DIFFERENTIAL DIAGNOSIS OF BIPOLAR DISORDER

Bipolar (affective) disorder, originally called manic depressive illness, is one of the most challenging psychiatric disorders to manage. Although it has been associated with creativity, it has a negative impact on the lives of most patients and more 6% die although suicide in the two decades after diagnosis.

How is bipolar disorder diagnosed?

1. Unipolar depression: Have a high index of suspicion of bipolar disorder in early onset severe depression or if there is a strong family history. Look for a history of elevated mood and remember that irritable agitation can be a presenting feature of bipolar disorder.
2. Reaction to stress: Check for associated symptoms suggestive of bipolar disorder when prominent fluctuating mood arise from stressful life events.
3. Substance misuse: Check whether mood changes came before or after an increase in drug or alcohol use because elevated mood can lead to loss of control of drug or alcohol intake.
4. Personality disorders, traits, or cyclothymia: Should be suspected if there is a long history of relatively mild, brief and often rapidly varying mood fluctuation starting in adolescence, without definite episodes of mania or hypomania or long periods of stable mood.
5. Attention deficit hyperactivity disorder (ADHD): ADHD and bipolar disorder have similar symptoms; because ADHD is more common, bipolar disorder should not be diagnosed before adulthood unless there are clear episodes of euphoric mood.
6. Schizophrenia or schizoaffective disorder: Prominent psychotic symptoms, especially if bizarre or not congruent with elevated or depressed mood, should raise the possibility of schizophrenia or schizoaffective disorder, particularly if the psychotic symptoms are-dale, or dominate, the mood symptoms.
7. Medical and organic brain condition: Suspect an underlying organic cause in atypical or fluctuating presentations or when manic-like or depressive a symptoms occur in the context of illness or drugs known to cause behavioral change. These include neurological conditions, cerebrocrine disorders and after administration of steroids. 

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RECORDS AND REPORTS

   Records is an account of something, written to perpetuate knowledge of events. Records and reports and indispensable aids to all who are responsible for giving best possible service to individuals, families and community. Good reports are time savers. They prevent duplication of work, decrease errors and show efficiency level of the staff.
   Records and reports hold an important place in the process of educational administration. The teacher should prepare records and reports after implementation of a plan over project and the educational administrator himself is expected to prepare a report about the organization and its function periodically.
   An educational institution is a composite of many activities of varied type. It is difficult for anybody to remember the details of those activities. Recording those activities in the registers regularly and then maintaining them is an essential duty of the administrator. Further, he/she has to make the record of student's achievements, rewards, punishments. And keeping the account accurate and up to date is another record essential in administration. 

Characteristics of good Recording and Reporting:

1. Accuracy: Information should be correct to prevent serious mistakes. Use of correct spelling and the institutions accepted abbreviation and symbols ensure accurate interpretation of information. It should be always complete with accurate signature. Do not use nick names.
2. Conciseness: Use a few words as possible to give the necessary information.
3. Thoroughness: Even a concise record or report must contain complete information.
4. Up to date: Recording should be done on time. A definite time and routine for the reporting make more time and routine for the reporting makes more efficient management. Delay in recording can result in serious omissions and delay the work.
5. Organization: Communicate all the information in a logical format or order.
6. Confidentiality: The information should be confidential.
7. Objectivity: Presentation of facts not personal feelings, to give true picture.

Importance of Records and Reports:
The importance of records can be describe under following heads:
1. Importance of records for patients

• Legal evidence
• It avoids duplication of treatment measures
• It avoids duplication of diagnostic and procedural measures
• It will assist in continuity of patient care
• It helps in health insurance of the patient

2. Importance of records for doctor 

• Assure quality of care
• It will help in evaluation of medical care given by doctors
• It protects the doctor from legal activities 

3. Importance of records for hospital

• Legal protection of hospital
• Evaluate medical care given by doctor 
• Evaluate performance of individual doctors
• It also assist in planning and justification of resources

4. Importance of records for public health

• Helps in early warning of epidemic and communicable disease
• Assist in planning preventive and social measures
• Provide information of vital statistics like mortality rate, morbidity rate, infant death rate etc.

5. Importance of records in education and research

• Forms basis of clinical research
• Aids in formal education of students and staff
• Reliable source of material for advancement in medical science.

