica , Adolescente , Anorexia Nerviosa/psicología , Anorexia Nerviosa/terapia , Niño , Preescolar , Mecanismos de Defensa , Trastornos Disociativos/enfermería , Trastornos Disociativos/psicología , Trastornos Disociativos/terapia , Femenino , Hospitalización , Humanos , Terapia PsicoanalíticaRESUMEN
Domestic violence often just reproduces the repeated violence suffered as a child. The treatment of a female victim depends a lot on her traumatic past, and the care is designed in coordination with various partners. By improving the identification and care of children who are so-called witnesses to family violence, but who are really co-victims, in other words abused, it is possible to avoid violence in all its forms being reproduced across the generations.
Asunto(s)
Trastornos de Ansiedad/enfermería , Trastorno Depresivo/enfermería , Trastornos Disociativos/enfermería , Violencia Doméstica/prevención & control , Violencia Doméstica/psicología , Maltrato Conyugal/psicología , Maltrato Conyugal/rehabilitación , Trastornos por Estrés Postraumático/enfermería , Adulto , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/psicología , Niño , Maltrato a los Niños/psicología , Maltrato a los Niños/rehabilitación , Abuso Sexual Infantil/psicología , Abuso Sexual Infantil/rehabilitación , Terapia Combinada , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Femenino , Humanos , Relaciones Enfermero-Paciente , Apego a Objetos , Psicoterapia , Psicoterapia de Grupo , Delitos Sexuales/prevención & control , Delitos Sexuales/psicología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicologíaRESUMEN
Around the clinical situation of a patient presenting an acute and transient psychotic disorder, the importance of team work becomes evident. Nursing care is present in all phases of the patient's care, from admission to discharge, including in the isolation room and the electroconvulsive therapy sessions. Presence, support, reassurance as well as the bond with the family are cornerstones of the nursing care.
Asunto(s)
Deluciones/enfermería , Alucinaciones/enfermería , Trastornos Psicóticos/enfermería , Enfermedad Aguda , Adolescente , Antipsicóticos/uso terapéutico , Terapia Combinada , Conducta Cooperativa , Deluciones/diagnóstico , Deluciones/psicología , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/enfermería , Trastornos Disociativos/psicología , Terapia Electroconvulsiva/enfermería , Femenino , Alucinaciones/diagnóstico , Alucinaciones/psicología , Humanos , Relaciones Enfermero-Paciente , Grupo de Enfermería , Admisión del Paciente , Alta del Paciente , Aislamiento de Pacientes , Relaciones Profesional-Familia , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicologíaRESUMEN
Sexually transmitted infections are a significant public health issue impacting women. Intimate partner violence (IPV) is one risk factor for STIs/HIV. Women who are the victims of IPV often experience psychological difficulties, including dissociation. Dissociative symptoms may play a role in women's ability to practice safe sex and negotiate condom use, although this has been underexplored. This mixed methods study examined the dissociative symptoms of 22 women experiencing IPV and examined the ways in which these women described their own sexual health and behaviors as well as how they protected themselves from sexually transmitted infections and HIV.
Asunto(s)
Trastornos Disociativos/enfermería , Delitos Sexuales/psicología , Enfermedades de Transmisión Sexual/enfermería , Maltrato Conyugal/psicología , Adulto , Conducta Anticonceptiva/psicología , Trastornos Disociativos/psicología , Femenino , Infecciones por VIH/enfermería , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Humanos , Persona de Mediana Edad , Delitos Sexuales/prevención & control , Conducta Sexual/psicología , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/psicología , Maltrato Conyugal/prevención & control , Sexo Inseguro/prevención & control , Sexo Inseguro/psicología , Adulto JovenRESUMEN
BACKGROUND: Oxytocin is a promising biomarker for psychiatric conditions arising from early relational trauma, childhood maltreatment, and attachment dysregulation, including posttraumatic stress and dissociative disorders. OBJECTIVE: This exploratory pilot study examined plasma oxytocin as a biomarker for alterations in the attachment system. DESIGN: We used a single group, repeated-measures design with 15 women. The protocol used a film clip previously validated as a provocation to the hypothalamic-pituitary-adrenal axis. RESULTS: The repeated-measures ANOVA showed differences in oxytocin across the three time points. Correlations with oxytocin indicated that measures of dissociation and somatization correlated most strongly with higher levels of oxytocin measured during exposure to the film's bonding scene and posttraumatic stress disorder correlated most strongly with lower levels at the film's abandonment scene. Post hoc analyses revealed differences in oxytocin response related to psychopathology. CONCLUSION: Replication studies should characterize participants on a range of psychiatric conditions associated with attachment dysregulation.
