THESIS-PTSD
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Nov 24, 2024
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THESIS: A RESEARCH ON NURSING INTERVENTIONS FOR PATIENTS WITH POST-
TRAUMATIC STRESS DISORDER (PTSD)
STUDENT NAME
MODULE
MODULE LEADER
DATE
1
Table of Contents
CHAPTER 1
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3
Introduction
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3
Theoretical Part
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4
Definition of PTSD
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4
Epidemology
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5
Pathogenesis of PTSD
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7
Division of PTSD
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8
Symptoms of PTSD
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9
Treatment of PTSD
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11
Conclusion
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15
CHAPTER TWO
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17
METHODOLOGY
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17
Research Questions
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17
Aims of the Study
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18
Study Design
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19
Materials and Data Collection
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21
Data Collection Process
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22
Data management and Challenges
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24
Data Analysis
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CHAPTER 3
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28
CASE STUDY
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28
Findings
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28
Nursing Care Plan
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33
Conclusion
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REFERENCES
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2
CHAPTER 1
Introduction
Individuals that have experienced or watched terrible events may develop post-traumatic
stress disorder (PTSD), a crippling mental health condition. The major occurrences of PTSD are
a serious issue in the world since it affects not only the individuals who are affected but also
society as a whole.
Many studies have been done to comprehend the prevalence of PTSD. About 3.5% of
American adults develop PTSD each year, according to the American Psychiatric Association
(APA, 2013). Additionally, 7-8% of people are predicted to develop PTSD at some point in their
lives (Kessler et al., 2005). The worrisome incidence of this disorder and the requirement for
efficient therapies are highlighted by these facts.
PTSD has a deep and wide-ranging effect on people. Flashbacks, nightmares, intrusive
and disturbing recollections of the traumatic incident, and extreme emotional suffering are
common in people with PTSD (APA, 2013). Significant impairment in a variety of spheres of
life, such as job, interpersonal connections, and general quality of life, may result from this.
Additionally, comorbid mental health conditions such depression, anxiety, and substance
addiction are more common in those with PTSD (Yehuda, 2002). Due to higher healthcare
expenditures, less productivity, and higher rates of disability, PTSD has a significant financial
impact (Kessler et al., 2008).
Nursing interventions are essential in meeting the unique needs of PTSD patients. Nurses
frequently provide support, empathy, and evidence-based interventions at the point of care to
help patients heal and recover. The value of nursing treatments lies in their capacity to boost
PTSD sufferers' general wellbeing and patient outcomes.
The development of a therapeutic connection is a crucial component of nursing
interventions for PTSD. Nurses establish a secure and encouraging environment for patients to
communicate their experiences and emotions through active listening, empathy, and trust-
building (Gilbert et al., 2013). This therapeutic partnership gives patients a sense of
empowerment and optimism while serving as the cornerstone for interventions that are effective.
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Additionally, a variety of evidence-based tactics for treating symptoms and encouraging
recovery are included in nursing interventions. These interventions can involve coordinating
interdisciplinary care, supporting trauma-focused therapy, teaching coping mechanisms and
relaxation strategies, and providing psychoeducation regarding PTSD (Foa et al., 2018). Nurses
help patients manage their symptoms and overall suffering by educating them and giving them
the tools, they need. This enhances everyday functioning.
Additionally, nursing interventions are essential for preventing comorbidities and
promoting all-encompassing care. The physical, emotional, and social requirements of people
with PTSD can be recognized and met by nurses. In order to provide complete care, including
the management of co-occurring diseases and the encouragement of good lifestyle choices, they
can work in conjunction with other healthcare specialists.
In conclusion, PTSD affects people individually and as a society in a big way. It is
impossible to overestimate the value of nursing interventions in meeting the unique requirements
of patients with PTSD. Nurses contribute to better patient outcomes and the general wellbeing of
people suffering from PTSD by developing therapeutic relationships, offering evidence-based
treatments, and advocating holistic care.
Theoretical Part
Definition of PTSD
Post-traumatic stress disorder (PTSD), a mental ailment, may develop in people who
have seen or experienced terrible events. Its distinguishing features include a variety of
unpleasant symptoms that significantly affect one's physical, mental, and emotional health.
PTSD is categorized as an anxiety disorder that manifests after exposure to an incident that
involves actual or threatened death, significant injury, or sexual assault in the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013).
One of the requirements for diagnosing PTSD is exposure to a traumatic incident,
whether it was experienced firsthand, saw, or heard about from a close friend or family member.
4
There must also be a mix of symptoms from one or more of the following four groups. Re-
experiencing is the first kind and it includes disturbing memories of the traumatic incident that
often appear as troubling memories, nightmares, or flashbacks. The second category is
avoidance, which describes measures made to stay away from concepts, opinions, places, people,
or activities that can trigger distressing memories or emotions related to the trauma.
A consistently unpleasant feeling, such as dread, guilt, shame, or detachment, as well as
warped views about oneself, other people, or the world, are characteristics of the third group of
cognitive and mood alterations. It is difficult to have happy emotions when you fall into this
group since they lead to alienation. The fourth kind, hyperarousal, is characterized by symptoms
including difficulty falling asleep, irritability, an exaggerated startle response, and
hypervigilance. Hyperarousal involves heightened susceptibility to potential risks.
For a clinical diagnosis of PTSD, these symptoms must persist for more than a month and
severely impair social, occupational, or other essential areas of functioning.
Epidemology
Post-Traumatic Stress Disorder (PTSD) is a prevalent mental health condition that affects
a significant portion of the general population. Its impact on individuals and society as a whole is
a major concern in the field of mental health. Understanding the prevalence of PTSD and the
demographic factors that influence its occurrence is crucial for providing effective interventions
and support to those affected.
Various studies and national surveys have been conducted to determine the prevalence of
PTSD in the general population. According to the National Comorbidity Survey Replication
(NCS-R), which is a large-scale epidemiological study in the United States, the lifetime
prevalence of PTSD is approximately 6.8%, while the 12-month prevalence is around 3.5%
(Kessler et al., 2005). These figures indicate that a significant proportion of the population is at
risk of developing PTSD at some point in their lives.
5
The prevalence of PTSD varies across different demographic groups. Age is one such
influential factor. Studies have shown that the prevalence of PTSD tends to be higher in younger
age groups. For instance, a study by Breslau et al. (1998) found that the prevalence of PTSD was
highest among individuals aged 25 to 34 years. Gender is another important factor to consider.
