Understanding The Nursing Diagnosis For Schizophrenia
Schizophrenia is a mental illness that can cause psychotic symptoms like hallucinations and delusions alongside mood-related symptoms like depression and low motivation. However, it can be challenging to understand what these symptoms might look like when someone with schizophrenia seeks help.
A nursing diagnosis is a diagnosis made by a nurse to describe a patient’s experiences when they seek care. To learn more about schizophrenia diagnoses, it may be helpful to explore how a nursing diagnosis differs from a medical diagnosis and the different diagnoses a nurse can make for someone living with schizophrenia.
Schizophrenia explained
To understand the different nursing diagnoses for schizophrenia, it may help to get familiar with its symptoms and causes.
Schizophrenia is a lifelong disorder that often appears during young adulthood. The fourth edition of the DSM (DSM-4) organized the condition by subtypes. However, as society’s understanding of mental health has evolved, so has public knowledge of schizophrenia. In the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, schizophrenia falls under the broader “schizophrenia spectrum” category. This spectrum also includes other mental illnesses like brief psychotic disorder and schizoaffective disorder.
Symptoms of schizophrenia fall into two main categories: negative and positive. Positive symptoms are thoughts, feelings, and behaviors added to a person’s experiences. Negative symptoms are thoughts, feelings, and behaviors that are reduced or absent from a person’s experiences. Common positive schizophrenia symptoms include:
- Experiencing sensory perceptions that are not truly occurring (hallucinations)
- Holding false beliefs that can’t be swayed (delusions)
- Mixing up words, going on tangents, or talking in a way others don’t understand (disorganized speech)
- Thinking in ways that don’t follow logic (disorganized thought)
Common negative schizophrenia symptoms include:
- A lack of pleasure in relationships and activities
- Reduced desire to interact with others
- Reduced emotional expression through tone of voice, hand gestures, or facial expressions
- A lack of motivation to go to work, bathe, or complete other daily tasks
Due to symptoms like delusions and hallucinations, people with schizophrenia may sometimes lose track of what’s real and what’s not. When someone experiences these positive symptoms and a loss of reality, they are experiencing “psychosis” or a “psychotic episode.”
Risk factors and causes of schizophrenia
Researchers haven’t pinpointed exactly what causes schizophrenia. However, they’ve identified certain risk factors that may put people at a higher risk of developing it. These factors include:
- Having family members with schizophrenia
- Being born in the winter months
- Using drugs early in life (especially cannabis)
- Having a low birth weight
- Living in an urban environment
Schizophrenia often develops due to a combination of genetics and environmental factors. However, not everyone who is at risk of schizophrenia will go on to develop the condition. According to the World Health Organization (WHO), the estimated rate of schizophrenia worldwide is under 1%.
Understanding nursing diagnoses
When you receive care for a mental or physical illness, a nurse may be involved in your treatment. They might give shots, run tests, or provide other forms of support beyond the treatments offered by doctors.
Another part of a nurse’s job is to collect information about how you’re feeling and what problems you’re experiencing so they can determine how to best help you. During this process, a nurse might develop a “nursing diagnosis.”
A nursing diagnosis is different from an official medical diagnosis, which is made by a doctor. It may be helpful to consider the flu as an example to understand the difference. A nurse’s job wouldn’t be to diagnose a person with the flu. Instead, they might provide other diagnoses to help plan their care, such as:
- Fatigue, which could mean a patient would benefit from assistance walking
- Fever, which might require the nurse to change the patient’s sheets or use damp cloths to cool them down
- Disrupted sleep, which might require the nurse to make the patient’s sleeping environment more comfortable
- Risk of dehydration, which could mean the patient will need to have water brought to them frequently
A nurse doesn’t diagnose what illness a person has. Instead, they diagnose what a person is experiencing to determine what nursing interventions they might need.
What is the nursing diagnosis for schizophrenia?
Schizophrenia can affect people in a wide range of ways. For this reason, there may not be one universal set of nursing diagnoses for it. However, several common nursing diagnoses could apply to schizophrenic patients, including but not limited to the following.
Disturbed sensory perception
Disturbed sensory perception refers to difficulty interpreting information from one's five senses. In someone with schizophrenia, this difficulty could apply to auditory or visual hallucinations. A nurse might address this challenge by creating a calming environment for their patient to reduce distress as a result.
Impaired social interaction
Related to symptoms like social withdrawal and reduced emotional expression, this diagnosis might require a nurse to ensure their patient has a sense of safety when talking to them. They might also connect their patient with community resources or encourage them to get involved in social activities.
Sleep deprivation
Sleep deprivation occurs when someone does not get enough quality sleep for a significant period. A person with schizophrenia might have difficulty sleeping due to their hallucinations or delusions. This challenge might require a nurse to ensure the patient goes to bed at a consistent time or keep their sleeping environment cool, dark, and comfortable.
Self-care deficit
This diagnosis may apply when clients struggle to care for their basic needs, such as bathing, eating, or getting dressed. Negative symptoms of schizophrenia can contribute to this challenge by lowering motivation. A nurse might respond by assisting with these tasks or helping their patient develop a self-care routine.
Ineffective coping
Ineffective coping means someone’s strategies for dealing with challenges aren’t effective in their unique situation. When schizophrenia symptoms become overwhelming, it may be challenging to manage them effectively. In response, nurses might walk their patients through stress management techniques or connect them with a solution-focused counselor.
By making these diagnoses, nurses may better help their patients with schizophrenia, support their medication adherence, and reduce their discomfort.
Getting help for schizophrenia
Nursing diagnoses may ensure people get the care they seek when looking for care for schizophrenia. However, because schizophrenia is a lifelong condition, it often requires ongoing support. With proper treatment, like medication and social skills training, people with schizophrenia may better manage their symptoms. At least one in three people with schizophrenia enter complete remission from their symptoms with treatment.
Counseling may play another role in improving individuals’ long-term quality of life with schizophrenia. Trained therapists can suggest healthy coping strategies while helping clients improve their thought patterns and behaviors.
However, if you’re living with schizophrenia, symptoms like low mood and motivation may make it more difficult to leave the house. This difficulty can make it challenging to attend therapy in person. With online therapy through a platform like BetterHelp, you can work with a therapist from your home, which may be more manageable than in-person therapy. In addition, you can access unique features like support groups, worksheets, and journaling prompts.
Studies have shown that online therapy may be an effective treatment for schizophrenia. In one 2016 study, veterans with schizophrenia at risk of suicide received a three-month telehealth intervention. By the end of the program, the majority of the participants saw improvements in their symptoms.
If you are experiencing suicidal thoughts or urges, call the 988 Suicide & Crisis Lifeline at 988 or text 988 to talk to a crisis provider over SMS. They are available 24/7 to offer support. 988 also offers an online chat for those with an internet connection.
Takeaway
When someone seeks care for an illness, a nurse might give them a nursing diagnosis. A nursing diagnosis is made based on symptoms and experiences rather than the underlying cause. Several nursing diagnoses could apply to schizophrenia, a mental illness that can cause hallucinations, delusions, and other symptoms. These diagnoses may help nurses decide how to provide the best care possible for schizophrenia patients.
Because schizophrenia is a lifelong condition, managing symptoms long-term may mean getting ongoing mental health support. Consider contacting a licensed therapist online or in your area for further support. If you’re in a crisis, reach out to crisis resources, such as the hotline above.
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