Asunto(s)
Oxitocina/sangre , Trastorno de Vinculación Reactiva/sangre , Trastorno de Vinculación Reactiva/enfermería , Estrés Psicológico/sangre , Estrés Psicológico/enfermería , Adolescente , Adulto , Nivel de Alerta/fisiología , Biomarcadores/sangre , Trastornos Disociativos/sangre , Trastornos Disociativos/enfermería , Trastornos Disociativos/psicología , Femenino , Humanos , Sistema Hipotálamo-Hipofisario/fisiopatología , Apego a Objetos , Proyectos Piloto , Sistema Hipófiso-Suprarrenal/fisiopatología , Valores de Referencia , Trastornos Somatomorfos/sangre , Trastornos Somatomorfos/enfermería , Trastornos Somatomorfos/psicología , Estadística como Asunto , Trastornos por Estrés Postraumático/sangre , Trastornos por Estrés Postraumático/enfermería , Trastornos por Estrés Postraumático/psicología , Estrés Psicológico/complicaciones , Estrés Psicológico/psicología , Estudiantes/psicología , Adulto JovenAsunto(s)
Internamiento Obligatorio del Enfermo Mental/legislación & jurisprudencia , Trastornos Disociativos/enfermería , Consentimiento Informado/legislación & jurisprudencia , Rol Judicial , Trastornos Mentales/enfermería , Adulto , Conducta Cooperativa , Conducta Peligrosa , Deluciones/enfermería , Deluciones/psicología , Deluciones/rehabilitación , Trastornos Disociativos/psicología , Trastornos Disociativos/rehabilitación , Francia , Humanos , Comunicación Interdisciplinaria , Entrevista Psicológica , Masculino , Trastornos Mentales/psicología , Trastornos Mentales/rehabilitación , Alta del Paciente/legislación & jurisprudenciaAsunto(s)
Trastornos Disociativos/enfermería , Trastornos Somatomorfos/enfermería , Adaptación Psicológica , Adolescente , Animales , Niño , Preescolar , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/terapia , Femenino , Humanos , Acontecimientos que Cambian la Vida , Masculino , Ludoterapia , Trastornos Somatomorfos/diagnóstico , Trastornos Somatomorfos/terapiaRESUMEN
Less well-known among the psychiatric disorders, dissociation is one of the most common underlying symptoms of individuals seeking mental health care (Maldonado, 2001). Closely associated with post-traumatic stress disorder, dissociation characteristics may include inconsistent consciousness, autobiographical forgetfulness, difficulties in self-regulation, regressions, alternate identities, disorganization in the development of a cohesive sense of self, depersonalization, and derealization (Trickett, Noll, Reiffman & Putnam, 2001). The major constructs and dimensions of the dissociative symptom disorders in adults are introduced. Several of the most prominent psychometric instruments that nurses and other mental health clinicians may use as adjuncts to diagnosis and treatment are described.
Asunto(s)
Trastornos Disociativos , Enfermeras Practicantes , Pautas de la Práctica en Medicina/organización & administración , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/enfermería , Trastornos Disociativos/psicología , HumanosRESUMEN
Dissociative identity disorder is a rare diagnosis, although people currently with a diagnosis of psychosis may in fact be experiencing what is associated with the disorder. This article is co-authored by a nurse and a person who has lived with alters (multiple personalities) for nearly all of her life. Because of the rarity of the diagnosis, there is much misunderstanding and ignorance among lay people and mental health professionals. This article therefore clarifies historical and contemporary issues surrounding this particular mental health problem both through examining the literature and through narrative of the person's experience. Special attention is given to the reality of coping with the difficulties that dissociative identity disorder create.
Asunto(s)
Adaptación Psicológica , Trastornos Disociativos/psicología , Trastornos Disociativos/terapia , Trastornos Disociativos/enfermería , Humanos , Narración , Enfermería Psiquiátrica/métodos , Calidad de Vida/psicologíaAsunto(s)
Enfermería Psiquiátrica , Trastornos por Estrés Postraumático/enfermería , Adaptación Psicológica , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/enfermería , Trastornos Disociativos/psicología , Femenino , Humanos , Persona de Mediana Edad , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicologíaRESUMEN
Dissociation is a defence mechanism whereby individuals under stress separate affect and/or behaviour from the normal flow of consciousness. It is common in people who have experienced trauma. A Dissociative Experience Scale was used to study 51 subjects who were members of inpatient or outpatient substance abuse programmes. Thirty per cent of the group scored 15 or higher, suggesting that dissociative events are common in this population. Nurses need to understand the phenomenon of dissociation and the relationship between trauma, dissociation and substance abuse. This will enhance their assessment of patients and increase their knowledge base regarding appropriate treatment.
Asunto(s)
Trastornos Disociativos/diagnóstico , Trastornos Disociativos/enfermería , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/enfermería , Adulto , Trastornos Disociativos/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Enfermería PsiquiátricaRESUMEN
This paper presents the results of an action research study into the acute care experience of Dissociative Identity Disorder. The study, which was grounded in principles of critical social science, utilized focus group interviews and narrative construction. Nurses and patients are under-represented in all clinical evaluation and their voices need to be heard if services are to be truly collaborative. Findings of the study extend intrapsychic theories of trauma to emphasize the interpersonal relationship between nurse and person who can work together to facilitate recovery from trauma, make connections both intra and interpersonally and build resilience.