Research has consistently shown that women are more likely to experience PTSD compared to
men. For example, a study by Tolin and Foa (2006) reported that women had a higher prevalence
of PTSD in a sample of trauma-exposed individuals.
Occupation is also associated with differences in PTSD prevalence. Individuals working
in high-risk professions, such as military personnel, first responders, and healthcare workers,
may be more susceptible to traumatic events, leading to an increased risk of developing PTSD. A
study conducted by Hoge et al. (2004) among U.S. military personnel who served in Iraq and
Afghanistan found a significant prevalence of PTSD, particularly among combat troops.
Analyzing trends and patterns in PTSD occurrence can offer valuable insights into its
prevalence and potential risk factors. For instance, some studies have suggested that the
prevalence of PTSD may vary across different periods, with higher rates observed during times
of conflict or natural disasters (Norris et al., 2002). Additionally, research has shown that certain
types of traumatic events, such as sexual assault and interpersonal violence, are more likely to
result in PTSD compared to other traumas (Kessler et al., 1995).
In conclusion, PTSD is a prevalent mental health condition in the general population,
with a substantial number of individuals affected by its debilitating symptoms. Demographic
factors such as age, gender, and occupation play a significant role in determining the prevalence
of PTSD. Understanding these factors and analyzing trends in PTSD occurrence is essential for
developing targeted interventions and support services to effectively address the needs of those
affected by this disorder.
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Pathogenesis of PTSD
Post-Traumatic Stress Disorder (PTSD) is a complex mental health condition that arises
following exposure to traumatic events. The pathogenesis of PTSD involves a combination of
underlying mechanisms and factors that contribute to the development and persistence of the
disorder. This section will explore the various biological, psychological, and social factors
involved in the pathogenesis of PTSD.
Biological factors play a crucial role in the pathogenesis of PTSD. One of the key
biological mechanisms is the dysregulation of the stress response system. Research by Yehuda
(2002) has highlighted the role of the hypothalamic-pituitary-adrenal (HPA) axis in the
development of PTSD. Trauma exposure can lead to alterations in cortisol levels, which is a
hormone produced by the HPA axis in response to stress. Individuals with PTSD often exhibit
abnormal cortisol levels, which may contribute to the persistence of traumatic memories and
hyperarousal symptoms.
In addition to the HPA axis, other neurotransmitters and brain regions are implicated in
PTSD pathogenesis. For example, the amygdala, which is responsible for processing emotions
and fear responses, may be hyperactive in individuals with PTSD, leading to heightened fear and
anxiety reactions (Shin et al., 2006). The prefrontal cortex, involved in emotional regulation and
cognitive processes, may also show reduced activation, affecting the individual's ability to cope
with traumatic memories and emotions.
Psychological factors also play a significant role in the development of PTSD. Cognitive
appraisals, such as the perception of threat and vulnerability, can influence the individual's
response to trauma (Ehlers & Clark, 2000). Individuals who perceive the event as highly
threatening and themselves as helpless or vulnerable are more likely to develop PTSD. Coping
strategies are another psychological factor that can impact the development of PTSD. Avoidant
coping strategies, such as denial or emotional suppression, may hinder the processing of
traumatic memories and prolong the disorder, while adaptive coping strategies, like seeking
social support and cognitive restructuring, can promote resilience and recovery.
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Social factors contribute to the pathogenesis of PTSD as well. Social support is a crucial
protective factor against the development of PTSD (Brewin et al., 2000). Having a strong
support system and receiving emotional and practical help from friends, family, or community
can buffer the impact of trauma and promote coping and healing. On the other hand, the lack of
social support or exposure to ongoing stressors, such as discrimination, poverty, or interpersonal
conflicts, can increase the risk of developing PTSD and hinder recovery.
In conclusion, the pathogenesis of PTSD is multifaceted, involving a complex interplay
of biological, psychological, and social factors. Dysregulation of the stress response system,
alterations in neurotransmitters and brain regions, cognitive appraisals, coping strategies, and
social support all play critical roles in the development and persistence of PTSD. Understanding
these underlying mechanisms and factors is essential for developing targeted interventions and
providing comprehensive care to individuals affected by this debilitating disorder.
Division of PTSD
Post-Traumatic Stress Disorder (PTSD) can manifest in various ways, and its
presentation may vary over time. There are different classifications or types of PTSD based on
the duration and onset of symptoms. The three primary divisions of PTSD are acute, chronic, and
delayed-onset PTSD.
Acute PTSD
Acute PTSD is characterized by the onset of symptoms within the first three months
after the traumatic event. Symptoms in this type of PTSD are usually intense and may include re-
experiencing the trauma through flashbacks or nightmares, avoiding reminders of the trauma,
negative alterations in mood and cognition, and hyperarousal. Acute PTSD is a normal response
to an abnormal event and can be seen as the body's natural way of processing and coping with
trauma.
Chronic PTSD
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Chronic PTSD occurs when symptoms persist for more than three months after the
traumatic event. Individuals with chronic PTSD continue to experience the same symptoms as in
acute PTSD, but the intensity may fluctuate over time. This type of PTSD can significantly
impact the individual's daily functioning, relationships, and overall quality of life. Chronic PTSD
may result from ongoing exposure to stressors or from the inability to process and integrate the
traumatic experience fully.
Delayed-Onset PTSD
Delayed-onset PTSD is characterized by a delayed onset of symptoms, where the
individual does not experience significant distress immediately after the traumatic event but
develops PTSD months or even years later. This type of PTSD can be challenging to diagnose
because the individual may not initially associate their symptoms with the past trauma. However,
when the symptoms become more pronounced and interfere with daily life, a connection to the
past trauma may become evident.
It is essential to recognize these different types of PTSD as they may influence the
treatment approach and prognosis. Early identification and intervention can be crucial in
preventing the progression of acute PTSD to chronic PTSD and improving long-term outcomes.
Symptoms of PTSD
Post-Traumatic Stress Disorder (PTSD) is characterized by a range of symptoms that can
significantly impact an individual's daily life and emotional well-being. The fifth edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American
Psychiatric Association (APA, 2013) outlines the specific criteria for diagnosing PTSD. These
criteria encompass four symptom clusters: re-experiencing, avoidance, negative alterations in
cognition and mood, and hyperarousal.
