Mental Health Nursing and First Episode Psychosis

Abstract

The purpose of this literature review is to identify mental health nursing's contribution to the care and treatment of patients with a first episode of psychosis; A systematic literature review was undertaken, with 27 articles selected for study. Five domains were identified: development of therapeutic relation, relapse prevention, enhancement of social functioning, stimulation of medication adherence, and support of family members. The level of evidence of mental health nursing's contribution to the care and treatment of those undergoing their first episode of psychosis was low. Our review suggests that mental health nurses should reflect upon their own daily practices within the five domains.

Patterns of knowledge used by nurses in caring for the patient in the first psychotic outbreak

“…This fact directly influences the demand for care, which is sometimes delayed. 12,13 Thus, when entering the service, both the patient and the family present numerous demands to be observed, with the NP and, in particular, the collection of data, being a means to favor the integral care of the subject and family in the context in which they live. Theories are also considered a means of providing qualified care.…”

“…12,13 Thus, it is fundamental that services are structured in such a way as to enhance the family, professional and service relationships. 12,13 Finally, through an evaluation of nursing, it is possible to know if the care provided by the team is providing benefits to the patient.…”

“…12,13 However, it is perceived that although Psychiatric Reform has provided significant advances, the care of the person suffering their first psychotic outbreak is still permeated by reductionist practices and common sense knowledge, as articles have dealt with the first psychotic episode superficially, lacking guidance regarding the role of nursing during treatment. 6,10,12,14 In view of the above and the need for more evidence on the role of mental health nurses in the treatment and care of these patients, the present study aims to understand how nurses provide care in the first psychotic outbreak, as well as to identify Carper's fundamental ways of knowing used in this action. 8 It should be noted that the relevance of this study lies in the discussion of the care given to the patient in question from the professionals' perspective, in order to recognize, through the patterns of knowledge, on what nursing in mental health is based.…”

“…In this way, this professional takes on the role of therapeutic agent and considers relationship issues with the patient and family, leaving aside the position of custodian and repressor. 4,[10][11][12] Throughout the first psychotic outbreak, the nurses' performance has been described as fundamental to the prognosis of the patient, since this professional, as manager of the team, can perform biopsychosocial actions within the family and, in particular, related to communication therapy. 12,13 However, it is perceived that although Psychiatric Reform has provided significant advances, the care of the person suffering their first psychotic outbreak is still permeated by reductionist practices and common sense knowledge, as articles have dealt with the first psychotic episode superficially, lacking guidance regarding the role of nursing during treatment.…”

“…4,[10][11][12] Throughout the first psychotic outbreak, the nurses' performance has been described as fundamental to the prognosis of the patient, since this professional, as manager of the team, can perform biopsychosocial actions within the family and, in particular, related to communication therapy. 12,13 However, it is perceived that although Psychiatric Reform has provided significant advances, the care of the person suffering their first psychotic outbreak is still permeated by reductionist practices and common sense knowledge, as articles have dealt with the first psychotic episode superficially, lacking guidance regarding the role of nursing during treatment. 6,10,12,14 In view of the above and the need for more evidence on the role of mental health nurses in the treatment and care of these patients, the present study aims to understand how nurses provide care in the first psychotic outbreak, as well as to identify Carper's fundamental ways of knowing used in this action.…”