Asunto(s)
Actitud del Personal de Salud , Actitud Frente a la Salud , Trastornos Disociativos/enfermería , Trastornos Disociativos/psicología , Relaciones Enfermero-Paciente , Personal de Enfermería en Hospital/psicología , Enfermería Psiquiátrica/métodos , Enfermedad Aguda/enfermería , Enfermedad Aguda/psicología , Adaptación Psicológica , Conducta Cooperativa , Femenino , Grupos Focales , Investigación sobre Servicios de Salud , Conducta de Ayuda , Humanos , Maquiavelismo , Masculino , Investigación Metodológica en Enfermería , Enfermería Psiquiátrica/normas , Teoría Psicológica , Apoyo Social , Transferencia PsicológicaRESUMEN
TOPIC: How advanced practice nurses can work with trauma survivors to decrease dissociation as a needed coping mechanism. PURPOSE: To review the literature on trauma and dissociation as well as current treatment perspectives. SOURCES: Review of the literature and authors' clinical experience. CONCLUSIONS: Advanced practice nurses can use knowledge of selected psychopharmacological medications and Erikson's stages of psychosocial development to plan treatment for posttrauma clients.
Asunto(s)
Trastornos Disociativos/enfermería , Psicoterapia , Trastornos por Estrés Postraumático/enfermería , Terapia Combinada , Trastornos Disociativos/psicología , Humanos , Enfermeras Clínicas , Evaluación en Enfermería , Psicotrópicos/administración & dosificación , Trastornos por Estrés Postraumático/psicologíaRESUMEN
The intensive care unit syndrome (ICU syndrome) is defined as an altered emotional state occurring in a highly stressful environment, which may manifest itself in various forms such as delirium, confusion, crazy dreams or unreal experiences. The purpose of this part of a study of patients' experiences is to describe and illuminate patients' experiences of acute confusion, disorientation, wakefulness, dreams and nightmares during and after their stay in the ICU. The data were obtained from 19 ventilated patients, who were interviewed twice and had stayed at least 36 hours in the ICU, the first interview being about one week after discharge from the ICU, and the second 4-8 weeks later. The hermeneutic approach used when interpreting and analysing the text from the interviews revealed that patients' experiences of unreal experiences were often associated with intense fear. Intense or continuous unbearable fear seems to result in frightening unreal experiences, which further increase the level of fear. Care actions or caring relationships with relatives or nurses can reduce this fear, which can help to prevent the occurrence and/or duration and intensity of the unreal experiences. Trust and confidence in nurses or significant others and feelings of self-control or trust in self-control seemed to reduce the risk of unreal experiences so that adverse stimuli might only trigger a mild confusion.
Asunto(s)
Actitud Frente a la Salud , Confusión/psicología , Cuidados Críticos/psicología , Trastornos Disociativos/psicología , Trastornos Psicóticos/psicología , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Confusión/etiología , Confusión/enfermería , Cuidados Críticos/métodos , Trastornos Disociativos/etiología , Trastornos Disociativos/enfermería , Femenino , Humanos , Estudios Longitudinales , Masculino , Investigación Metodológica en Enfermería , Personal de Enfermería en Hospital , Trastornos Psicóticos/etiología , Trastornos Psicóticos/enfermería , Respiración Artificial/enfermería , Respiración Artificial/psicología , Encuestas y Cuestionarios , SíndromeRESUMEN
Women diagnosed with Dissociative Identity Disorder (DID) may experience episodic crises characterized by intense states of disconnection from self and others. Crises which result in potential harm to self/others may require inpatient treatment. With economic emphasis on shorter lengths of stay, a treatment program or model which focuses on the DID patient's sense of connectedness to self and others can enhance treatment efforts during brief inpatient hospitalizations. The Relational Model of Jean Baker Miller uses mutuality and empowerment within the therapeutic relationship and inpatient mileu to move the patient beyond therapeutic impasse/crisis toward a state of greater connectedness to self and others.
Asunto(s)
Trastornos Disociativos/enfermería , Psicoterapia/métodos , Mujeres/psicología , Adulto , Femenino , Feminismo , Humanos , Relaciones Interpersonales , Modelos PsicológicosRESUMEN
Nursing care of the alcoholic patient becomes multifaceted and complex with the presence of a psychiatric-mental health disorder. Although issues surrounding dual-diagnosis patients have been addressed in the literature, there is a paucity of research and theory regarding care of the patient who has both alcoholism and dissociative identity disorder. This article presents a synthesis of the nursing literature with the author's experience to elucidate factors that enhance healing. Nursing interventions that are unique and sensitive for the alcoholic patient with dissociative identity disorder are discussed.