CONCEPTUAL MODEL OF MENTAL HEALTH NURSING PRACTICE

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CONCEPTUAL MODEL OF MENTAL HEALTH NURSING PRACTICE
Dian Wahyuni MENTAL HEALTH AND COMMUNITY
DEPARTMENT BINAWAN INSTITUTE OF HEALTH SCIENCES
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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

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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 ?

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• 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.

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• 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.

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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.

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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.

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• 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.

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• 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

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• 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.

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MODEL

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

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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

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BERBAGAI MODEL

• Psikoanalitis
• Sosial
• Interpersonal
• Eksistensial
• Komunikasi
• Perilaku
• Medis
• Keperawatan

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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.

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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

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MODEL SOSIAL

• (Szasz, Caplan )
• Faktor sosial lingkungan stres
• ansietas
• 
  gejala
• Perilaku menyimpang
• - sistem sosial
• - sistem politis

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Model Sosial

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

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Model Sosial

• Peran
• Mengemukakan masalah
• Menggali sistem sosial
• Menggunakan sumber tersedia

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Model Interpersonal

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

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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

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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

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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

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Model Komunikasi

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

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Model Perilaku

• Eysenck, Wolpe Skinner
• Perilaku dipelajari

• ansietas
• perilaku tak diinginkan
• Gejala perilaku

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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

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• Model Medis

• Perilaku Proses penyakit

-
SSP

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

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Model Medis

• Proses Terapeutik
• Berdasarkan diagnosa
• Terapi somatik interpersonal
• Respons simptomatis
• Tenaga kesehatan lain

• Peran
• Mengikuti terapi fisik
• Melaporkan efek terapi
• Mengajarkan tentang penyakit

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Model Keperawatan

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

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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

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Perbandingan Model Biomedis Keperawatan
Keperawatan
Medis
Penyebab
Kelemahan
Penyakit
Resiko
Masalah
Respons
Kesehatan
Manusia
Penyembuhan
Perawatan
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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.