1. BY NIA AYU SURIDATY

2. Certain emotional and psychological responses can be expected in patient with any illness The nurse can anticipate responses patients must be assessed carefully to determine how they have responded to their circumstances

3. In assessing the psychological responses to the patient, the nurse should do following : 1. Observe the patient’s behavior when alone and interacting with others 2. Establish rapport with the patient: provide opportunities for communication in whatever way possibilities, depending on which communication skills 3. Focus comunication on the patient by using openden questions, provided the patient has adequate neurological function to respond 4. Listen to what the patient has to say and how it is said 5. Collect information from the patient and family 6. Validate the information collected with the appropriate person 7. Validate perceptions

4. Fear Personality Identity Disturbance Anxiety Hopelessness Powerlessness Body image disturbance Altered role performance Impaired social interaction Altered family processes Impaired verbal communication Ineffective individual coping Impaired adjusment Ineffective family coping : compromised

5. Anxiety Anxiety is feeling of uneasiness, apprehension or dread that is associated with unrecognized, subjective source of anticipated danger Nursing Intervention Anticipate potential sources of anxiety and provide information Explaining to the patient what is going to be done before beginning and then keep patient apprised of what is being done while care is administered Providing information and comfort the patient Giving relaxation therapy

6. Frustation is the feeling that occurs when a course of action or activity cannot be carried out or brought to a desirable conclusion Nursing Intervention Identify the basis of frustation Identify realistic goals Asking patient to express the frustation

7. Anger is an intense feeling of displeasure and antagonism in response to mounting frustation, conflict or anxiety Nursing Interventions Identify cause of anger Giving quiet environment Giving anger management

8. Fear is feeling of extreme apprehension or dread associated with a potential or real threat to the well being of individual Nursing interventions Identify the basis of patient’s fear Identify the source of the fear Verify the patient’s understanding and perceptions of information

9. Denial is defense mechanism, sometimes called a temporary protective mechanism whereby the persons refuse to acknowledge the existence or significance of known fact Nursing Interventions Giving support for adaptation Giving time to hear the patient and back patient to the reality

10. Depression is a feeling of sadness and self depreciations accompinied by difficulty in thinking and conducting usual activities and responbilities Nursing interventions Identify cause of depression Preventing suicide action

11. Powerlessness is defided as a perceived or real lack of control over one’s body mind, environment or life. Nursing interventions : Helping the patient to recogize the power that they have and should be encouraged to use it appropriately Participating in rehabilitation program

12. Neurological illness has serious consequences not only for the patients but also for family members and significants other Family members will react to illness indivually including anxiety, anger, depression, denial, grieving and fear

13. Talk to the family to determine their understanding and perceptions of the patient’s illness Allow to the family members to express their feling Correct misinformation and provide data as necessary Allow the family to become involved in the care of the patient Support the family in their decision about patient’s care or plan for posthospital care Be prepared to repeat information

14. Common job related stressor include caring for patient who have the following conditions : 1. Neurological injury as a result of trauma ( e.g motor vehicles accidents) 2. Dignose of terminal illness especially if they are young 3. Cognitive and emotional disabilities 4. Tracheostomy tubes, ventilators and support equipment 5. Being designated as brain dead