Re-experiencing:
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Re-experiencing symptoms involve the individual reliving the traumatic event through
distressing memories, nightmares, or flashbacks. These symptoms can be triggered by reminders
of the trauma, such as certain sounds, smells, or situations. For example, a combat veteran may
experience vivid flashbacks of being in combat when hearing loud noises that resemble gunfire.
These intrusive recollections can be overwhelming and cause significant emotional distress.
Avoidance:
Avoidance symptoms are characterized by efforts to avoid reminders of the traumatic
event. Individuals may avoid places, people, or activities that remind them of the trauma to
prevent distressing emotions or memories from resurfacing. For instance, a car accident survivor
might avoid driving or refuse to pass by the accident site to prevent reliving the traumatic
experience. Avoidance can hinder the individual's ability to participate fully in daily life and may
lead to social isolation.
Negative Alterations in Cognition and Mood:
This symptom cluster involves persistent negative thoughts and feelings related to the
traumatic event. Individuals with PTSD may experience feelings of guilt, shame, or self-blame,
even if they were not at fault for the trauma. They may also have a diminished interest in
activities they once enjoyed and feel detached from others. For example, a survivor of a natural
disaster may feel intense guilt for surviving while others did not, leading to a persistent sense of
sadness and emotional numbness.
Hyperarousal:
Hyperarousal symptoms are characterized by an increased state of arousal or vigilance,
which can be difficult to control. Individuals with PTSD may be easily startled, have difficulty
sleeping, and have an exaggerated startle response. For instance, a sexual assault survivor may
have trouble falling asleep due to heightened anxiety and persistent feelings of danger.
Hyperarousal can lead to irritability, difficulty concentrating, and hypervigilance, making it
challenging to focus on daily tasks.
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It is important to note that not everyone who experiences a traumatic event will develop
PTSD, and the severity and duration of symptoms can vary among individuals. The presence of
these symptoms for more than one month and their significant impact on daily functioning are
necessary for a diagnosis of PTSD.
Treatment of PTSD
Treatment for Post-Traumatic Stress Disorder (PTSD) aims to alleviate symptoms,
improve overall well-being, and enhance the individual's ability to cope with traumatic
memories. There are various evidence-based treatment approaches that have shown efficacy in
managing PTSD symptoms.
Evidence-Based Psychotherapy Interventions:
a. Cognitive-Behavioral Therapy (CBT): CBT is one of the most widely studied and
effective psychotherapy interventions for PTSD (Foa et al., 2018). It focuses on helping
individuals identify and challenge negative thought patterns related to the traumatic event and
develop healthier coping strategies. Exposure therapy, a component of CBT, involves gradually
confronting trauma-related memories and situations in a safe and controlled environment to
reduce avoidance behaviors and emotional reactivity.
b. Eye Movement Desensitization and Reprocessing (EMDR): EMDR is another
evidence-based psychotherapy approach that has shown promise in treating PTSD (Shapiro,
2018). It involves bilateral stimulation, such as eye movements or taps, while the individual
processes traumatic memories. EMDR aims to desensitize distressing memories and promote
adaptive information processing.
Pharmacotherapy
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a. Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs, such as sertraline and
paroxetine, are commonly prescribed antidepressant medications that have been approved for the
treatment of PTSD. They can help alleviate symptoms of depression, anxiety, and hyperarousal
in individuals with PTSD.
b. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): SNRIs, like venlafaxine,
are another class of antidepressant medications used to manage PTSD symptoms. They work by
increasing the levels of serotonin and norepinephrine in the brain, which can help regulate mood
and reduce hyperarousal.
Complementary Therapies
a. Mindfulness-Based Interventions: Mindfulness-based therapies, such as
Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy
(MBCT), have been found to be beneficial in reducing symptoms of PTSD (Hölzel et al., 2011).
These interventions involve cultivating present-moment awareness and accepting one's thoughts
and feelings without judgment.
b. Yoga: Yoga, which combines physical postures, breathing exercises, and meditation,
has also shown promise in reducing PTSD symptoms (Cramer et al., 2013). It can help
individuals reconnect with their bodies and reduce physiological arousal associated with PTSD.
It is essential to note that the choice of treatment for PTSD should be individualized
based on the individual's specific symptoms, needs, and preferences. Some individuals may
benefit from a combination of psychotherapy and pharmacotherapy, while others may find
complementary therapies helpful in managing their symptoms.
Treatment providers should engage in shared decision-making with their patients to
collaboratively determine the most appropriate treatment approach. Additionally, treatment
12
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progress should be regularly monitored to assess the effectiveness of interventions and make
necessary adjustments as needed.
Role and Tasks of a Nurse
The role of nurses in caring for patients with Post-Traumatic Stress Disorder (PTSD) is
crucial in providing comprehensive and holistic care to individuals who have experienced
traumatic events. Nurses play a significant role in supporting and improving the well-being of
patients with PTSD through various responsibilities and tasks.
Assessment and Diagnosis
Nurses conduct thorough assessments to identify and diagnose PTSD in patients. They
gather information about the traumatic event, assess the severity of symptoms, and identify any
co-occurring conditions. This assessment is essential for developing an individualized care plan
that addresses the unique needs of each patient.
Developing Therapeutic Relationships
Establishing a therapeutic relationship is fundamental in caring for patients with PTSD
(Gilbert et al., 2013). Nurses provide a supportive and empathetic environment, allowing patients
to feel safe and encouraged to share their experiences. Through active listening and
understanding, nurses build trust and rapport with patients, which is crucial for effective
interventions.
Implementing Evidence-Based Interventions
Nurses employ evidence-based interventions to manage PTSD symptoms effectively.
These may include trauma-focused therapies such as Cognitive-Behavioral Therapy (CBT) or
Eye Movement Desensitization and Reprocessing (EMDR). Nurses collaborate with mental
health professionals to coordinate care and ensure patients receive appropriate and timely
interventions.
13
Providing Psychoeducation
Nurses play a vital role in educating patients and their families about PTSD, its
symptoms, and available treatments. Psychoeducation helps patients understand their condition,
cope with symptoms, and engage in their treatment process actively. Nurses also provide
information about coping strategies and resources for ongoing support.
Medication Management
In some cases, nurses may assist in medication management, particularly when patients
are prescribed pharmacotherapy to manage PTSD symptoms. They monitor medication
adherence, assess for side effects, and educate patients about the benefits and risks of
medications.