Purposes of Keeping Records

• Communication
• Education
• Assessment
• Documentation of continuity and justification of case
• Research
• Auditing
• Legal documentation
• Individual case study

   Records and reports play an important part in nursing education programme. Apart from being necessary for the day to day administration of school of nursing; they provide continuity from the time the school is established, thus facilitating evaluation of the programme. 

Types of Records
They types of records usually kept in a school office may be divided into 3 categories.
1. Those concerning students:

• Application forms and other reports called for at the time of recruitment, selection and appointment, such as references, medical reports, school records and result of any test carried out at the time of selection.
• A record of each students clinical performance.
• A progress report showing grades and other pertinent information.
• A final record/permanent record giving a summary of instruction, clinical experience, grades and relevant material.
• A health record.
• Admission record.
• Anecdotal record.

   Records and Reports for INC

1. Admission register
2. Students attendance register
3. Clinical experience records
4. Students health records
5. Staff attendance records
6. Acquittance register
7. Internal assessment register
8. External marks register
9. Report of various committee

2. Records concerning school staff:
    In the personal file of each staff member, there should be the following:

• Application forms.
• Copy of letter of appointment (or posting order) and any subsequent letter showing changes in status.
• Job description what candidate is expected to do in each category.
• Record of staff member's educational qualification, previous experience, any short term educational courses attended, membership in professional society such as contribution of articles in journals, holding office in associates or organization, participation in seminars, conference etc.
• Periodic evaluation or progress report.
• Leave record.
• Health record.
• Anecdotal record.

3. General school records:
    These consist of :

• The philosophy, objectives and curriculum of the school.
• Written policies of the school.
• Statement of budget proposals and allotments.
• Letters of agreement with affiliating agencies.
• Minutes of staff meetings.
• Copy of school brochure (or prospectus).
• Inventories of stocks.
• Admission.

REPORTS

   The number and nature of reports will be depending on what is required by the controlling body and nursing council.

   The type of information which is commonly required in an annual report is as follows:

1. Factual data relating to students, staff, clinical facilities, physical facilities, administration and curriculum.
2. Developments made in the school programme since the last report.
3. Proposals and plans for future developments.
4. Recommendation.

Role of Administrator  

   The nurse administrator should see that every body is following common guidelines for recording information:

• Information recorded is true and complete.
• Entries should be legible and written in link.
• Only facts should be recorded.
• Entries should be brief, accurate, legible and correctly spelt.
• If item error is made while written, the nurse should not erase or overwrite, instead draw a single line over it and sign it. Then note it down correctly.
• Do not leave blank space in a note.
• Always make chart for yourself and never for someone else.
• Should write in chronological order of date and time.
• Each page of record should be properly identified with identification data. 

Keeping records and reports is an important responsibility of the nurse administrator. The main points include:

• The records and reports should be kept under safe custody.
• No individual sheet is separated from the complete record.
• Records must place confidentially.
• No stranger is permitted to read the record.
• All records to be handled carefully.
• Protection from loss.
• Filling should be done alphabetically, numerically with cards and geogra-phically.
• Assess periodically to determine the use of record and reexamine for means of simplification. 

   Keeping records and reports is necessary activities in every administrative and educational programme. reports also serve as a source of reference and it has legal value too. The nurse administrator should see her role in maintaining records and reports in nursing education in order to save time. The form of record should be simple and easy to fill.

 

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NATURALISM PHILOSOPHY OF EDUCATION

Naturalism is a philosophy with the belief that nature alone represents the entire reality. There is nothing beyond behind, or other than nature. According to this philosophy, human life is the part of the scheme of nature. This philosophy gives emphasis to matter, the physical world. It does not believe in spirituality and supernaturalism. There are three different types of naturalism: 

• Physical naturalism: It is believed that reality exists in the natural universe not within the individual. Tagore has called nature as a 'manuscript of God'.
• Mechanical naturalism:It regards man as a mere machine. There is no spirit or soul. Only matter is everything. Mind is also a matter made up atoms, empty space, and motion.
• Biological naturalism: It tries to explain man in terms of lower form of life from which he has evolved.

The chief exponent of naturalism are Bacon, Comenius, Herbert Spencer, Huxley, Bernard Shaw, and Rousseau.

