Aim: to understand the importance of a thorough biopsychosocial assessment to reliably identify factors that will lead to diagnosis of a mental health issue and appropriate nursing care management.

Description: You are to write an essay which analyses a case study in order to discuss appropriate biopsychosocial factors and nursing management or interventions relevant to that case. Recent and relevant literature must be used to support your discussion.

Instructions:

1) Select a case study provided.

2) Userecent literature to support your discussion:

2.1) Identify and discussbiopsychosocial factors that contribute to the development of the selected disorder.

2.2) Describe and discussnursing management or interventions appropriate for your selected case study.

2.3) Outline and discussethical implications for the selected case study.

Other elements:

· Ensure that you use scholarly literature (digitised readings, research articles, relevant Government reports and text books) that has been published within the last 10 years.

· Provide a clear introduction and conclusion to your paper.

· You may use headings to organise your work if you wish.

· Unless otherwise instructed, write in the third person.

· Use academic language throughout.

· Refer to the marking guidelines when writing your assignment. This will assist you in calculating the weightings of the sections for your assignment.

· State your word count (excluding your reference list) on the Title page.

Marking Criteria

Possible marks

1. INTRODUCTION

- Assignment has as an opening paragraph that contextualises the assignment.

- Clearly identifies the aim of the assignment

/3

2. IDENTIFY AND DISCUSS BIOPSYCHOSOCIAL FACTORS RELATED TO THE CASE STUDY

- Clearly identifies and discusses biopsychosocial factors influencing the development of the disorder in the selected case study.

/10

3. DESCRIBE AND DISCUSS NURSING MANAGEMENT OR INTERVENTIONS

- Using research evidence clearly identify and discuss nursing management or interventions appropriate for the selected case study.

/15

4. OUTLINE AND DISCUSS ETHICAL IMPLICATIONS

- Clearly discusses ethical implications appropriate for the selected case study

/10

5. CONCLUSION

- Has a concluding paragraph that summarises the overall argument in the assignment.

- Does not introduce any new information or references in the conclusion.

/2

6. RESEARCH AND REFERENCING

- Identifies, analyses and uses good quality evidence to support the outlined relevant points. Uses at least 10 relevant sources from the scholarly literature published in the last 10 years.

- Separate page for reference list headed “References”

/5

7. ACADEMIC WRITING

 Correct word count (2,000 words). Uses academic language throughout.

 Essay is well presented, with correct spelling, grammar, and well-constructed sentence and paragraph structure.

/5

TIP: From the criteria sheet, identify headings for your essay structure.

CASE STUDIES

Case 1: First episode psychosis

John is an 18-year-old student. He lives with his mother Anne, who is 50 years old, and his stepfather Greg, who is 53 years old. Anne was remarried 9 years ago. John is the youngest of three children and he is the only child to still live in the family home with his parents.

John is now in Grade 12. He liked to socialise with friends and was fun-loving. In the past seven months he started to have changes in behaviours and appearance. John was disruptive and started to talk and laugh inappropriately in class. He also became isolated and did not want to join in any activities at school. He used to receive good grades but since the beginning of the year he started to lose his concentration and attention. His school performance became poor and he was frequently tardy. John had finally stopped going to school over the last two months. John has a history of drug abuse. He started to use marijuana when he was in Grade 9 because the group of friends he was hanging out with also used drugs. John uses amphetamines on a regular basis. He occasionally drinks alcohol and smokes cigarettes.

John was brought to a mental health unit by his parents after he had been noted wandering around the house and talking to himself for over a week. This is his first admission. On admission, John appears suspicious and has unkempt hygiene. He stated he heard voices from a group of two men and a woman. The voices kept telling him that he was “no good” and “everybody hated” him. Sometimes they told him to kill himself and sometimes to kill older people. John also believes that he has special powers and he is a spy working for the government. John is argumentative and sometimes becomes aggressive. He has a history of aggression and violence.

John’s mother told the admitting nurse that John’s father has schizophrenia and he was abusive to her and the children. They divorced when John was 8 years old. After the divorce, John’s family relocated to different cities. John also had to move to different schools, so he did not have any close friends.