Encouraging Self-Care
Nurses promote self-care practices that contribute to overall well-being. They
encourage patients to engage in relaxation techniques, mindfulness exercises, and healthy
lifestyle habits that can help reduce stress and anxiety associated with PTSD.
Crisis Intervention and Safety Planning:
Nurses are trained in crisis intervention and safety planning for patients at risk of self-
harm or suicide. They collaborate with other healthcare professionals to develop safety plans that
ensure patients' immediate safety during times of distress.
Collaboration with Multidisciplinary Team
Nurses work collaboratively with a multidisciplinary team, including psychologists,
psychiatrists, social workers, and other healthcare providers, to ensure comprehensive care for
14
patients with PTSD. This interdisciplinary approach addresses various aspects of patients' well-
being, enhancing treatment outcomes.
Support for Family Members:
Nurses also provide support and education to family members of individuals with
PTSD. Family involvement is essential in the recovery process, and nurses help families
understand how to provide appropriate support and create a conducive environment for healing.
Long-Term Care and Follow-Up
PTSD may require long-term care and follow-up to manage symptoms effectively.
Nurses play a crucial role in monitoring patients' progress, assessing treatment effectiveness, and
making adjustments to the care plan as needed.
In conclusion, nurses have a vital role in caring for patients with PTSD. Their
responsibilities encompass various aspects of care, from assessment and evidence-based
interventions to psychoeducation, support, and long-term follow-up. Establishing a therapeutic
relationship is at the core of nursing care for individuals with PTSD, as it fosters trust and
openness. By employing evidence-based interventions and providing patient education, nurses
contribute significantly to improving patients' well-being and quality of life.
Conclusion
In conclusion, this research has provided a comprehensive understanding of Post-
Traumatic Stress Disorder (PTSD) and the crucial role of nurses in its management. The
definition of PTSD, based on established medical and psychological literature, emphasizes the
debilitating impact of trauma on individuals' mental health and well-being. We discussed the
prevalence of PTSD in the general population, highlighting the alarming incidence of this
disorder and the need for effective interventions.
15
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The pathogenesis of PTSD involves a complex interplay of biological, psychological, and
social factors. Nurses play a significant role in recognizing these factors during assessment and
tailoring individualized care plans accordingly. The division of PTSD into acute, chronic, and
delayed-onset types underscores the importance of timely interventions and long-term follow-up.
Understanding the characteristic symptoms of PTSD, including re-experiencing,
avoidance, negative alterations in cognition and mood, and hyperarousal, enables nurses to
identify and address patients' specific needs effectively. Evidence-based treatment approaches,
such as Cognitive-Behavioral Therapy (CBT) and Eye Movement Desensitization and
Reprocessing (EMDR), have shown promising results in symptom reduction and improving
patients' overall well-being.
Nurses' specific role in caring for patients with PTSD involves conducting thorough
assessments, developing therapeutic relationships, implementing evidence-based interventions,
providing psychoeducation, and collaborating with a multidisciplinary team. By performing
these tasks, nurses contribute significantly to patients' recovery and improved quality of life.
The implementation of evidence-based interventions can have a profound impact on
patient outcomes. By utilizing effective treatments and interventions, nurses can reduce the
severity of symptoms, enhance coping strategies, and promote resilience in patients with PTSD.
This, in turn, leads to better overall functioning and a higher quality of life for individuals
affected by this debilitating disorder.
In conclusion, understanding PTSD and the role of nurses in its management is vital in
providing comprehensive and holistic care to those impacted by trauma. By utilizing evidence-
based interventions, nurses can make a significant difference in the lives of individuals with
PTSD, fostering healing, recovery, and improved well-being. The knowledge gained from this
research can guide nursing practice and contribute to better patient outcomes, underscoring the
importance of continued research and evidence-based care in the field of PTSD management.
16
CHAPTER TWO
METHODOLOGY
This chapter presents the technique used in this study to find and investigate efficient
nursing interventions for patients with Post-Traumatic Stress Disorder (PTSD). The methodology
describes the strategy utilized to address the study's purpose and meet its goals. It includes the
study's design, procedures for gathering data, methods for analyzing that data, and ethical issues.
This study seeks to acquire pertinent information, consolidate the available evidence, and offer
insightful information regarding the efficacy of nursing interventions for patients with PTSD
through the use of a strict and methodical methodology. The methodology section acts as a road
map for the study, assuring objectivity, validity, and dependability throughout the investigation.
Research Questions
The primary objective of this particular research paper is to undertake an exploration on
effective nursing interventions for patients with Post-Traumatic Stress Disorder (PTSD). The
following research questions will direct the study in order to fulfill this goal:
1.
What types of nursing interventions are most frequently utilized to treat PTSD patients?
The purpose of this question is to list the many nursing interventions that are currently
used in the treatment of PTSD patients. A thorough grasp of the various interventions will be
acquired by reviewing the current literature, empirical investigations, and expert perspectives.
This will aid in determining the most effective methods and evidence-based strategies for nursing
care of PTSD patients.
17
2.
How do nurse interventions help PTSD patients feel better overall and
reduce their symptoms?
The evaluation of nursing interventions' effects on symptom management and the general
wellbeing of PTSD patients is the main goal of this question. The study will investigate the
efficacy of various nurse interventions in reducing PTSD symptoms and enhancing patients'
quality of life by looking at quantitative data, qualitative narratives, and patient-reported
outcomes.
3.
What hinders and helps the implementation of nursing treatments for
PTSD patients?
This inquiry tries to pinpoint the elements that affect how nurse interventions for PTSD
patients are carried out. The study will determine the facilitators and barriers that affect the
successful implementation of nursing interventions by looking at healthcare systems,
organizational variables, healthcare provider perspectives, and patient experiences. This
knowledge will be useful in creating approaches to get over obstacles and increase the adoption
of successful therapies.
4.
How can nursing treatments be modified to address the unique
requirements of various PTSD patient populations?
This query acknowledges the significance of tailored treatment for PTSD sufferers,
taking into account their particular traits and histories. The study will investigate methods for
modifying nursing interventions to meet the unique requirements of various patient populations,
including those with a range of ages, cultural backgrounds, and co-existing diseases. Healthcare
practitioners can improve patient-centered care and results by comprehending the variables that
affect the success of customized interventions.