Naturalism and Education
   Naturalism is a revolt against traditional system of education, which gives very little freedom to the child. In naturalism, maximum freedom and central position is given to the child. This philosophy believes that education should be according to the nature of child. It advocates creation of natural conditions in which natural development of child can take place.
   Whenever a system of education becomes stereotype, there is reaction against it in the form of revival of naturalism. According to Rousseau, there are three sources of education namely, nature, men, and things. Education from nature is to prepare a natural man.

Aim of Education

self-realization, self-expression and self-preservation.

Curriculum

   There is no fixed curriculum. Every child is given the right to determine his own curriculum. He is expected to learn directly from nature through personal experiences. Subjects like agriculture, nature study, gardening, art, craft, geology, and astronomy are taught. The subjects are correlated with the physical activities of the child and with the life around him.

Methods of Teaching

   Learning by doing, playway method, observation and experimentation are used, so as to govern self. According to Rousseau, 'Students should not be given any verbal lessons rather they should be taught experience alone. Teacher tries to give lots of hand-on training and practical experiences'. 

Discipline

   Naturalist gives utmost freedom to the child to do and learn the behavior. There is no punishment of any kind. External discipline is not desirable, as it stands in the ways of child development. Naturalism also believes that formal education is the invention of society, which is created and can be called artificial. Therefore, rigid man-made discipline must be avoided in the teaching-learning process.

Role of Teacher

Teacher is always behind the screen. He is a spectator or an observer. Teacher plays his role behind the scene. He does not interfere in students' activities. Teacher acts as a facilitator, a setter of the stage, and as a supplier of materials and opportunities.

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DEVELOPMENT OF MEASUREMENT TOOL

Research studies conducted in nursing measure every conceivable phenomenon and communicate findings to others in a concise and expedient manner.The methods of measurement commonly used are self-reports, observations and physiologic markers. Out of thousands of measurements tools and instruments, the task of the researcher is to choose or develop instruments that accurately, precisely, sensitively measure the variables of interest. The instrument of research should be carefully chosen. Though a large number of instruments are  available, it may be difficult to locate the exact instrument needed for a research study.

The development of a good instrument is an intensive task and should only be undertaken when an adequate, previously developed instrument is not found. The technique of developing measurement tool involves certain definite steps.

General outline in developing research instrument
The steps involved in developing a research instrument are:

Identify the concept to be measured: 
                                                     The most critical step in instrument development is identification and specification of the research concept. The researcher should be thoroughly familiar with all the literature on the concept. This allow the researcher to determine whether a suitable and adaptable instrument exists and ensure that all the dimensions of interest are tested. Once the researcher has determined the parameters of the concept, an outline should be developed. For examples, a researcher is interested in examining the concept of lies. Lying may be examining from many view points. An inclusive instrument would address each of these different approaches. The outline may be as follow:

• Philosophical aspects of lying.
• Ethical aspects of lying.
• Moral aspects of lying.
• Religious aspects of lying.
• Professionals aspects of lying.

The concept development step is more apparent is theoretical studies than in pragmatic research, where fundamental concept are already established.

Determine the format of the measurement:

                                                               The researcher's knowledge of the concept and the respondent's knowledge of the concept will influence the choice of format. The researcher will also want to consider, how the information will be handled and what results are needed. For example, an unstructured interview may result in transcript of words that will have to be content analyzed. Though it may give a rich data st, it may be measured only at a nominal level. A questionnaire on the same topic may mean less rich data, but can give data measured at the internal/ratio level.

Develop the items: 

                         Using previously developed items, the researcher developed the items. The researcher must decide the format, for example, in case of questions- open ended or closed ended. Open ended questions do not give any specific response and may be long and difficult to categorize, closed ended questions result only in short answers and are easier to code and analyze. The number of questions too small number may not capture the subject, and too many may fire the respondent and may fail to answer the questions. The wording also should be considered the researcher who knows the concept very well, should be able to translate the knowledge into items that are understood by the respondent. The items should be worded concisely and simply. The researcher should consider reading level of the responding if a pen-paper instrument is developed. The wordings should be carefully phrased so that it will bias the respons by the sample.

Sequence the items:

                            Questions that ask about sensitive topics, such as income, sexual habits, should be placed at the end of the questionnaire. Respondents may not answer these questions. In such situations, the researcher can salvage some data. There should be logical sequence in the questionnaire -  simple to complex, less sensitive to more sensitive, most interesting to least interesting. Questions about different topics may be asked together. If there is no logical sequence random is best choice.  

