Specific Core Nursing Content # 9: Health Promotion and Illness Prevention
Clinical Learning Outcomes
- Identify individuals, groups, and populations at risk for mental health problems.
- Display competent mental health assessment skills using evidence-based strategies and tools (mental status exam, use of psychometric rating scales such as PHQ-9, GAD-7, etc.).
- Demonstrate effective health promotion skills using teaching and counseling abilities grounded in supporting motivation and self-efficacy for seeking healthy behaviors.
- Show ability to plan, implement, and evaluate preventive care on primary, secondary, and tertiary levels.
- Display best practices for patients at risk for, or experiencing psychiatric disorders.
Classroom Teaching Strategies
- Lecture with focus on health promotion concepts and health teaching
- Present and demonstrate theoretical principles associated with cognitive behavioral therapy and motivational interviewing for psychiatric nurses assuming the counseling and teaching roles (re: standards of practice)
- Journal articles to supplement text:
- Rubak, S., Sandbæk, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: a systematic review and meta-analysis. Br J Gen Practice, 55(513), 305-312.
- Velligan, D. I., Weiden, P. J., Sajatovic, M., Scott, J., Carpenter, D., Ross, R., & Docherty, J. P. (2010). Strategies for addressing adherence problems in patients with serious and persistent mental illness: recommendations from the expert consensus guidelines. Journal of Psychiatric Practice®, 16(5), 306-324.
- Turkington, D., Kingdon, D., Rathod, S., Hammond, K., Pelton, J., & Mehta, R. (2006). Outcomes of an effectiveness trial of cognitive-behavioral intervention by mental health nurses in schizophrenia. The British Journal of Psychiatry, 189(1), 36-40.
- Davidson, K., Norrie, J., Tyrer, P., Gumley, A., Tata, P., Murray, H., & Palmer, S. (2006). The effectiveness of cognitive behavior therapy for borderline personality disorder: results from the borderline personality disorder study of cognitive therapy (BOSCOT) trial. Journal of personality disorders, 20(5), 450.
- Brown, S., & Chan, K. (2006). A randomized controlled trial of a brief health promotion intervention in a population with serious mental illness. Journal of Mental Health, 15(5), 543-549.
- Fetter, M. (2009). Promoting health literacy with vulnerable behavioral health clients. Issues in Mental Health Nursing, 30(12), 798-802. doi:10.3109/01612840902887725
- Demonstrate range and use of psychometric assessment tools
- Documentary "Out of the Shadow" (2004).
- Depicts resilience with an individual working ultimately to adopt a healthier lifestyle and maintain recovery. Per the author, “helps dispel the stigmas and misconceptions surrounding” schizophrenia. Available at http://outoftheshadow.com
Clinical Teaching Strategies
- Students focus on stress management, healthy diet, exercise, tobacco cessation, and treatment/medication adherence using best practices.
- Focus on behavior change and resource supports, incorporating beginning motivational interviewing skills along with therapeutic communication and relationship building skills
- Scenarios characterizing individual and group mental health disparities influenced by primary and secondary prevention strategies
- Example Simulation using Standardized Patient: Assessment Interview & Medication Administration for a Client with Clinical Depression & Alcohol Abuse
- This simulation is appropriate for undergraduate psychiatric mental health students. It should be placed after students have had theoretical introduction to clinical depression, Suicidal Ideation assessment, and treatment of acute alcohol withdrawal using substitution therapy.
Case Assignment with Student Questions
- Where would she seek accurate epidemiological and evidence-based information?
- What are critical stressors in the family, peer group, and community which influence adolescent suicide?
- How does the nurse provide primary prevention relative to suicide?
Clinical Skills Checklist
- Exhibit effective administration of screening tools for identifying patterns of psychiatric symptoms in mental health clients (Standard 1. Assessment)
- Demonstrate ability to teach clients with mental illness strategies to manage acute symptom exacerbations in support of sustaining recovery and preventing relapse (Standard 5B. Health Teaching)
- Identify and establish a plan of care for clients with mental illness supporting education in self-care themes such as attention to diet, exercise, and sleep hygiene (Standard 5B. Health Teaching, Standard 8. Education)
- Display skill in counseling clients regarding ways to modify behavioral patterns to those embracing health promotion. Relevant behavior modification should include teaching and motivating clients in use of relaxation skills and mindfulness meditation to maintain a grounded posture. (Standard 5B. Health Teaching)
- Effectively educate client on implementing treatment adherence plans including medication compliance and ongoing talk or group therapies in addition to wellness program participation for health maintenance (Standard 5B. Health Teaching, Standard 8. Education)