These research questions will act as a roadmap for carrying out the study and as a
framework for gathering, analyzing, and interpreting data. By answering these queries, the study
hopes to add to the body of existing knowledge and guide nursing practice in developing
successful therapies for PTSD patients.
18
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Aims of the Study
This paper's main aim and objective is to comprehensively define and deeply investigate
and detect the range of nursing interventions that are particularly useful for patients with Post-
Traumatic Stress Disorder (PTSD). The objective is to conduct a thorough examination on a
wide range of nursing interventions that are implemented in the care and treatment of patients
with PTSD. This particular paper intends to identify the most efficient and evidence-based
nursing care practices for PTSD patients by conducting a thorough evaluation of pertinent
literature, empirical investigations, and expert viewpoints. The goal of the study is to provide
light on therapies that have shown promise for managing symptoms, improving general health,
and improving patients' quality of life.
This study aims to promote nursing practice by illuminating the efficient therapies that
provide positive results for people dealing with PTSD through rigorous examination and review
of the body of available research. In order to equip healthcare workers with evidence-based
methods and enable them to provide complete and patient-centered care for people with PTSD,
the research aims to identify the most effective nursing interventions. The ultimate objective is to
optimize patient outcomes, raise the standard of care overall, and promote a setting that supports
PTSD patients' healing and recovery.
Study Design
Introduction
The design of the inquiry itself has a considerable impact on a research study's
procedures and results. This section will provide an overview of the research methodology that
will be used for this study, whose aim is to identify and evaluate efficient nursing treatments for
PTSD patients. We will justify the chosen approach by stating that it is appropriate for attaining
the study's goals. The research approach that will be used is a systematic review since the
foundation of this study is past research.
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Methods of Research for Systematic Reviews
A systematic review is a naturally thorough and rigorous method that is used to integrate
the findings of prior research on a specific topic. The method is characterized by searching for
appropriate information across a range of sources, choosing what is pertinent, assessing it, and
then synthesizing it in a logical and structured way. This paper’s approach is considered most
suitable since it allows for an extensive examination of the prior work on nursing treatments for
patients with post-traumatic stress disorder (PTSD).
This study's systematic review approach offers a number of potential advantages. It first
ensures that the procedure will be transparent and simple to duplicate. The systematic review
requires the research selection and data extraction techniques to comply with a set of specified
criteria, which enhances the rigor and dependability of the conclusions. This is considered vital
in the undertaking of secondary research because it allows other researchers to replicate the
study and confirm the findings (Tricco et al., 2018).
So as to minimize on the probability of bias, a systematic review is undertaken using a
thorough search method. A search will be carried out across a variety of databases, including
PubMed, CINAHL, and PsycINFO, to find any and all relevant research. Using gray literature,
which includes items like conference proceedings and unpublished dissertations, according to
Moher et al. (2009) helps to further ensure that a varied array of pieces of evidence are reviewed.
The use of a design that incorporates systematic reviews, which lessens selection bias, improves
the validity of the research.
Furthermore, a systematic review makes sure that the integration of the results from
varied and numerous types of study into a single coherent whole. This research will combine
quantitative, qualitative, and mixed-methods investigations in order to provide a complete
picture of the effectiveness of nursing treatments for PTSD patients. The systematic review's
methodology enables a more thorough assessment of the presently available evidence and
enables a nuanced examination of the treatments and results (Higgins & Green, 2011). This is
made feasible by accounting for various research design approaches.
The systematic review's approach makes it simpler to spot patterns, trends, and gaps in
the body of current research. Because it combines data from several research, this study is able to
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examine variations in nursing treatments, patient groups, and outcomes. This method, according
to Sandelowski et al. (2012), provides helpful insights for evidence-based practice and aids in the
identification of areas that need for more investigation.
Comparatively to gathering primary data, doing a systematic review enables a more
effective use of the available evidence, which also saves time and resources. The utilization of
secondary methods of research, including systematic reviews, makes it feasible to make use of
the large amount of knowledge that already exists. By expanding on the foundation of earlier
research, which will be achieved via the synthesis and analysis of earlier studies, this study will
be able to provide findings that are relevant (Harden et al., 2018).
The limitations that come with the design of a systematic review must be understood,
however. The quality and accessibility of the incorporated research affect the validity of the
findings. A publishing bias may exist because studies with positive or statistically significant
results are more likely to be published than those with contradictory or inconclusive findings. To
develop an accurate and reliable synthesis of the available data, these restrictions may be
eliminated (Hartling et al., 2018). By following strict inclusion criteria and using thorough search
strategies, this may be achieved.
In conclusion, the study's goal—to identify and examine efficient nursing treatments for
patients with post-traumatic stress disorder (PTSD)—makes a systematic review the most
suitable research technique. The systematic review's methodology opens an opportunity for a
thorough examination of the literature available, ensures that the method can be verified and
replicated, and lowers the likelihood of bias by using thorough search strategies. By combining
information from several research, the structure of a systematic review enables a thorough study
of nursing treatments and the results they create. The systematic review approach enhances the
use of the evidence that is currently available and provides meaningful data for the creation of
evidence-based practice.
Materials and Data Collection
Data Sources
A variety of sources will be used in this research study on nursing treatments for patients
with Post-Traumatic Stress Disorder (PTSD) to guarantee a thorough and evidence-based
approach.
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A significant chunk of the data sources will be scholarly journals. Searching credible
academic resources like PubMed, CINAHL, and PsycINFO while utilizing pertinent keywords
linked to patient care, nursing interventions, and PTSD will be part of the process. Peer-reviewed
publications from prestigious nursing and mental health journals are accessible via these
databases, providing a wealth of data for analysis and evaluation.
Books are yet another excellent source of information. To get a deeper grasp of the
subject, text books, reference works, and monographs on nursing interventions and PTSD will be
examined. These materials provide in-depth knowledge of theoretical frameworks, useful advice,
and evidence-based practices, laying the groundwork for choosing the best nursing treatments for
PTSD patients.
Additionally, clinical recommendations will be cited as crucial sources of evidence.
Much basis will be input on the published guidelines of The American Psychiatric Nurses
Association (APNA) and the International Society for Traumatic Stress Studies (ISTSS)which
will be examined to determine the best nursing treatments for PTSD patients. These
recommendations are supported by research and are generally accepted in the industry, ensuring
that the interventions chosen adhere to industry best practices and accepted standards of care.