Write the directions:

                          Respondents need carefully constructed, clear directions if they are to complete the instrument correctly. This is true for interview schedule. Questionnaires also require a cover letter if they are to be mailed. The covering letter should carefully state the purpose of study information about confidentiality, what the respondent should do with the questionnaire when it is completed and how the respondent may obtain further information.

Develop draft instrument and supporting materials:

                                                                           Once all the elements are ready, the instrument should be assembled. The 'look' of the instrument is also important when given to respondents. Such things as spacing the question, colour of the paper all can affect responses.

Review and pre-test:

                          The instrument should be reviewed by other knowledgeable researchers. The researcher should be asked to examine the instrument for completeness, clarity and layout. archrs. Content experts (both lay and professional) should be asked to comment on the instrument. After making needed changes, the questionnaire should be pre-tested using a small sample that possess characteristics similar to those proposed for  a larger study, under similar circumstances of proposed study. The pre-test helps the researcher to determine if the respondents can understand the items, directions are clear, and testing validity and reliability. It may be helpful to interview respondents after the pre-testing to elicit their suggestions and opinions.

Revise:

       Once pre-test is complete, the researcher should revise the instrument as indicated. If the researcher finds it necessary to make major revisions, a second pilot test should be performed.

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CRITICAL ANALYSIS OF TEACHER EDUCATION

Preservice Education

• Lack of uniformity due to variety of programmes with diverse curriculum leading to variations in entry level qualifications required for different levels of education.
• Reduced focus on faculty development.
• In comparison with the theoretical aspects, less weightage is given to practical aspects of education.
• Less orientation towards classroom realities.

In-Service Education

• Requires more coordinated efforts.
• Training must be based on the findings of needs analysis.
• Designing of in-service education must show difference in meeting the expectations of various levels of teachers.
• Privileging based on in-service education can be introduced.

Need for Schemes for development of Teacher Education

• Current teacher education programmes need revision and evaluation.
• New teacher education programmes need to be developed based on educational technology.
• Development of standards and quality indicators of teacher education is needed.
• Improve administration through capacity building of trainers.
• Monitor the outcomes of teacher education.
• Synchronize the work to reach the desired goals.

Approaches for Improving the Quality of Teacher Education
Some approaches for improving the quality teacher education are as follows:

• Creation of ideal institute for teacher education in every state by the central government.
• Development of centres of resource for teacher education for learning materials.
• Promoting need-based continuing education and strengthening of teaching capacities of educators.
• Updating of preservice education programmes.
• Encouragement of follow-up studies and follow-up activities.
• Conversion of all the teacher education programmes to the university level.
• Making available of online distance education for continuous education.
• Institution of all-inclusive colleges of education.
• Formation of state boards or teacher education.
• Continuous updation of teacher education curriculum.
• Increasing importance on direct teaching experience.
• Recuperating the quality of support system for teacher education.
• Strengthening of databases to support policies and decision-making.
• Introducing licensing and grading system for teachers to professionalize teaching.
• Continuous appraisal of teacher education institutions and their programmes. 

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AIMS OF EDUCATION

Education is a continuous lifelong process. The aim of education is to provide direction to the process of education. There are different aims of education like social aim, vocational aim, cultural aim, moral aim, spiritual aim, intellectual aim, etc.

Medical -surgical Nursing Quiz
Social Aim
Human being is considered to be a social animal. Education can make him to be a productive member of the society. Every individual is born with some potential. It is the education that helps the individual to meet his potential. Society is considered to be the result of interaction among the individuals either in small or large group. Education ensures peaceful existence of the society. By education, students realize the importance of social values like justice, fair play, healthy competition and harmony, etc. Education makes the individual accountable to the community and the nation. With social aims, education gives direction to the society in its development.

Vocational Aim
Process of education makes the individual to be capable of his livelihood, so that he can useful and lead a productive life in the society. The individual respects the dignity of labour. This aim makes him self-reliant and sufficient and fills the gap between education and vocation. Vocational aim has utilitarian dimension too. Education provides knowledge and skills to an individual in a fruitful manner.

Cultural Aim
Education has a cultural aim also. By undergoing education, child becomes civilized and cultured. An educated person develops aesthetic sense and respects other's culture. Knowing the culture includes gaining or acquiring knowledge about existing beliefs of a society, art, morals, laws, etc.

