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CONCEPTUAL MODEL OF MENTAL HEALTH NURSING PRACTICE

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Title: CONCEPTUAL MODEL OF MENTAL HEALTH NURSING PRACTICE


1
CONCEPTUAL MODEL OF MENTAL HEALTH NURSING PRACTICE
Dian Wahyuni MENTAL HEALTH AND COMMUNITY
DEPARTMENT BINAWAN INSTITUTE OF HEALTH SCIENCES
2
Objectives
  • Understand the function of conceptual models in
    shaping mental health nursing practice
  • Identify ones mental health conceptual model
  • Implement the conceptual models in planning
    mental health nursing care

3
How do you see the world around you?
  • A (23 years old) is a college student who was
    raised by his mother (his father died when he was
    2 years old). He is a rather shy student and he
    has some difficulties with his study. A is often
    expressing his suicide ideation.
  • What would be your explanation for As behavior ?

4
  • A It always seems to me that hes really unsure
    of him self-somehow frightened of committing
    himself. I think its got something to do with
    the fact that his father died when he was a baby.
    His mother must have had a really bad time of
    it-dealing with losing a husband and coping with
    a new baby at the same time. Although he probably
    doesnt remember it, I am sure it must have
    affected him.

5
  • B I think its more likely to do with the fact
    that hes never learned to stand up for himself.
    Its as if he always has to say the right thing
    or people wont like him.
  • C Im sure his never really felt accepted or
    allowed to be himself. That must have affected
    him.
  • D Well, I think its just the way he is. He was
    probably born to be a shy person.

6
Which hypothesis you choose?
  • A This explanation views that early experiences
    and relationship in ones life is very crucial,
    even if the person has no recollection of them
  • B This explanation views that behaviors are
    learned. This statement clearly believes in the
    importance of learning in the development of a
    person and also in the effect of perceived
    consequences on behaviors.

7
Which hypothesis you choose?
  • C This statement views that environmental
    influences as significant, but this time the
    emphasis is on the importance of acceptance to a
    person development.
  • D This statement explains in terms of genetic
    inheritance. Nature rather than nurture which
    determines how people are and why they act as
    they do.

8
  • Psychodynamic theories
  • Statement A
  • Stress the crucial role of both early experiences
    and of the unconscious in determining thoughts,
    feelings and behaviors.
  • Cognitive-Behavioral Theories
  • Statement B
  • Views that behaviors are acquired through
    learning. They also emphasize the effect that
    mental process, such as beliefs, thoughts and
    perceptions, have on behaviors.

9
  • Humanistic Approach
  • Statement C
  • Emphasizes that individuals inborn striving for
    personal growth and, given the right environment,
    the ability to achieve his or her creative
    potential.
  • Biological Theories
  • Statement D
  • Belief that genetic and other biological factors
    affects the extent of a persons personality

10
  • Theories help us to EXPLAIN the relationship
    between specific behavioral patterns and mental
    process and their causes.
  • If any theory is going o be put to the test, it
    needs not only to explain, but also to PREDICT
    future events.

11
MODEL
  • Penyajian konseptual tentang realitas
  • Realitas dalam bentuk abstrak dan rekonstruksi
  • Terdiri dari konsep dan ide umum

12
MODEL KONSEPTUAL
  • Serangkaian konsep dan pernyataan yang
    terintegritas menjadi susunan berarti
  • Abstrak
  • Umum
  • Tak terbatas
  • Pedoman
  • Apa yang dilihat
  • Bagaimana memandang
  • Aspek-aspek yang dipertimbangkan

13
BERBAGAI MODEL
  • Psikoanalitis
  • Sosial
  • Interpersonal
  • Eksistensial
  • Komunikasi
  • Perilaku
  • Medis
  • Keperawatan

14
MODEL PSIKOANALITIS
  • (Sigmund Freud)
  • Mental structure
  • Id encompassing the primitive instincts and
    energies underlying all psychic activity
  • Ego the conscious part of the personality, and
    the part that most immediately controls thought
    and behavior
  • Superego, the conscience.