Grey literature will also be taken into account in order to provide a variety of data
sources. This can include looking at reports from governmental or nonprofit groups, which often
provide insightful observations and real-world examples of nursing interventions and patient
outcomes. Grey literature may provide a distinctive viewpoint and support the conclusions drawn
from more conventional scholarly sources.
The research attempts to compile a wide variety of data by using a mix of academic
publications, books, clinical recommendations, and grey literature. This strategy guarantees that
the study results are comprehensive, trustworthy, and representative of the most recent ideas and
methods in the area of nursing treatments for PTSD patients.
In conclusion, this study's sources of data include scientific writings, books, clinical
recommendations, and maybe gray literature. This multifaceted strategy broadens and deepens
the scope of the study, adding to the analysis of successful nursing treatments for PTSD patients.
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Data Collection Process
To guarantee the validity and reliability of the results, the data collecting procedure for
this study on nursing treatments for patients with Post-Traumatic Stress Disorder (PTSD) will
use a systematic and rigorous approach.
A thorough search strategy will first be created to find relevant literature and data
sources. In doing so, suitable databases like PubMed, CINAHL, and PsycINFO will be chosen,
as well as acceptable keywords and search queries. To guarantee that the literature evaluated is
current and up to date, the search will be done within a certain period.
The selection of research and data sources will be governed by inclusion and exclusion
criteria that will be created. These requirements may include elements like publication date,
study design, sample size, and applicability to nursing therapies for PTSD patients. They will be
dependent on the research questions and the study's objectives. The analysis will only include
high-quality and relevant research thanks to this methodical technique.
To extract relevant data from the chosen research, data extraction techniques will be used.
To systematically extract important information, including research characteristics, participant
demographics, intervention specifics, and outcome measures, a data extraction form or template
will be created. The data will be more organized and standardized as a result of this approach,
allowing for thorough analysis and cross-study comparison of the results.
In order to find patterns, themes, and similarities relating to nursing treatments for PTSD
patients, the data gathered will be thoroughly examined and evaluated. The relevant statistical
techniques will be used to assess quantitative data, including statistical results and effect sizes.
To detect recurrent themes and insights, thematic analysis will be used to qualitative data,
including narrative descriptions and qualitative results.
There will be measures taken to guarantee the authenticity and reliability of the results
throughout the data gathering procedure. Data extraction will include many researchers, and any
inconsistencies or disagreements over interpretation will be discussed and resolved at frequent
meetings. The trustworthiness of the results is increased and possible biases are minimized by
this collaborative method.
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It is essential to stress that ethical standards will be respected all along the line of data
gathering. To safeguard the privacy and rights of participants in the initial studies analyzed in the
investigation, the study will abide by relevant research ethical rules and standards.
In conclusion, a systematic and exacting strategy will be used in the data gathering
procedure for this investigation. To acquire relevant and trustworthy data, a thorough search
strategy, inclusion and exclusion standards, and data extraction techniques will be used. The
research seeks to provide solid data that add to our knowledge of effective nursing treatments for
patients with PTSD by upholding strict standards and ethical concerns.
Data management and Challenges
This section will go into further detail about the data collecting procedure for the research
study on nurse treatments for patients with Post-Traumatic Stress Disorder (PTSD), in addition
to the stages described in the data collection. It will particularly concentrate on extra data
sources, data management, and possible difficulties.
Other relevant sources of data, outside scientific papers and clinical recommendations,
will be taken into consideration. Books, theses, conference proceedings, and gray literature are a
few examples. A thorough and complete knowledge of nursing treatments for PTSD patients may
be attained by utilizing a wide variety of data sources.
A strong data management strategy will be built in order to handle the obtained data
properly. The methods for organizing, storing, and documenting data will be included in this
strategy. Data will be safely kept, guaranteeing privacy and adherence to data protection laws.
Additionally, a detailed record of the data gathering process, including search tactics, selection
standards, and data extraction techniques, will be kept. This meticulous documentation will assist
the study's transparency and repeatability.
Several difficulties that must be resolved may develop throughout the data collecting
procedure. Publication bias, when research with significant findings are more likely to be
published than those with null or negative results, is a frequent problem. It will be attempted to
incorporate unpublished papers and look for relevant active research initiatives in order to lessen
this bias.
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The variability of the included research, which includes variations in study design,
sample characteristics, and intervention methods, is another possible obstacle. This will be
addressed by a thorough evaluation of the included studies that takes into consideration their
methodological merit and relevance to the research goal. To investigate the effect of study
heterogeneity on the overall results, subgroup analysis or sensitivity analyses may be carried out.
The likelihood of bias in the initial research should also be taken into account. This
covers biases associated with participant selection, research design, measurement, and reporting.
Within the constraints of the research, these biases will be recognized and explained,
highlighting the need for careful findings interpretation.
Finally, the data gathering procedure shall follow ethical guidelines to guarantee the
anonymity and protection of participant rights. The research will adhere to all ethical rules and
laws, especially when handling private information about patients' mental health.
This research project intends to obtain solid evidence on nursing treatments for patients
with PTSD by using a thorough data gathering method that includes several data sources,
efficient data management procedures, and resolving possible obstacles. The information
gathered will play a significant role in improving patient care, educating clinical practice, and in
directing further field research projects.
Data Analysis
Data Synthesis
This part will concentrate on the data synthesis process, which entails integrating and
interpreting the gathered data to provide insightful findings. The purpose is to identify and
examine significant themes, patterns, and connections in regard to nursing treatments for PTSD
patients.
First, all the information gathered from different sources, including academic
publications, papers, and clinical recommendations, will be carefully examined and categorized.
In order to do this, we first study the material and get acquainted with it. Then, we must extract
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the pertinent information and carefully classify the data according to how well it relates to the
research questions and goals.
A methodical and iterative strategy will be used in the data synthesis process. To begin
with, the information will be meticulously classified to highlight key concepts, ideas, and topics.
To prepare data for further analysis, this coding procedure comprises identifying and classifying
data chunks. It guarantees that important data is recorded and arranged in an organized way.
After the data has been coded, it will be analyzed to spot recurring patterns, themes, and
linkages. This will include classifying them into larger topics or groups and grouping codes that
are related together. Recurring thoughts and notions about nursing treatments for PTSD patients
will emerge via this process, revealing insights into the efficient tactics, methods, and results.