Case 2: Eating disorder

Charlie is a 19-year-old girl. She is a second year university student. Charlie shares a flat with two other students who have always been very supportive of her. Jo, one of Charlie’s flatmates, has contacted Charlie’s parents and expressed concern over Charlie’s appearance and behaviours. Charlie used to go out and have dinner together with her flatmates. She started to isolate herself about four months ago. She spends much of her time alone in her room. Charlie eats very little throughout the day and takes laxatives on a daily basis. After eating, Charlie immediately goes to the toilet and spends at least half an hour in the bathroom. Charlie has lost 10 kilograms in the last three months and her menstrual periods have ceased. Charlie is pale and thin. Her hair is dry and brittle. Though it is summer, she is wearing several layers of clothing.

Charlie is the youngest daughter of Pam, who is a registered nurse, and Jack, who is a dentist. Both parents work full time and lead busy lives. Charlie always sets high standards for herself. She feels that she needs to be as perfect as her parents. She describes her relationship with her parents as overprotective and controlling. Charlie has a brother who is working in a well-paid company.

Charlie was taken to see the family doctor who has referred her to the Eating Disorders Unit in Brisbane. Charlie’s family reports that Charlie was a high achiever at school. The nurse interviews Charlie although she is pleasant the nurse gains little information as Charlie is guarded and reluctant to talk about her eating. Charlie, however, says she is “too fat” and believes that she needs to lose more weight to be more attractive. Charlie feels worthless. She believes she is not as smart as her brother and this has made her parents do not care much about her. Charlie sometimes has self-harm urges. She feels that it is the only time she can control herself.

Charlie is admitted to the unit and is prescribed multivitamins, antidepressants, and anxiolytic medication.

Case 3: Depression

Amy is a 75-year old woman. She has been diagnosed as having depression for ten years. She started to feel depressed after she was diagnosed with diabetes and hypertension. She felt more depressed after the loss of her husband three years ago. She was hardly eating anything and wasn’t sleep. She felt like she had no one to talk to. After the death of her husband, Amy moved to a retirement village. While living at the retirement village, Amy manages her medications by herself. Sometimes she forgets to take her medications.

Amy has two daughters. They live in another city, about one hour drive from her home. They visit her almost every month. Amy is a quiet but caring person. She likes to keep things to herself. Amy has similar characters to her mother who also had depression and passed away fifteen years ago.

Amy was brought to a mental health hospital by Sue, one of Amy’s daughters, after the retirement village manager contacted her. This is her fourth admission to the hospital. Over a period of two weeks, Amy has experienced a loss of interest in her activities and sleep disturbance. Amy was restless at night and she found it hard to fall asleep. Over the past two weeks, Amy has felt increasingly tired and fatigued, resulting in her not wanting to get out of bed. Amy has lost her appetite. She has lost six kilograms in the past two months. Amy expresses feelings of worthlessness, helplessness, and hopelessness. She feels she is a burden for her daughters. Amy reported low mood and stated “If I were gone, things would be easier for my daughters”.

The doctor prescribes Amy another group of antidepressants. While she is in an inpatient unit, she attends cognitive behavioural therapy as well as art and craft group activities.

NOTES:

Essay Structure:

Introduction – include a thesis statement/argument, e.g., “it will be argued that”

Biopsychosocial factors related to the case study

Nursing management or interventions

Ethical implications

Conclusion

Next steps:

Include and use the above headings in your essay to help you frame/focus your response

Copy from the criteria sheet the points to address for each section

Jot down initial thoughts/ideas to these points

Do your research, draft and re-draft your essay

Use the criteria sheet as a checklist as a to ensure that you have addressed all requirements of the task

Planning Your Essay – Paragraph Structure

Topic sentence – indicates the main idea of the paragraph, e.g., “Several biopsychosocial factors can influence the development of…”

Supporting sentences – sentences that support the main idea, which refer to scholarly evidence, e.g., “According to Author (year), one such factor is…”

Concluding sentence –

Synthesises the points made in the paragraph around the main idea

Links back to thesis statement/central argument

Leads the reader onto the next paragraph

E.g., “It is clear that several biopsychosocial factors can influence…”

Summary

Keywords in the task are important in understanding the essay question

Refer to the criteria sheet in planning the structure of your essay

An introduction to Problem Based Learning (PBL)

Benefits of PBL:
• Stimulates critical thinking and problem solving

• Can mirror the processes when receiving information from handover or assessment details

• Encourages ‘thinking like an RN’

Case is presented
Concept map developed

Identify details from the Case study that are significant

SOCIAL

NETWORK

AGE

GENDER

CHILDHOOD

HISTORY

FAMILY

HISTORY

CASE

STUDY