15
PROSES TERAPEUTIK PSIKOANALITIS
  • Psikoanalisa
  • Asosiasi bebas interpretasi mimpi
  • Interpretasi perilaku
  • Transferens pengalaman traumatis
  • Resistans Area masalah
  • Peran
  • Verbalisasi pikiran dan mimpi
  • Terapi lama
  • Menggunakan transferens
  • Menggali resistans
  • Menafsirkan pikiran dan mimpi

16
MODEL SOSIAL
  • (Szasz, Caplan )
  • Faktor sosial lingkungan stres
  • ansietas

  • gejala
  • Perilaku menyimpang
  • - sistem sosial
  • - sistem politis

17
Model Sosial
  • Proses Terapeutik
  • Mengatasi sistem sosial
  • Intervensi krisis
  • Manipulasi lingkungan
  • Dukungan sosial kelompok

18
Model Sosial
  • Peran
  • Mengemukakan masalah
  • Menggali sistem sosial
  • Menggunakan sumber tersedia

19
Model Interpersonal
  • Sullivan Peplau
  • Ansietas interpersonal
  • Ansietas proteksi
    gejala
  • Penolakan takut
  • Kebutuhan rasa aman
  • kepuasan
  • hubungan interpersonal
  • kebutuhan


20
Model Interpersonal
  • Proses Terapeutik
  • Hubungan terapis (rasa aman) pasien
  • Membantu menjalin hubungan rasa percaya dan
    mencapai kepuasan
  • Hubungan akrab di luar terapi
  • Peran
  • Membagi ansietas perasaan
  • Hubungan dekat dibina
  • Empati
  • Koreksi pengalaman interpersonal

21
Model Eksistensial
  • Frakl
  • Hidup berarti menerima diri sepenuhnya
  • Kemurnian hubungan
  • Proses terapeutik
  • Ketulusan hubungan
  • Terapi kelompok
  • Menggali meningkatkan penerimaan diri
  • Pengendalian perilaku
  • Peran
  • Bertanggung jawab terhadap perilaku
  • Pengalaman berarti belajar tentang diri
  • Mengenal nilai diri
  • Klarifikasi kenyataan situasi

22
Model Komunikasi
  • Berne
  • Peran merusak arti
  • Verbal non verbal tak serasi/harmoni
  • Proses Terapeutik
  • Menganalisa pola komunikasi
  • Umpan balik untuk klarifikasi masalah
  • Terapi keluarga
  • Analisa transaksi

23
Model Komunikasi
  • Peran
  • Melihat pola komunikasi
  • Klarifikasi dan validasi komunikasi
  • Menafsirkan pola komunikasi pada pasien
    berkomunikasi dengan orang lain
  • Mengajarkan prinsip berkomunikasi

24
Model Perilaku
  • Eysenck, Wolpe Skinner
  • Perilaku dipelajari
  • ansietas
  • perilaku tak diinginkan
  • Gejala perilaku

25
Model Perilaku
  • Proses Terapeutik
  • Perilaku menyimpang
  • Perilaku normal
  • Perilaku dapat diterima ansietas
  • Terapi rileksasi dan latihan asertif

-
  • Peran
  • Praktik teknik perilaku
  • Hirarki perilaku
  • Perilaku meningkat


26
  • Model Medis
  • Perilaku Proses penyakit

-
SSP
  • Gejala faktor fisiologis, genetik,
    sosial, lingkungan
  • Perilaku menyimpang toleransi terhadap
    stres

27
Model Medis
  • Proses Terapeutik
  • Berdasarkan diagnosa
  • Terapi somatik interpersonal
  • Respons simptomatis
  • Tenaga kesehatan lain
  • Peran
  • Mengikuti terapi fisik
  • Melaporkan efek terapi
  • Mengajarkan tentang penyakit

28
Model Keperawatan
  • Orlando, Peplau, King, Orem, Rogers, Roy, dll
  • Biopsikososial gangguan mns utuh
  • Faktor predisposisi dan kelemahan
  • Rentang adaptif maladaptif

29
Model Keperawatan
  • Proses Terapeutik
  • Proses keperawatan
  • Asuhan keperawatan mutual
  • Kolaborasi dengan tenaga kes. Lain
  • Tujuan spesifik
  • Peran
  • Kerjasama klien dalam asuhan kep.
  • Kolaborasi dengan klien tenaga kes.
  • Modifikasi askep dg umpan balik klien
  • Terapi modalitas

30
Perbandingan Model Biomedis Keperawatan
Keperawatan
Medis
Penyebab
Kelemahan
Penyakit
Resiko
Masalah
Respons
Kesehatan
Manusia
Penyembuhan
Perawatan
31
FROM THE MODEL TO PRACTICE
  • Mental Health Nursing practice model of practice
    helps you to
  • Determines priorities
  • Locate therapies
  • Decide about implementation
  • Consider outcomes
  • The choice of interventions are depend on to the
    extent of HOLISTIC APPROACH of a mental health
    nurse.
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