Moral Aim
Education helps in building up of character of an individual. Most values like honesty, truthfulness, justice, goodness, purity, courage, punctuality, and dutifulness are nurtured through education.

Old Question Paper
Spiritual Aim
Education is necessary to promote spirituality among the individuals. He raises himself above self-interest and works for the welfare of others, which is called to be the state of self-actualization. He not only preaches right or wrong, but also practices it in his life.

Intellectual Aim
Education provides opportunities to an individual to develop innate power or intellectual capacity to think rationally and lead his life independently with confidence.


Perioperative Nursing                                Educational Video

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LEGAL RESPONSIBILITY OF A NURSE

To prevent the legal issues, it is very necessary for nurses to follow some responsibilities.
The main areas to prevent legal issues are:

Legal responsibility of a nurse during admission and discharge of Medico Legal Case (MLC)
While providing nursing care in any medico legal case nurse must take care of following thigs:

• After receiving the patient from OPD to ward, immediately inform the doctor on duty of that unit.
• All the records of patient like OPD slip, admission slip, admission files must be kept under lock and key to prevent legal issues.
• It is nurse responsibility not to show the patients records to anybody.
• It is nurse responsibility not to show or hand over to any police personnel.
• It is also a nurse responsibility not to throw any discharge of patient without the permission of physician.
• Nurse should keep the belonging of the patient in her custody.
• Take consent of relative or patient for any kind of procedure or treatment.
• Avoid answering enquirers to an insurance agent.
• The condition of patient should be reported verbally to relatives.
• Maintain all records of the patient accurately

Responsibility of nurse during the discharge of patient

• On discharge, no record should be handed over to the police by nurse.
• Entered clearly, if patient is transferred to another ward or hospital.
• Before allowing the patient to leave the hospital, nurse should clearly enter or write the name of relatives of the patient.
• It is nurse responsibility to keep all the records concerning to patient under lock and key after discharge of the patient.

In case of death of the patient

After death of the patient, if patient is medico legal nurse must get written instruction from the medical officer for handing over the body of the person to mortuary/police officer.

• Note complete name and address of patient.
• Note identification number.
• Signature of witness.
• Note list of belongings of the patients.
• Maintain privacy and give full respect to dead body.

Legal responsibility of a nurse in Admission and Discharge of mentally ill patients

• As per Indian Mental Health Act 1987 major patient (mental ill) gets admitted on a voluntary adult basis.
• After admission, nurse should check the application form for admission is accompanied by report of two medical officers out of which one should be government doctor.

Responsibilities during discharge of mentally ill persons

• Check the signature of patient or relative after discharge of the patient.
• Note permanent and correspondence address of patient.

Responsibilities of a nurse in case of absconding of patient

• Check  the number of patients admitted with actual number of patients present in the ward while handing over and taking over charges from one nurse to another.
• Inform immediately to in-charge of the unit and keep the record of patient under lock and key.

Responsibilities of a nurse during examination of a female patient

• It is nurses responsibility to maintain the privacy of female patient during the examination.
• Nurse must present during the examination.
• Little exposure of patient is to be made.
• Protect the right of the patient during examination of female patients.
• It is nurse responsibility to discourage if repeated examination of breast/perineal part by the male doctor.

Legal responsibilities of a nurse while administrating medication

• Keep in mind 5k while administering medication.
• Follow only written order of physician.
• Strict monitoring of medicines especially one which change the chemistry of blood.
• Medicine containers must be properly labelled.

Legal Responsibilities during sterilization and abortion

For permanent sterilization, it is essential to

• Get informed consent signed by both (husband and wife).
• Eugenic sterilization to prevent procreation of unfit such as mentally retarded, mentally ill, habitual criminal and sexual deviates is prescribed in some part of the world. But each case is taken independently.

Legal responsibilities of a nurse during organ transplant

As a nurse, she should be aware that an uninformed donor prepared under sedation for removal of any part is criminal in the court of law. So it is nurse's responsibility to get the consent signed by relatives as per the desire of the deceased.

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IMPORTANCE OF SOCIOLOGY

Sociology Studies Society Scientifically 

A scientific knowledge of society is the prerequisite to any marked improvement in the state of human affairs.

• Sociology studies roles of the institutions in the development of the individual: Sociology studies social institutions and the relation of the individual to each of these institutions. The home and the family, the school and education, the church and religion, the state and government, industry and work, the community and associations - these are the great institutions through which society functions.

