Component Task: Managing a Patient with Inappropriate Thought Content (Delusion)

This is the process of assisting a psychiatric patient who cannot tell what is real from what is imagined to gain an awareness of the symptoms and be in touch with reality. It involves the use of a sequence of psychological steps that the nurse can use to aid a patient to organize and interpret reality. This patient usually has unshakeable beliefs in something untrue despite the availability of clear evidence to the contrary.

Aims

·         Help increase awareness of the symptoms to interpret reality

·         Prevent patient’s condition from worsening

·         Promote recovery

Requirements

·         Table

·         Chair

·         Pen and paper

·         Patient’s folder (Electronic/Manual)

·         Serene environment

Steps

1.        Establish rapport (refer procedure) and explain procedure

2.      Interview patient to determine whether delusion is present

3.      Respect patient’s views, maintain control and distance during interview

4.      Encourage expression of feelings and thoughts

5.      Identify precipitating factors

6.      Show acceptance, listen and avoid arguing with patient

7.       Give honest perceptions of reality in feedback

8.      Observe for verbal and non-verbal cues

9.      Inform patient about the support system available

10.    Teach patient therapeutic values of medicines and daily routines that promote compliance

11.      Express appreciation and direct patient to the next activity

12.    Document observations and findings in nurses’ notes/patient’s folder