Depression is a natural kind of feeling or emotion that accompanied psychological component: think hard, gloomy, sad, hopeless and unhappy, and somatic components: anorexia, constipation, skin moist (cold), blood pressure and pulse rate decreased slightly.
Depression is caused by many factors including: heriditer factors and genetic, constitutional factors, premorbid personality factors, physical factors, psychobiology factors , neurologic factors, biochemical factors in the body, factors electrolyte balance and so on.
Depression is usually triggered by physical trauma such as infectious disease, surgery, accidents, labor and so on, as well as psychic factors such as loss of love or self-esteem and the effect of hard work.
Depression is a normal reaction when it takes place in a short time, with a clear trigger, long and deep depression that factor originators. Psychotic depression is when a complaint is concerned no longer compatible with reality, not to judge reality and can not be understood by others.
The data needs to be assessed in patients with Depression
a. Subjective data:
Not being able to express their opinions and lazy talk. Often argued somatic complaints. Feeling themselves are not useful anymore, no meaning, no purpose in life, feeling hopeless and suicidal.
b. Objective data:
Body movements were blocked, curved body and when sitting with slumped attitude, facial expressions moody, slow gait dragged by step. It can sometimes happen stupor. Patients seem lazy, tired, no appetite, difficulty sleeping and crying.
The thinking process too late, as if his mind blank, impaired concentration, had no interest in, can not think, do not have any imagination. In patients with depressive psychosis there is a deep sense of guilt, unreasonable (irrational), Objective Data delusions, depersonalization, and hallucinations.
Sometimes patients prefer hostile, irritable and do not like to be disturbed.
2. Maladaptive coping
a. Subjective Data: declare hopeless and helpless, unhappy.
b. Objective Data: look sad, irritable, agitated, unable to control impulses.
Nursing Diagnosis for Depression
1. Risk for Self Harm related to depression
2. Depression related to maladaptive coping.
Nursing Interventions for Depression
General Purpose: Clients do not self-injure.
1. Clients can build a trusting relationship
- Introduce yourself to the client
- Interact with the patient as much as possible with the four attitudes.
- Listen to patient statements, patient manner, empathy and use more non-verbal language. For example: a touch, a nod of the head.
- Note the patient talks and give responses according to her wishes.
- Speak with a low tone of voice, clear, concise, simple and easy to understand.
- Accept the patient is without comparing with others.
2. Clients can use adaptive coping
- Give encouragement to express his feelings and said that nurses understand what the patient feels.
- Ask the patient the usual way to overcome feeling sad / painful.
- Discuss with patients the benefits of coping used.
- With patients looking for alternatives coping.
- Encourage the patient to choose the most appropriate coping and acceptable.
- Encourage the patient to try to coping have been.
- Instruct the patient to try other alternatives in solving the problem.
3. Clients are protected from self injuring behavior
- Monitor carefully the risk of suicide / self-mutilation.
- Keep and store the tools that can be used by patients to injure himself / others, in a safe and locked.
- Keep the tool material harm to the patient.
- Supervise and place the patient in a room that is easily monitored by nurses.
4. Clients can increase self-esteem
- Help to understand that the client can overcome despair.
- Assess and internal sources mobilized individuals.
- Help to identify the sources of expectations (eg, interpersonal relationships, beliefs, things to be resolved).
5. Clients can use social support
- Assess and use individual external sources (those closest to the team of health care, support groups, religious affiliation).
- Assess support systems beliefs (values, past experiences, religious activities, religious beliefs).
- Make referrals as indicated (eg, counseling, religious leaders).
6. Clients can use the medication correctly and appropriately
- Discuss medications (name, frequency, effects and side effects of medication).
- Help for using drugs; really patient, medication, method, period.
- Encourage talking about the effects and side effects are felt.
- Give positive reinforcement when using the drug properly.