Self-Care Deficit - Nursing Care Plan for Schizophrenia

Nursing Diagnosis and Interventions for Schizophrenia

Schizophrenia is a syndrome with various descriptions of the cause (many not yet known) and the course of the disease (not always a chronic or "deteriorating") wide, as well as a number of which depends on the balance due to the influence of genetic, physical, and social culture. Generally characterized by fundamental and characteristic deviations of mind and perception, as well as the affect that is not fair (inappropiate) or blunt. Consciousness is clear (clear consciousness) and intellectual ability is usually maintained, although certain cognitive decline may develop later.

Schizophrenia is equally prevalence between men and women. However, there are differences in the onset and course of the disease. Men have earlier onset than women. Peak age of onset for males is 15 to 25 years ; the peak age for women is 25 to 35 years. Onset of schizophrenia before age 10 years or after 50 years is very rare.

Principal symptoms of schizophrenia can be grouped into four disturbance on :
1). Natural Mind

• Thought disorder in patients with schizophrenia is a disorder of mind and the current form of the content of thought disorder. (Roan, 1997). In schizophrenic patients there was indeed a core disturbance in thought processes and is particularly disturbed association, namely :
• Patients sometimes have an unfinished idea expressed, but had other ideas arise.
• People with schizophrenia often using symbolic meaning, so that the schizophrenic mind can not be followed and understood by others.
• In patients with schizophrenia often also found what is called the blocking, ie the contents of the mind which sometimes arise stops and no idea anymore.
• Other symptoms are hallucinations that the patient feels no noises in his ears.
• Strange way of thinking (ambivalence).
• The presence of delusions are under control.
• Feeling no pain and feel self -righteous themselves (egocentric). (Yusuf and Ismed, 1991).

2). Responsiveness (Perseption)

• In this disorder can occur any illusion that an event response of an outside stimulus. Or a response in the absence of external stimuli. Major disruption of perceptual disorders are various types of true hallucinations (Roan, 1997).

3). Natural feelings
At the beginning of mood disorders , patients are usually more sensitive than normal people. Patients who appear are easily offended, irritable and sensitive to things that small should not be offended or upset. In a state of further disruption or worse, the atmosphere will actually care about the people around it (Yusuf and Ismed, 1991). Feelings or emotional disturbances in people with schizophrenia can be classified in two ways, namely :

• Mood disorder.
• Impaired expression of feelings.

In daily life the sense of disorder appears in behavior, usually expressed as :

• Chirpy (nood elevasion).
• Sad (depression).
• Lost sense (perplekxity).
• Excessive emotion.
• Loss of emotional rapport.
• Ambivalaensi (fragmented personality).

4). Behavior disorders
Behavior disorder (psychomotor) of diverse often seen , especially in the form of acute attacks and real. Schizophrenic behavior is often strange and incomprehensible. such as :

• Can occur from the great reduction in reactivity to the environment in the form of reduced movement and spontaneous activity, the patient will be stiff and reject efforts to move.
• Excessive motor movements (exited) and looks not intended and are not influenced by external stimuli (such as no noise / furor catatonic).

Lots of behavior that can be found in people with schizophrenia , but most often are :

• Restless rowdy (exitement).
• Stupor.
• Impulsive behavior. (Wibisono, S. 1998).

Nursing Care Plan for Schizophrenia

Nursing Diagnosis : Self-Care Deficit related to withdraw

General objectives :

• Clients expressed a desire to perform activities of daily living.

Specific objective :

• Able to perform activities of daily living independently and demonstrate a desire to do so.

Outcomes :

• Clients are able to perform daily activities.
• Clients feed themselves without assistance.
• Clients choose appropriate clothing, taking care to dress themselves without help.
• Clients maintain optimal personal hygiene by bathing every day and perform procedures unassisted defecation and urination.

Interventions :

• Encourage the patient to perform activities of daily living fit the patient's level of ability .
• Support the patient's autonomy , but give assistance when the patient can not perform some activities .
• Show concretely , how do the activity to which the client is difficult to do so.
• Assist in preparing equipment ADLs .
• Give positive recognition and awards for its ability to be independent.

Rationale :

• Independent activity can improve the ability to do client activity.