Somatic Disorders - Nursing Care PowerPoint Presentation

Somatic Disorders VALERIE ALFORD STONE MSN RN   Definition  Instead of anxiety, depression, etc, these clients experience unexplained skin rashes, paralysis, pain etc  Researchers are just now beginning...

Somatic Disorders VALERIE ALFORD STONE MSN RN   Definition  Instead of anxiety, depression, etc, these clients experience unexplained skin rashes, paralysis, pain etc  Researchers are just now beginning to What is understand somatization Somatization?  Somatization causes  Increased Health Care Cost  Increased length of stay  o There are severe impairments to occupational and social functioning o Rarely seen in inpatient settings (Psychiatric) Somatic Seen more in Disorders o Outpatient clinics/Primary Care o Med Surg In patient units Somatic Symptom Disorder Types of Somatic Disorders Illness Anxiety Disorder (Hypochondriasis) Conversion Disorder Psychological Factors Affecting Medical Condition Factious Disorder   Combination of distressing symptoms and excessive or maladaptive responses or associated health concerns with no physical findings Somatic  No cause for physical findings  Ages 16-25 Symptom  Difficult to distinguish from physical disorder Disorder  Pay close attention to patients hx.  Increased medical utilization but concerns are not alleviated Somatic Syndrome Disorder  Commonly seen symptoms This Photo by Unknown Author is licensed under CC BY-NC-ND This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-SA   Symptoms can affect function Somatic Syndrome  May MD shop Disorder  Feel stigmatized  Frustrates health care workers  Misdiagnosis is common   First degree relative who has somatic symptom disorder  Decreased levels of neurotransmitters- serotonin and endorphins  Depressive Disorder Risk Factors  Personality Disorder  Anxiety Disorder  Childhood abuse, trauma, or neglect  Learned Helplessness Expected Findings  Somatic manifestations disrupt daily life  Expressive preoccupations with illness  Increased anxiety about somatic manifestations for longer than 6 months  Probable alcohol or substance abuse  High utilizers of health care providers  Lab and diagnostic tests  PHQ-15.pdf (bcidaho.com)   Preoccupation with illness  No symptomatic symptoms are present and if they are, they are very mild  Thoughts are obsessive and intrusive Illness Anxiety  Have extreme worry Disorder  PCP will suggest a Mental health referral, but (Hypochondriasis) it is usually refused  Symptoms are worse in times of increased stress or stressful situations  May be due to depression Nursing Care Supportive care Reattribution Treatment  Assist patient to identify the link between physical manifestations and psychological factors while promoting a sense of caring and understanding  Four Stages  Stage 1 Feeling Understood  Stage 2 Broadening the Agenda  Stage 3 Making the Link  Stage 4 Negotiating Further Treatment Medications Patient Education Reinforce stress managment Illness Anxiety Disorder  Misinterpret physical manifestations as evidence of a serios medial condition or disease process  Overly aware of bodily sensations and attribute them to a serious illness.  Will research the illness excessively and constantly examine themselves  Seek numerous medical opinions or will avoid seeking treatment for fear of increased anxiety  Still have anxiety despite   First degree relative  Previous losses or disappointments resulting in anger, guilt or hostility Risk Factors   Childhood Trauma, abuse, or neglect De pressive disorder  Major Life Stressor  Low self esteem Excessive Anxiety that a serious illness is present or will be acquired Expected Findings Preoccupied with performance of behaviors that are health related 2 types 1. 2 Laboratory and Diagnostic Tests   Nsg Care Patient Centered  Medication Care  Education  Neurologist finds nothing  Psychiatrist finds nothing  Channel emotional issues and stresses into physical symptoms.  Some MRIs show abnormal patters of cerebral activation Conversion  Some people have a lack of emotional Disorder concern with the physical illness and others appear distressed.  Deficit in voluntary motor or sensory functions  Blind, paralyzed, etc  Must assume an organic cause until proven that physical pathology is ruled out https://youtu.be/bwQAkgq7-e8 Risk Factors  First Degree relative  Childhood trauma-physical or sexual  Comorbid psych conditions  Female Expected FIndings   Nursing Care Patient Centered  Medications Care  Education Psychological  Risk Factors factors  Expected Findings affecting other  Nursing Care medical  Education conditions Factitious Disorder  https://www.bing.com/videos/search? view=detail&mid=42E9DA7DC261C5DA620C42E9DA7DC261C5DA620C &q=factitious+disorder+VIDEOS&shtp=GetUrl&shid=2702702c-90d6- 44da-96ee- 8f12de13e767&shtk=VGhlIGNhc2Ugb2YgdGhlIGJhZCBtb3RoZXI6IEZhY3R pdGlvdXMgZGlzb3JkZXI %3D&shdk=TXVuY2hhdXNlbiBzeW5kcm9tZSBieSBwcm94eSAoTVNCUCk gaXMgYSBtZW50YWwgY29uZGl0aW9uIHdoZXJlIGEgY2FyZWdpdmVyIG1h a2VzIHVwIGFuIGlsbG5lc3MgaW4gdGhlIHBlcnNvbiB0aGV5IGFyZSBjYXJpb mcgZm9yLiBFeHBsb3JlIHRoaXMgY29uZGl0aW9uIHdpdGggdGhlIGNhc2Ug b2YgRGVlIERlZSBCbGFuY2hhcmQgYW5kIEd5cHN5IFJvc2UgQmxhbmNoYX JkLiBMZWFybiBhYm91dCB0aGUgY29tbW9uIGJlaGF2aW91cnMgZXhwcmV zc2VkIGJ5IHBlb3BsZSB3aXRoIE1TQlAsIHRoZSBjYXVzZXMsIHRoZSB0cmVh dG1lbnRzIGFuZCBjb21tb24gY2hhcmFjdGVyaXN0aWNzIHByZXNlbnQgaW 4gLi4u&shhk=xe7euTyIiI74SCV%2BQku17RKRIxVDimzdhscLd2fqZEg %3D&form=VDSHOT&shth=OSH.HJCcMxdtSgr7k%252F23YjQNpg Factitious Disorder  Previously known as Munchausen Syndrome. Conscious decision by pt to report physical or psychological manifestations. Done in the absence of personal gain. Does fill an emotional need  Factitious Disorder imposed on another person  Causes deliberate injury or illness to someone else  Usually have above average IQ  New manifestations after negative test results  Not malingering Factitious Disorder  Risk Factors  Expected Findings  Lab and Diagnostic Tests  Patient Centered Care Cultural Considerations  Somatic symptoms vary across cultures  African burning sensation to hands and feet  South Asia Ants under skin and worms in head  Greek/Puerto Rican men have more somatization