• The study of sociology is indispensable for understanding and planning of society: Society is complex phenomenon with a multiplicity of intricacies. It is almost impossible to understand it and solve its various problems without the study of sociology. A certain amount of knowledge about the society is necessary before any social policy can be carried out. For example, a policy of population control cannot be determined in exclusive economic terms because matters of family organization, customs and traditional values must be taken into account, and these require a sociological type of analysis.

• Sociology is of great importance in solving social problems: The present world is suffering from many problems which can be solved only through a scientific study of the society. It is obvious that social  evils do not just happen. Everything has its due cause. It is the task of sociology to study that social problems through the methods of scientific research and find out solutions for them.

• Sociology has drawn our attention to the intrinsic worth and dignity of man: Sociology has been instrumental in changing our attitude towards human beings. In such a huge and specialized society as ours, we are all limited as to the amount of the organization and culture that we can experience directly  

• Sociology has changed our outlook with regard to the problem of crime, etc.: Again it is through the study of sociology that our whole outlook on various aspects of crime has been changed. The sciences of criminology and penology, social work and social therapy, which are rendering commendable service in understanding social situations and solving individual problems, are but handmaids of sociology.

• Sociology has made a great contribution to human culture: Human culture has been enriched by the contribution of sociology, which has removed many cobwebs from our minds and knowledge and inquiry. Sociology also impress egoistic ambitions and class hatted.

• Sociology is of great importance in solving International problems: The progress made by physical sciences has brought some nations of the world to a stage of advancement that is much ahead as compared to those who have been left behind by the revolutionary progress of the science.

• Sociology is useful as a teaching subject: In view of its importance, sociology is becoming popular as a teaching subject also. It is being accorded as important place in the curriculum of college and universities.

• Sociology as a Profession: The value of sociology lies in the fact that it keeps us up to date on modern situations; it contributes to making good citizens; it contributes to solving community problems; it adds to knowledge of society; it identifies good government with community and it helps one understand the causes of things; and so on 

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PURPOSES OF NURSING RESEARCH

General Purpose of nursing research is to answer the questions or solve problems of relevance to the nursing profession.

Specific purposes: Specific purposes of nursing research includes:

• Basic research to extend the base of knowledge in nursing.
• To formulate or refine a nursing theory.
• Applied research to find solutions to existing problems.
• To enhance the immediate utility of Evidence-Base-Practice.
• To study the effectiveness of a nursing interventions.
• To discover general principles of human behavior to solve problems in nursing practice.
• To achieve varying level of explanation.
• To identify, describe, explore, explain and predict and to exert control over the existing health problem situation.
• To link research findings with Evidence-Base-Practice.
• To develop and rigorously test a new method of measuring patient outcomes.
• To help nurses make Evidence-Base treatment decisions.
• To determine the benefits and risks of the newly developed or existing interventions.
• To assess the cost-effectiveness of nursing interventions.
• To diagnose, assess patients and to measure important clinical outcomes.
• To facilitate the development of long-term care plans for patients. 
• To provide guideline to patients to make important lifestyle choices and to be vigilant for key symptoms.
• To decide resource allocation.
• To prevent harm to the patients.
• To determine the factors that, influence the health or cause illness, mortality, morbidity.
• To design effective interventions.
• To motivate people to comply with the treatment.
• To engage in health promotion activities.
• To study the barriers to positive health practices.
• To understand the processes clients experience in a transition through health care crisis.

The purpose of research can be further studied depending on the nature of the study, i.e. the quantitative or qualitative study.

Purposes of Quantitative Research

• To assess the prevalence of phenomenon. (How much?)
• To study the frequency of the phenomenon. (How often?)
• To understand the nature of phenomenon. (What is?)
• To study the factors related to the phenomenon. (What influence)
• To know the antecedents of the phenomenon. (What leads to?)
• To identify the causal pathway of the phenomenon.
• TO apply theory to explain the phenomenon.
• TO understand the alterations in the phenomenon with modification or introduction of an intervention.
• To predict the occurrence of cause and effect.
• To make the phenomenon occur or to alter its prevalence.

