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Implementing trauma-informed care in mental health services
It has been recognised that trauma underpins several mental health conditions, and that retraumatisation, in which a person re-experiences a traumatic event, is common in mental health services.This article explores the effects of childhood trauma on adult mental distress, and describes the symptoms and behaviours associated with trauma. Mental health practitioners, services and organisations need to ensure trauma-informed care is standard practice to enable service users to move beyond the traumatic events they have experienced. Trauma-informed care should be viewed as a concept rather than an intervention to promote a cultural shift from what is ‘wrong’ with a person to what has happened to them.
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Well-being, physical and mental health: part 3. Helping service users cope with schizophrenia
Schizophrenia affects the mental well-being of service users but also their physical and social well-being. This article explores the causes of schizophrenia and how the illness can contribute to self-neglect. The interaction of mental and physical health in people with schizophrenia is explored and how mental health nurses might work with colleagues to help service users to cope. A case study is used to illustrate how healthcare professionals from different backgrounds worked with a service user and his family to help manage his self-care and improve his well-being. This is the third article in a series on well-being, physical and mental health.
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Nursing care plans in mental health
This article explores best practice in co-creating recovery-orientated care plans. Recovery is a holistic experience that involves the service user beginning to regain a sense of control, alongside a reduction or absence of symptoms of mental distress. A care plan documents the needs of the service user and the interventions that will support their recovery. The history and development of care plans are explored and the benefits of care planning, involving good-practice guidelines and co-production, with service users are discussed. A case study is used to show strategies for planning care and recovery tools, and troubleshooting suggestions are provided for when there is a lack of engagement from the service user.Care planning is an important part of a mental health nurse’s role, as a legal record of care given and as a therapeutic tool to encourage recovery.
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Improving the physical health of people with a mental illness: holistic nursing assessments
People with a mental illness are more susceptible to physical ill health than the general population, which leads to significantly higher mortality rates among this group. Reasons for this include lifestyle factors such as smoking, lack of exercise and poor diet. Inadequate knowledge and skills about physical health among mental health nurses can lead to uncoordinated care and inadequate access to physical health services for people with mental ill health. This article aims to guide nurses to make initial holistic assessments with specific focus on areas of greatest physical disparity: dental health, eye conditions, sexual and reproductive health, smoking, drugs and alcohol, and metabolic syndrome. Relevant screening tools and health resources are explored. If nurses carry out holistic assessments as a basis for care, make appropriate referrals and deliver timely health promotion, physical health outcomes for people with mental illness will improve.
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Well-being, physical and mental health: part 2. Responding to trauma
Mental and physical health work together to support well-being, and never more importantly than when a patient experiences a sudden and devastating trauma. This article explores the interplay of mental and physical health in the context of acid attack burns to someone’s face. It explains trauma in event terms and how an understanding of types of psychological trauma can be drawn on to advance collaborative nursing practice in a burns unit. While nurses have been educated in separate disciplines, it is argued that working across the traditional divide can be advantageous in trauma situations. This is the second article in a series on ‘well-being, physical and mental health’.
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Effective management of type 1 diabetes in children and young people
Type 1 diabetes is the most common type of diabetes among children and young people, and requires careful management to ensure that blood glucose levels stay as close as possible to the target range. Suboptimal management can lead to serious health consequences, including damage to various organs and body systems. Many children with type 1 diabetes are not diagnosed until they develop diabetic ketoacidosis, which is distressing and potentially life-threatening.This article provides an overview of the management of type 1 diabetes in children and young people, including the insulin replacement therapy and dietary management required. It also emphasises the importance of regular and ongoing monitoring of blood glucose levels, quarterly measurement of glycated haemoglobin, and the management of hyperglycaemia and hypoglycaemia.
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Biological basis of child health 15: understanding the renal system and common renal conditions in children
This article, the 15th and last in a series on the biological basis of child health, focuses on the renal system, in particular the kidneys. It provides an overview of their role, function, anatomy and physiology, and embryological development. The renal system has a crucial role in homeostasis, so renal function impairment can have wide-ranging and potentially serious consequences for a child’s overall health. The article describes some of the common renal conditions seen in children and how these are managed. It explains how to interpret the results of renal function tests and urine sampling conducted to assess renal function and to investigate acute and chronic disease.
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Clinical assessment and management of children with bronchiolitis
Bronchiolitis is a common seasonal viral illness in babies and children aged under two years. Its significance has increased in the light of a predicted surge in respiratory illness in children this winter and the continuing effect of the coronavirus disease 2019 (COVID-19) pandemic on parental anxiety and cross-infection. Children’s nurses will have a central role in delivering high-quality care and support to children and families during this time. To support children’s nurses to prepare for a surge, this article summarises the pathophysiology of bronchiolitis, risk factors, transmission, diagnosis and clinical management of children with the illness, including recent national policy changes. It also considers the potential effect of the COVID-19 pandemic on the healthcare system, children and families.
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Biological basis of child health 14: understanding the immune system, vaccines, allergy and disease
This article, the 14th in a series on the biological basis of child health, focuses on the immune system. It provides an overview of pathogens to which the human body is susceptible, some of the milestones in the embryological development of the immune system, and some of the mechanisms of innate and acquired immunity. The article explains the importance of immunisations and provides examples of immune system dysfunctions and autoimmune conditions that children may experience. It is essential that children’s nurses have an understanding of how the immune system develops, how it is structured and how it functions, since such knowledge will be relevant in the care of a range of conditions where nurses need to explain infection, inflammation and immune processes to children and parents.
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Biological basis of child health 13: structure and functions of the skin, and common children’s skin conditions
This article, the 13th in a series on the biological basis of child health, focuses on the skin. The skin is the largest organ in the body and covers its whole outer surface, protecting it from external threats, assisting in retaining body fluids, eliminating waste products and regulating temperature. The skin also has a crucial role in wound healing and vitamin D synthesis. Skin conditions in children are often distressing for children and parents, and may significantly affect their everyday lives. This article explains how the skin develops in utero, describes the structure and functions of the skin, and explores the aetiology, manifestations and management of skin conditions commonly seen in children.