The themes will be discovered, and they will be discussed and defined in depth using
evidence from the data sources. In order to do this, citations, paraphrases, and quotations from
the literature or clinical recommendations will be provided. For the results to be credible and
reliable, it is crucial to preserve openness and provide detailed documentation of the data
sources.
Data from many sources will be compared and contrasted throughout the synthesis
process to spot convergent or divergent viewpoints and to create a thorough grasp of the subject.
This will make it possible to analyze the many elements, such as patient characteristics,
healthcare environments, and intervention modalities, that affect the efficacy of nursing
treatments for PTSD patients.
Depending on the kind of the obtained data, other analytical methods could be used in
addition to thematic analysis. For instance, statistical analysis, such as descriptive statistics or
inferential tests, may be used to analyze correlations between variables or gauge the efficacy of
certain treatments if quantitative data is available. To provide a thorough and rigorous study, the
selected analytical procedures will be in line with the research questions and goals.
It is crucial to remember that data synthesis is an iterative process, and that changes and
improvements could be made as the analysis goes forward. To make sure that the detected
themes and interpretations are accurate and legitimate, the researchers will participate in debates
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and reflections. To increase the validity and rigor of the data synthesis process, peer review and
subject matter expert advice may also be sought.
This research attempts to identify important themes and patterns in relation to nursing
treatments for patients with PTSD by using a methodical and exacting approach to data
synthesis. This study will add to the body of knowledge already known in the area by offering
insightful information on the efficacy of various tactics, techniques, and treatments. The
conclusions will support evidence-based practice, direct clinical judgment, and perhaps enhance
patient care and outcomes.
Data Analysis Tools and Software
Numerous software programs and tools are available in the area of data analysis to help
researchers understand and analyze the acquired data. These tools provide sophisticated features
and methods that help create an analysis that is more thorough and informative. To organize,
manage, and analyze the data for this research on nursing treatments for patients with Post-
Traumatic Stress Disorder (PTSD), data analytic tools and software are essential.
NVivo is a program that is often used for analyzing qualitative data. Researchers may
input, arrange, and code qualitative data using the software program NVivo for qualitative data
analysis. It enables the methodical grouping of data into themes, making it easier to see trends
and connections. NVivo offers a variety of tools for data exploration and analysis, including the
capacity to build queries, carry out text searches, and examine coding patterns. Researchers may
quickly browse the data using NVivo and get a greater knowledge of the patterns connected to
nursing treatments for PTSD patients.
Statistical software applications including the infamous SPSS, R, and SAS are most often
utilized in the analysis of quantitative data. The paper may investigate and interpret quantitative
data using a broad variety of statistical methods and tests made available by these software
programs. Different statistical studies, such as regression analysis, correlation analysis,
inferential statistics, and descriptive statistics, may be carried out by researchers. These
instruments enable the investigation of the correlations between variables, the evaluation of the
efficacy of interventions, and the determination of statistical significance. Researchers may
create thorough statistical reports and graphically portray data via charts and graphs using
statistical software, which improves the presentation and clarity of the results.
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Spreadsheet programs like Microsoft Excel may also be used for data analysis in addition
to specialized software suites. For organizing and evaluating quantitative data, Excel offers
fundamental statistical functions and data manipulation tools. Researchers may compute
descriptive statistics, carry out fundamental data transformations, and produce graphs and charts
to represent the data.
The type of data, the topic of research as well as the researchers' experience handling the
tools are all considered when making a decision on tools and software to be used. It is crucial to
choose tools that are suitable for the kind of data and the goals of the research. Researchers must
also take into account the accessibility of technical assistance, training materials, and
compatibility with other research instruments.
For this case, based on the consideration laid above, Microsoft excel will be employed in
the statistical analysis due to its user-friendly nature.
CHAPTER 3
CASE STUDY
Chapter 3 delves into a comprehensive case study that focuses on nursing interventions
for patients with PTSD. This chapter presents the findings of the study, highlighting the
effectiveness of identified interventions. Additionally, a detailed nursing care plan is developed
for a hypothetical patient with PTSD, utilizing NANDA nursing diagnoses to address their
specific needs. By examining the case study, readers will gain insights into evidence-based
practices for managing PTSD and promoting patient well-being. The chapter serves as a practical
guide for nurses, offering valuable information to enhance their understanding and skills in
providing optimal care for individuals with PTSD.
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Findings
Introduction
The paper's findings subheading delves into the conclusions and findings from the
analysis of nursing treatments for patients with Post-Traumatic Stress Disorder (PTSD). The
goal of the research is to discover and investigate efficient nursing treatments that may be used to
meet the unique requirements of people with PTSD. The importance of this study rests in its
potential to better patient outcomes and raise the standard of treatment given to PTSD sufferers.
Healthcare personnel may adapt their strategies to better match the individual requirements of
patients by recognizing and comprehending successful nursing treatments, thereby promoting the
patients' overall health and recovery. By identifying evidence-based methods that may help
clinical decision-making and direct future research in the areas of mental nursing and trauma
care, this study adds to the body of knowledge in nursing.
Description of Nursing Interventions
So as to achieve the unique requirements of patients with post-traumatic stress disorder
(PTSD), nursing treatments are essential. These therapies are designed to lessen symptoms,
enhance general wellbeing, and encourage healing. We will go through each of the three nursing
interventions in depth in this part, emphasizing their goal, method of execution, and anticipated
results. Evidence from the literature, including scientific papers and clinical recommendations,
will be used to support the efficacy of each intervention.
Nursing Intervention 1: Cognitive Behavioral Therapy (CBT)
For PTSD, Cognitive Behavioral Therapy (CBT) is a widely used and supported by
research intervention. With the use of CBT, patients may learn to recognize and confront
troubling ideas, build coping mechanisms, and encourage adaptive behavior. It is a kind of
organized, goal-oriented treatment that emphasizes the relationships between ideas, emotions,
and actions.
CBT adoption comprises a number of crucial steps. In the beginning, the therapist forms
a therapeutic alliance with the patient, fostering a climate of safety and trust. The patient and
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therapist then work together to identify and comprehend the traumatic events and accompanying
symptoms. Techniques for cognitive restructuring are used to refute and alter unfavorable
attitudes and ideas about the trauma. Another CBT element called exposure treatment assists
patients in progressively and safely confronting their concerns, which lessens avoidance
tendencies.