Purposes of Qualitative Research

• To define the phenomenon.
• To label the phenomenon.
• To understand the dimensions of the phenomenon.
• To know the important aspects of the phenomenon.
• To understand the nature of the phenomenon in depth.
• To study the events/outcomes to which the phenomenon leads.
• To illustrate the process by which the phenomenon evolves or experienced.
• To identify what makes the phenomenon occur/exist.
• To study the working of the phenomenon.
• To learn the meaning of the phenomenon.
• To evaluate the occurrence of the phenomenon.    

The nursing research, through a recently developed dimension of nursing profession; had existed ever since the nursing existed. From its most primitive trial and error form, it has evolved to today's most modern and scientific study. It is only three decades back it got momentum with the rapid inventions and technological advances in the health care delivery. From the transition of family doctor to nurse, research literacy is vital for nurses to provide cost-effective managed care.

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MENTAL HEALTH TEAM

Teamwork is paramount for the success of any group. Teamwork means the combined, co-coordinated & dedicated effort of each & every member of the team toward achievement of the vested interest, target or goal of the team as an entity. 

Members of the Mental Health Team:-

1.     Psychiatrist

2.     Psychiatric nurse clinical specialist

3.     Registered nurse in a psychiatric unit

4.     Clinical psychologist

5.     Psychiatric social worker

6.     Psychiatric para-professionals

·        Psychiatric nursing aids / attendants

·        ECT Techniques

·        Auxiliary personnel

·        Occupational therapist

·        Recreational therapist

·        Diversional play therapist

·        Creative art therapist

·        clergymen

Psychiatrist:-The psychiatrist is a doctor with post-graduation in psychiatry with 2-3 years of residence training. The psychiatrist is responsible for diagnosis, treatment & prevention of mental disorders, prescribe medicines & somatic therapy & function as a leader of the mental health team.

Psychiatric nurse clinical specialist:-The psychiatric nurse clinical specialist should have a master degree in nursing, preferably with post –graduate research work. She participates actively in primary, secondary & tertiary prevention of mental disorder & provides individual, group & family psychotherapy in a hospital & community setting. She also takes up the responsibility of teaching, administration & research.

Registered nurse in a psychiatric unit:-The registered nurse undergoes a general nursing & midwifery program or B.Sc nursing / post-basic B.Sc nursing program with added qualification such as diploma in psychiatric nursing. Diploma in nursing administration etc. This nurse is skilled in caring for the mentally ill, gives holistic care by assessing the patient’s mental, social, physical, psychological & spiritual needs.

Clinical psychologist:-The clinical psychologist holds a doctoral degree in clinical psychology & is registered with the clinical psychologist’s association. She/he conducts psychological, diagnosis tests, interprets & evaluates the finding of these tests & implements a program of behavior modification.

Psychiatric social worker:-The psychiatric social worker is a graduate in social work & post-graduate in psychiatric social work. She/he assesses the individual, the family & community support system, helps in discharge planning, counseling for job placement & is aware of the state laws & legal rights of the patient & protects these rights.

Psychiatric para-professionals:- 

a.     Psychiatric nursing aids / attendants:-They have high school training & are trained on the job. They aid maintaining the therapeutic environment & provide care under supervision.

b.     ECT Techniques:-They undergo training for 6-9 months. Their function is to keep ready the ECT under the supervision of a psychiatrist or anesthetist.

c.      Auxiliary personnel:-They are volunteer housekeeper or clerical staff & require in-service education to interact with the patient therapeutically.

d.     Occupational therapist:-Occupational therapist goes through specialized training. He /she has a pivotal role to play by using manual & creative techniques to assess the interpersonal responses of the patient. Patients are helped to develop skill in the area of their choice & become economically independent. They are helped to work in sheltered workshop.

e.     Recreational therapist:-The recreational therapist plans activities to stimulate the patient’s muscle co-ordination, interpersonal relationship & socialization. These approaches are need-based.

f.       Diversional play therapist:-Makes observation of a child / patient during his play. The behavior of the child while playing, the type of toys & his reaction toward the doll, beating, calling or throwing are the focus of attention.

g.     Creative art therapist:-He/she is an art graduate & encourages the patient to express his work freely with colors & analysis the use of various colours, drawing of various scenes etc. this therapy helps in diagnosis & also in bringing the repressed feelings of the patient to the conscious level. 

h.     Clergymen:-These are religious persons who may be asked to come to the hospital unit once a week (depending on the patient’s religious faith) & have a spiritual talk with the patient.

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