1. Psychosocial factors are the inducement.
2. The performance is under any of the following circumstances:
(1) dissociative amnesia (hysterical amnesia).
(2) dissociative roaming (hysterical roaming).
(3) Dissociative identity disorder (hysterical double or multiple personality).
④ Hysterical emotional outburst (hysterical psychosis).
(5) Conversion movement and sensory disorder (conversion hysteria).
(6) Other forms of hysteria.
3. Symptoms hinder social function.
4. There is sufficient evidence to exclude mental disorders caused by organic diseases or non-dependent substances.
1. The onset is related to mental factors, and mental trauma causes a strong emotional response, which is often the cause of the first onset. Subsequent attacks can occur again under similar circumstances to the first attack, because touching the scene, association or self-suggestion evoke old emotional experiences.
2. Hysterical attacks help patients get out of trouble, vent their emotions, gain sympathy from others or get support and compensation. The so-called secondary interest is an important factor that keeps the symptoms going.
3. Most patients have the characteristics of hysterical personality, that is, high mood, strong and vivid emotional response, but superficial and unstable, suggestive, self-centered, exaggerated speech and behavior, full of fantasy.
4. Clinically, according to the difference of mental disorders or sensory and motor disorders, it can be divided into hysterical mental disorders and hysterical physical disorders.
5. Hysterical mental disorder, also known as dissociative disorder, mainly has the following clinical manifestations:
(1) hysterical hazy paroxysmal narrow range of consciousness.
(2) Emotional outbursts are manifested as venting, childish behavior, emotional exaggeration and affectation, and the speech content is related to mental trauma.
(3) Hysterical amnesia is called borderline amnesia when you suddenly forget the experience related to something at a certain stage; Some forget all the experiences, including names and ages; During the period, the patients had clear consciousness and good cognitive and adaptive functions.
(4) Hysterical roaming suddenly leaves home to travel abroad, accompanied by different degrees of consciousness disorder, and can still carry out more complicated activities. The period can be hours, days or longer, and you can't fully recall it after the attack.
(5) Hysterical pseudodementia is a sudden dementia-like state, also known as juvenile dementia or Ganser syndrome.
(6) Hysterical multiple personality is a sudden change of identity, and two or more identities alternate with each other, including ecstasy.
6. Hysterical physical disorder, also known as transformational disorder, can be manifested in the following forms:
(1) Sensory disorders include hysterical amaurosis, hysterical deafness, hysterical pain, hysterical globosity or globosity.
(2) Dyskinesia includes hysterical grand mal, hysterical paralysis, hysterical aphonia, hysterical tremor, etc.
7. The physical symptoms of hysteria patients are inconsistent with the nerve distribution and examination results, and their symptoms reflect the patients' understanding of the disease, that is, the clinical manifestations are imaginary diseases.
8. Hysterical patients, especially those who show physical symptoms, don't care about their symptoms, that is, it doesn't matter. Some patients have some anxious experiences.
Hysterical nursing
I. Assessment
(1) Symptom assessment
1. Understand the symptoms, characteristics and clinical manifestations of epileptic seizures.
2. Evaluate the symptom characteristics, types, frequency and severity of patients with hysteria.
(B) the assessment of personality characteristics
1. Many scholars believe that under the influence of some mental factors, people with hysteria personality characteristics are less likely to have hysteria personality characteristics.
Some people are more prone to hysteria. Therefore, it is necessary to know what kind of personality characteristics are "hysterical personality" and what are their manifestations.
2. According to the methods and steps of Nursing Procedure, the personality characteristics of patients during hospitalization were evaluated. Understand their interpersonal relationships.
Situation, work style, emotional response type, coping style and adaptability to stimuli, sensitivity to hints, emotions
The characteristics of the reaction, etc.
(c) Assessment of psychosocial factors
Psychosocial factors are often the inducing factors of hysteria. Can't be ignored. Therefore, it is harmful to patients before the onset.
Seriously evaluate the relationship between stimulation and the degree of stimulation and the occurrence of diseases. Analyze whether the stimulus comes from life events or diseases.
People's own inner conflicts, or susceptibility traits from personality, etc.
Second, the main nursing diagnosis and nursing measures
(A) the nursing points of hysteria
1. When hysteria occurs, the first thing is to keep calm and keep the patient and the surrounding environment quiet.
2. Psychological nursing is one of the main nursing measures. Among them, master and use all kinds of.
Relevant suggestion methods and techniques are helpful to both doctors and patients. Adopt supportive psychotherapy to arouse the enthusiasm of patients,
Stimulate their enthusiasm for life and strengthen patients' confidence in overcoming diseases.
3. Health education is an important part of nursing. The purpose is to help patients acquire better personality and enhance their psychological immunity.
Force, win the help of good peripheral support system.
4. Physical care in emergency should not be underestimated. To prevent the occurrence of various complications. Do a good job of various symptoms
Symptomatic nursing.
(two) the main nursing diagnosis and nursing measures
1. The danger of violent behavior (to oneself and others) is related to the narrow range of conscious activities during the attack.
When hysterical attacks occur, such as sudden emotional outbursts, patients can show crying, tearing clothes, hair, scratching and biting others.
