Understanding Acute Stress Disorder, Empathy, PTSD, And Informed Consent In Nursing Practice

Acute Stress Disorder

Question:

Discuss about the Mental Health and Communication Terminology.

Acute stress disorder is a response that build up after a short or long exposure to traumatic event. An individual who is experiencing acute stress disorder shows symptoms that can exists for days or months. The symptoms include dissociative, negative mood and avoidance.

Empathy has been identified as very important communication qualities and for an individual nurse to provide high quality nursing care service empathy is a requirement. Different research findings have established that empathy is catalyst that help nursing students attain a higher quality of patient-centered education and in practice.

Post-traumatic stress disorder happens after experiencing or witnessing a traumatic action military combat, certain death of a close friend among others.

Informed consent in the context of research and nursing practice refers to a document that prove willingness of an individual to take part in a research. It is a requirement that the participants should be given adequate information about the treatment or research, the language used in the consent form should be simple and clear to enable participants to make decision willingly about their participation in the study.

According to World Health Organization. (2013), acute stress disorder(ASD) is a response that a healthy individual develops whenever an exceptionally traumatic event occurs. Patients with acute stress disorder visits health facilities when they are at different phases of acute stress disorder: According to Figley (2013), the first phase is dissociation and it is characterized by lack of emotion responsiveness and dissociation amnesia. The last phase involves the flashbacks of the traumatic events. During the last phase, researcher findings have established that the avoidance of the stimuli acts as a trigger to the remembrance of the traumatic event and it presents with noticeable symptoms such as insomnia, lack of concentration, irritability and anxiety among others (American Psychiatric Association [APA], 2013). According to Perry et al. (2015), 14% of the nurses experiences mental issues ,13% of the nurses were diagnosed with anxiety, 6% were under psychoactive medication and with 65.1% having experienced symptoms associated with acute stress disorder in the last the last 12 months. The findings of the study underline the importance of the need to train and equip nurses who work in a psychiatric wards and mental facilities in general, so that they are able to discharge nursing services in such environment without being traumatized by the situations that occur within their working environment. One of the challenges experienced in the training of nurses is the lack of clinical practicums for psychiatric-mental health nursing involving patients with acute stress disorder. A study conducted by Langham et al. (2016) on training of nursing students using simulation on acute stress disorder revealed a change of negative attitude of students towards mental health patients and highlighted the benefit of improved healthcare services provision by newly graduated nursing students to people with acute stress disorder. It’s important for nurses to understand how to manage and treat acute stress disorder using different approaches for example use of an approach that encourage physically facing fear, cognitive exposure, lowering of stressors.

The Importance of Empathy in Nursing

Empathy defines our ability to understand the needs of the patient and it forms the basic unit for ethical conduct towards others, it is not possible to exercise sympathy and kindness as a virtue in the absence of empathy (Gault et al., 2016). Empathy and sympathy have sometimes been used interchangeably. However, a clear difference between the two do exist, empathy is intellectual and emotional awareness and fully understanding another person’s thought, feelings and behavior while sympathy is the sharing of an individual’s feelings and experiences (Bousso et al., 2014). Empathy and compassion are grouped together as a fundamental concept that constitutes person-centered care in nursing. The basic principle of understanding an individual’s needs and effort to relieve the suffering summarizes empathy as an attribute of compassion as a concept in the nursing care (RCN, 2014).For example , a cohort study conducted with nurses have established the relationship between empathy and reduced stress consequences among the nurses working in environment with disturbing experiences such as ICU wards , the study focused on the use of Trait Meta-Mood scale to measure the role of perceived emotional intelligence(PEI) with major focus on quality of nursing services offered by the nurses working in mental health facilities (Langham, Jones, & Terry, 2016 ). The study concluded that empathy as an attribute of compassion in nursing is  the best indicators of social and emotional support for the mental health patients (Montes & Augusto, 2007). According to Webb et al. (2016) there exists a relationship between empathy and reduction in stigma . Adult attachment style was found to influence empathy, the stigma was focused on psychosocial and health concern. With regards to nursing care the empathy is an attribute that are related to compassion as a nursing concept. in conclusion nurses who have empathy are better equipped to handle difficult situations (Adamson & Dewar, 2011).

Persons experiencing post traumatic disorder (PTSD) has certain clinical manifestation resulting from exposure to extreme traumatic action. The clinical symptoms associated with PTSD include mood swing, feeling of need to be alone, cognition, and changes in excitements. Traumatic events have been defined by Psychiatrists as an event that can provoke sense of fear in an individual or shock due to risk of injury or death according to (Yehuda, 2002; APA, 2013). PTSD was first documented in the Diagnostic and Statistical Manual Disorder,3^rd ed. (DMS III) in the year 1980. For example, in a resent cohort study done by Mealer et al. (2007), nurses working in the ICU wards were found to have higher prevalence of PTSD clinical manifestation when compared to the nurses working in general ward. The results from the study findings helps to highlight the importance of creating awareness of the PTSD symptoms and the need to develop interventions to improve the mental health status of the nurses and boost ICU nurses career fulfilment. In another cohort study done by Mealer (2007), revealed that 24% of the nurses working in the ICU were positively diagnosed with symptoms of post-traumatic stress disorder and the result was linked to their working environment this was much lower than the 14% recorded among the general nurses, of interest is the fact that the same ICU nurses did not register high amount of stress in life outside their working environment when compared to the general nurses, the study findings would help to address the issues nurses undergo as they render services. Studies have established that experiencing and learning PTSD can challenge an individual’s sense of safety resulting to feeling vulnerability among the nurses and the mental health patients. 

Informed consent in the context of research or nursing practice is document that prove willingness of an individual to take part in a research. It is a requirement that the participants should be given adequate information about the treatment or research, the language used in the consent form should be simple and clear to enable participants to make decision willingly about their participation in the study.

For example, nurses who would want to engage in clinical studies they should be able to understand the importance of the principle of the consent of archiving data which is another fundamental issue with regards to research ethics. For example, most of the researchers make their data set available to the entire research community by archiving them in the database, and without proper consent from the study participants, this can be matter of a great concern. The participants should be empowered to enable them to make decision on the data storage after the research is done. There are issues to consider including: how long should the participant’s information be kept before a fresh consent is sought from them to enable further storage? should the details identifying researcher be removed from the recording? Under the guidelines of the researcher are under the obligation to prevent the re-use of identifiable data collected during one particular research and such data can’t be used for administrative or commercial purposes according to Miller et al. (2012).

There are regulations that governs the recruitment of children as participants in research. Several countries have ratified UN convention on the rights of children, which contain clause highlighting children right to participation. This empowers children on their right to be consulted, right to information, and challenge decision that is made on their behalf this is according to (Alderson & Morrow, 2011; Morrow & Richards, 1996). Nurses who are involved in a study as researchers should ensure that the children are protected from the risk of distress or humiliation, the best approach to this is by listening to children opinion on what worry them most. When children under the age of 15 are recruited into the study a written consent from the parent is a requirement according to Dickson et al. (2008).   

Conclusion

health facilities and nursing training institution to promote intervention that enhance evidence based practice. High quality nursing care demands nurses understanding and practice of compassionate and empathy when providing nursing services to patients. At the same time it is necessary for the nurses to develop intervention mechanisms when handling patients with mental conditions. proper understanding of the conditions will enable nurses make a well-informed decision regarding treatment or referral of the cases.

References

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