Biological: Traumatic injuries account for more than five million deaths worldwide annually, and account for nine percent of global mortality (NIH. 2011). Survivors are often faced with secondary health issues that may affect their physical, emotional and financial status (NIH, 2011). Likewise, Frank, having been a survivor to a traumatic car accident, has been diagnosed with somatoform disorder secondary to this major event. Jozefowicz and Smith (2012) define somatoform disorder as functional impairment caused by chronic pain without having any underlying biological determinants. Therefore, chronic pain has been established as an important nursing diagnosis relevant to Frank (NANDA).
In a clinical scenario, nurses play vital role towards formulating an appropriate pain management regime for their patients (Brown et al., 2015). Furthermore, critical monitoring tasks are needed when addictive agents, such as opiates, are in use. Drug dependence is a major issue towards use of high risked opiates (Bryant & Knights, 2014). Frank was prescribed opiate medication by his general practitioner to manage his pain, however, overuse of this opiate has resulted Frank to be dependent on the prescribed opiate to carry out normal functioning. Bryant and Knights suggest that, the best way to get off a person from drug dependence is to administer lower doses, lower frequency and substitution with simpler analgesics by the nurse collaborating with participating practitioner and consumer. This procedure would be carried out slowly, with close patient monitoring and with collaborative information sharing to enhance nurse-consumer participation in recovery. Pain scale would be used to measure pain and collect data on patient recovery status.
Jozefowicz and Smith (2012) suggest that administration of SSRIs may have positive outcome on patients with somatoform disorder. The researchers suggest that SSRIs may help balance the neurological chemical serotonin levels in the body and promote recovery. SSRIs may also help consumers faced with somatoform disorder to cope with comorbid psychological effects such as anxiety and Post-Traumatic Stress Syndromes (PTSD).
Psychological: American Psychiatric Association (2013), believe that somatoform disorders are disorders that are symptomatic to medically un-diagnosable conditions that are accompanied by several mental distresses. For instance, Frank was diagnosed with somatoform disorder and has been complaining about severe chronic back pain without any clinical rationale. Additionally, Frank presents with comorbid psychological disturbances such as anxiety and post-traumatic stress syndrome that has impacted on his daily lifestyle activities. Anxiety and Post-Traumatic Stress syndrome are nursing diagnosis that will be elaborated in this section of paper (NANDA).
Bjorn et al., believe that patients with somatoform disorder often lack ability to recognise emotions and epithetical deficits that may lead to stress related mental disorders such as anxiety. Anxiety generally causes people to have enhanced concerns about specific situations that may result in harming ideations and actions (Barsky, 2013). Frank has been anxious about his health condition regardless of several tests run to rule out any degenerative or any medical conditions applicable. This may be a result of anxiety where Frank’s thought process has been disturbed. Collaterally, Post- Traumatic Stress Syndrome is another major issue that commonly occurs side by side with somatoform disorders, which contributes to increased levels of anxiety (Bjorn et al., 2012). Having been through a major traumatic incident, it is inevitable that Frank has concerns and anxiety towards his health status. Management of PTSD is therefore, critical towards Frank’s journey to recovery. Psychotherapy such as Cognitive Behaviour Therapy (CBT), has been found to be effective in management of anxiety and PTSD (Abbass et al., 2014). There are several exercises that may help Frank to cope with mental stressors. For instance, deep breathing, mindful meditation, focusing on single objects of the room, etc. can help manage stress (Gerace, 2018). Self-assessment tools will be used to measure anxiety levels and recovery. These tools are HAM and RAS DS respectively. Furthermore, MSE can also be used to keep track of recovery and psychological disorder management.
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