Hysteria, also known as hysteria. This is a mental disorder caused by mental factors, such as major life events, inner conflicts, emotional excitement, suggestion or self-suggestion, which acts on susceptible individuals. Mainly manifested as various physical symptoms, narrowing the scope of consciousness, selective forgetting or emotional outbursts and other mental symptoms; However, there is no corresponding organic damage as its pathological basis.
1) pathogen
1. Mental factors, especially mental tension and fear, are important factors causing hysteria. The acute hysteria in this kind of battle is particularly obvious.
2. Childhood traumatic experiences, such as mental abuse, physical or sexual destruction, are one of the important areas in which transformed and separated hysteria occurs in adulthood. Whether mental factors cause symptoms or what type of hysteria is related to the physiological and psychological quality of patients. Women who are emotionally unstable, easy to accept hints, often hypnotize themselves, have low education level, are superstitious, and are in adolescence or menopause are more prone to hysteria than the average person.
3. People who have strong emotional reactions, exaggerated expressions, seek the continuous attention of others and are self-centered are prone to hysteria after being frustrated, having psychological conflicts or accepting hints. But this personality trait is not a necessary condition for hysteria. Some people who do not belong to this personality will also have hysteria reaction under the influence of strong mental factors.
4. The genetic research results of hysteria are quite inconsistent. Some studies think that hysteria is influenced by genetic factors, while others think that genetic influence is very small. Some people think that hysteria is a multifactorial genetic form.
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6) Disease assessment
1. Symptom assessment
① Understand the symptoms, characteristics and clinical manifestations of epileptic seizures.
② To evaluate the symptom characteristics, types, frequency and severity of patients with hysteria.
2. Personality assessment
Many scholars believe that under the influence of some mental factors, people with hysteria personality characteristics are more likely to suffer from hysteria than those without hysteria personality characteristics. So we should 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 relationship, work style, emotional response type, coping style and adaptability to stimuli, the degree of being easily hinted, and the characteristics of emotional response.
3. Assessment of psychosocial factors
Psychosocial factors are often the inducing factors of hysteria. Can't be ignored. Therefore, the relationship between the adverse stimulation and the degree of stimulation before the onset of the disease and the occurrence of the disease is carefully evaluated. Analyze whether the stimulus comes from life events, from the patient's own inner conflict, or from the susceptible quality of personality.
7) Nursing measures
1. nursing points
(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, it is particularly important to master and use various related suggestion methods and skills, which are helpful to both doctors and patients. Take supportive psychotherapy, arouse the enthusiasm of patients, stimulate their enthusiasm for life, and enhance their confidence in overcoming diseases.
③ Health education is an important nursing content. The purpose is to help patients acquire a better personality, enhance their psychological immunity and win the help of a good peripheral support system.
④ Physical care in an emergency should not be taken lightly. To prevent the occurrence of various complications. Do a good job in symptomatic care of various symptoms.
2. Diagnostic measures
① The danger of violence (to oneself and others) is related to the narrow range of conscious activities during the attack.
During the onset of hysteria, if the mood suddenly breaks out, patients may show behaviors that hurt themselves and others, such as crying, tearing clothes, hair, scratching and biting others. For example, in the hazy state of hysteria, the scope of conscious activity is narrow. Therefore, it is necessary to strengthen preventive measures.
Nursing measures:
A. It needs to be clear that although the emotional outburst of hysteria has dramatic and venting characteristics, it is necessary to avoid using excessive words to stimulate patients or paying too much attention to patients when contacting patients in nursing. Patients may make exaggerated behaviors, leading to self-harm or injury, so pay attention to the use of language. Language should be strong enough for patients to understand and understand their own behavior mistakes, and will not cause malignant psychological stimulation to patients.
B. When the patient has an attack, try to keep the environment around the patient quiet, avoid noise and reduce too many people to watch, so as to reduce the degree of the patient's attack, which is also conducive to the smooth progress of treatment and nursing.
C for hospitalized patients, medical treatment should be strictly controlled. In particular, it is necessary to limit the visits of relevant personnel who may cause adverse stimulation to patients in order to facilitate the early recovery of the disease.
D. Patients who are extremely excited, fidgeting and have a strong emotional reaction should be closely monitored. Ask the doctor to use an appropriate sedative.
② The risk of injury is related to the disturbance of consciousness during roaming.
During the onset of hysteria, some patients may have roaming disorder: suddenly leaving, accompanied by different degrees of consciousness disorder. At this time, if there is no necessary special care or unsafe environmental factors, patients may be injured to varying degrees.
Nursing measures:
A. 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.
B It's better to have someone take care of the patients outside or in the hospital. Don't let the patient live in a room alone. Lock the door at night. Inpatients should limit their range of activities.
C. don't put dangerous goods in the ward. So as to reduce unsafe hidden trouble.
D. 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 this symptom has no positive signs of nervous system, it can still seriously affect the normal activities of patients if it is not effectively treated for a long time or accompanied by physical incentives. Patients stay in bed for a long time, can't walk on the ground, and rely on others to take care of their daily lives, which leads to the dangerous state of physical system degradation. Some people may have physical complications. Such as bedsore, constipation and urinary tract infection. Strength and endurance also decreased significantly.
Nursing measures:
A. When the patient has hysteria, explain the nature of the disease to the patient. Relieve patients' fear and anxiety. 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.
B master the methods and skills of using drugs, hypnosis and combining benign language hints to assist doctors. Help patients to carry out regular physical activity training. Encourage patients to get out of bed and walk around to prevent muscle atrophy.
C. Massage the compressed parts of the skin every day to prevent bedsores.
D. provide patients with high-fiber food. Do abdominal massage every day. Give patients plenty of water to prevent constipation. If constipation has occurred, move it in time, observe and use laxatives or enema according to the doctor's advice to prevent intestinal obstruction. Rinse perineum for patients every night to prevent urinary tract infection. Ensure indoor humidity, regular ventilation and disinfection, assist patients to change clothes with the seasons, and prevent colds.
④ Lack of knowledge
A. Patients' lack of knowledge is mainly manifested in the lack of mental health knowledge. Lack of common sense of mental health care. When they encounter bad external stimuli, they lack psychological endurance, will not use good and effective psychological prevention mechanisms to protect themselves, and their personality is not perfect.
B. lack of understanding of patients' relatives. It shows that they don't know much about this disease and can't provide effective help for patients. On the contrary, unintentional behavior and inappropriate language often play a bad suggestive role, which aggravates 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 their relationship with diseases. Teach patients some scientific and applicable methods to improve their personality and deal with tense interpersonal relationships; Regulate bad emotions and enhance psychological endurance. Instruct patients to deal with some difficult problems with reason rather than emotion.
In addition, it is also necessary to help patients' families understand the common sense about Italian symptoms, so that patients can get more effective help from them. It is also the content of our nursing measures.
3. Expected objectives
① During the onset of hysteria, there was no injury or self-injury behavior.
② When hysterical paralysis occurs, patients will not have complications such as muscle atrophy, constipation and bedsore under the care.
(3) after receiving health education guidance. Patients can objectively evaluate physical personality defects. Or have the desire to perfect personality and change behavior.
④ Family members of patients can clearly retell the characteristics, symptoms and nursing points of the disease.
⑤ The patient does not suffer from "roaming" under supervision.
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