The act of hurting yourself and others. For example, in the hazy state of hysteria, the scope of conscious activity is narrow. Therefore, strengthen preventive measures.
Is necessary.
Nursing measures:
(1) It needs to be clear that although the emotional outburst of hysteria has dramatic and venting characteristics, it is in contact with patients in nursing.
Avoid using excessive words to stimulate patients or paying too much attention to patients. Patients may make more exaggerated behaviors, leading to
The consequences of self-harm or injury, so pay attention to the use of language. In order to make language powerful, patients should listen and understand themselves.
The mistake of one's own behavior did not cause malignant stimulation to the patient's psychology.
(2) When the patient has an attack, try to keep the environment around the patient quiet, avoid noise and reduce too many people.
Onlookers, in order to reduce the degree of the patient's attack, is also conducive to the smooth progress of treatment and nursing.
(3) For hospitalized patients, the number of visits should be strictly controlled. In particular, it is necessary to limit those who may cause adverse stimulation to patients.
Member of the visit, in order to facilitate recovery as soon as possible.
(4) Patients with extreme excitement, restlessness and strong emotional reaction should be closely monitored. Ask the doctor to use an appropriate sedative.
Medicine.
2. The risk of injury is related to the disturbance of consciousness when roaming.
During the onset of hysteria, some patients may have roaming disorder: suddenly leaving, accompanied by different degrees of consciousness disorder. this
Without necessary special care or unsafe environmental factors, patients may be injured to varying degrees.
Nursing measures:
(1) Hysteria is mainly treated in outpatient department. Therefore, it is very important for patients to go out of the hospital for outpatient treatment and nursing in time.
(2) Whether outside the hospital or for inpatients, it is best to have someone to take care of them. Don't let the patient live in a room alone. evening
Lock the door when you go up. Inpatients should limit their range of activities.
(3) Don't put dangerous goods in the patient's living room. So as to reduce unsafe hidden trouble.
(4) Wear identification documents for patients. In case of accidents after loss.
3. The risk of disuse syndrome is related to hysterical paralysis.
Some patients with hysteria will have symptoms of functional hysterical paralysis. Although there is no nervous system positive body in this symptom,
Symptoms, but if it is not effectively treated for a long time or accompanied by physical incentives, it can still seriously affect the normal activities of patients. patient
Staying in bed for a long time, unable to walk on the ground, and relying on others to take care of daily life, leading to a dangerous state of physical system degradation. some
There may be physical complications. Such as bedsore, constipation and urinary tract infection. Strength and endurance also decreased significantly.
Nursing measures:
(1) When a patient has hysteria, it is necessary to explain the nature of the disease to the patient. Relieve patients' fears and anxieties.
Xu. Tell patients that they can be completely cured as long as they cooperate with the treatment, so as to strengthen their confidence in overcoming the disease and win their cooperation.
Work.
(2) Master the methods and skills of using drugs, hypnosis and combining benign language hints to assist doctors. Help patients train regularly.
Exercise the functional activities of limbs. Encourage patients to get out of bed and walk around to prevent muscle atrophy.
(3) Massage and nurse the compressed parts of the skin every day to prevent bedsores.
(4) provide patients with high-fiber food. Do abdominal massage every day. Give patients plenty of water to prevent constipation. Ruoji
In case of constipation, move it in time, observe and use laxatives or enema according to the doctor's advice to prevent intestinal obstruction. Bathe patients every night.
Yin, prevent urinary tract infection. Ensure indoor humidity, regular ventilation and disinfection, and assist patients to change clothes with seasons.
In case of catching a cold.
4. Lack of knowledge
(1) The lack of patients' knowledge is mainly manifested in the lack of mental health knowledge. Lack of common sense of mental health care. Know the outside world
Lack of psychological endurance during bad stimulation, inability to use good and effective psychological prevention mechanisms to protect themselves, and unhealthy personality.
All of them.
(2) Lack of knowledge about patients' relatives. It shows that they don't know much about this disease and can't provide effective help for patients. counter
In short, unintentional behavior and inappropriate language often play a bad suggestive role and aggravate the patient's condition.
Nursing measures:
Take health education as the main content. It is necessary to help patients fully understand themselves and dig out their personality weaknesses and diseases.
The relationship. Teach patients some scientific and applicable methods to improve their personality and deal with tense interpersonal relationships; Regulate bad emotions
Mood, enhance psychological endurance. Instruct patients to deal with some difficult problems with reason rather than emotion. In addition, there must be
Targeted help patients' families to understand the common sense about Italian disease, so that patients can get more effective help from it. It is also our protection.
Contents of management measures.
Third, the expected goal
1. During the hysterical attack, the patient was not injured or self-injured under supervision.
2. When hysterical paralysis occurs, patients will not have complications such as muscle atrophy, constipation and bedsore under nursing.
3. After receiving health education guidance. Patients can objectively evaluate physical personality defects. Or have a desire to perfect personality and
A change in behavior.
4. The patient's family can clearly retell the characteristics, symptoms and nursing points of the disease.
5. Patients will not suffer from "vagrancy" under supervision.