Studies have repeatedly shown the efficiency of CBT in easing PTSD symptoms and
enhancing general functioning. For instance, a systematic study by Smith, Norman, and Whelan
(2019) showed that CBT is effective in treating people with PTSD. CBT has been shown to
lessen hyperarousal symptoms, intrusive thoughts, nightmares, and avoidance behaviors.
Additionally, it equips patients with powerful coping mechanisms to handle stressors and keep
stability in their everyday lives.
Nursing Intervention 2: Eye Movement Desensitization and Reprocessing (EMDR)
A specific therapeutic method called Eye Movement Desensitization and Reprocessing
(EMDR) has demonstrated promising benefits in the treatment of PTSD. Exposure treatment,
cognitive restructuring, and bilateral stimulation are all used into EMDR. The goal of EMDR is
to ease the processing of traumatic memories and lessen the suffering they cause.
Patients concentrate on painful memories during EMDR sessions while doing sets of eye
movements or other bilateral stimulation techniques. Traumatic events may be processed again
thanks to this mechanism, which stimulates the brain's information processing system. Patients
are urged to examine unfavorable ideas, feelings, and physical sensations connected to the
trauma via guided attention shifts and bilateral stimulation.
History-taking, preparation, evaluation, desensitization, instillation of empowering
beliefs, and body scan are among the components that make up the EMDR process. The patient
is guided by the therapist through these stages, guaranteeing a secure and orderly procedure.
Studies have repeatedly shown that EMDR is beneficial in easing PTSD symptoms and
enhancing general wellbeing (Shapiro, 2018). For instance, a randomized controlled experiment
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by van der Kolk et al. (2021) revealed that EMDR recipients significantly reduced their PTSD
symptoms and improved their ability to regulate their emotions.
Nursing Intervention 3: Mindfulness-Based Interventions
The utilization therapies that are based mindfulness for the treatment of PTSD has
gradually been on the rise, more so the mindfulness-based cognitive therapy (MBCT) and
mindfulness-based stress reduction (MBSR). These two treatments criteria are alluded to
increase patients' present-moment awareness and encourage acceptance of their feelings and
ideas.
The goals of mindfulness-based therapies are to develop self-compassion, lessen
reactivity to painful thoughts and emotions, and enhance general wellbeing. They include doing
moderate yoga poses, meditation, and mindfulness exercises. Patients may tend to grow a form
of resilience and learn to react to stresses more efficiently by practicing nonjudgmental
mindfulness.
Based on randomized clinical studies by Moran et al. (2020) to examine the efficacy of
mindfulness-based stress reduction for PTSD-affected veterans, individuals who received MBSR
had much less severe PTSD symptoms, sadness, and anxiety when compared to those in the
control group.
In summary, the description of nursing treatments for PTSD patients offers insightful
information on the goals, method of implementation, and anticipated results of these
interventions. PTSD sufferers may benefit from evidence-based therapies such as cognitive
behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and
mindfulness-based interventions. These therapies have been successful in symptom reduction,
general wellbeing enhancement, and recovery promotion. Healthcare providers may make
educated judgments and offer the most suitable and efficient nursing care for patients with PTSD
by leveraging the literature and clinical standards.
Implication
Consequently, this research has contributed significantly to the understanding of the
efficacy of nursing treatments for individuals suffering from post-traumatic stress disorder
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(PTSD). The data collected from the research have input much emphasis on the vital the
importance of evidence-based treatments for PTSD, including Cognitive Behavioral Therapy
(CBT), Eye Movement Desensitization and Reprocessing (EMDR), and mindfulness-based
treatments. These therapies have shown promising results in symptom relief, general wellbeing
improvement, and recovery promotion.
These results have important nursing practice ramifications. Nurses are essential in the
treatment of patients with PTSD, and they may improve patient outcomes by using efficient
therapies. To provide top-notch care to patients with PTSD, nurses must complete thorough
education and training on these evidence-based therapies. The results also highlight the value of
multidisciplinary cooperation as nurses often collaborate with other medical specialists in the
treatment of PTSD.
There are two ramifications for nursing education. First and foremost, PTSD treatment
should be included in nursing curriculum to ensure that future nurses have the knowledge and
abilities to properly handle the special requirements of patients with PTSD. Secondly, ongoing
education and professional development programs have to be made available to working nurses
in order to improve their knowledge of and proficiency with regard to executing these
interventions.
Although the research has offered insightful information, it is not without flaws. The
dependence on prior research, which may have different study designs, sample sizes, and
methodology, is one drawback. Large-scale, well-planned studies should be the goal of future
research in order to confirm the efficacy of these nursing treatments. A more complete
understanding would also result from investigating the experiences and viewpoints of patients
and healthcare professionals on the implementation and results of these treatments.
The results of this research add to the expanding body of information about efficient
nursing treatments for PTSD patients, to sum up. Nurses can help people with PTSD live better
lives by putting evidence-based therapies like CBT, EMDR, and mindfulness-based methods into
practice. To improve patient outcomes and enhance our knowledge of the most efficient
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approaches to meet the particular requirements of this group, more research and cross-
disciplinary cooperation are required.
Nursing Care Plan
Background Information and Patient Profile
The nursing care plan part is dedicated to the creation of an all-rounded plan of care for a
fictitious patient who has post-traumatic stress disorder (PTSD). The patient in this instance is a
man named John, 35, who had a horrific encounter six months before. John's terrible event
significantly impacted his wellbeing and ability to carry out everyday tasks, which resulted in the
onset of PTSD symptoms.
It's crucial to look into John's past and trauma history in order to offer context for the
treatment plan. Before the traumatic experience, there is no record of John having any notable
mental issues having grown up in a stable and caring family setting. However, later on John was
involved in a serious auto accident that claimed the life of a close friend six months ago. He was
drastically shaken by this incident, and this also brought on the first signs of his PTSD.
John is now dealing with a number of PTSD-related symptoms. He regularly has
disturbing thoughts and vivid dreams connected to the traumatic occurrence, which significantly
disrupts his sleep and causes him tremendous discomfort. John also exhibits hypervigilance,
which is the quality of being always alert, quickly startled, and hyperaware of possible threats in
his surroundings. John has adopted avoidance habits, such as avoiding places, people, or
activities that make him think of the traumatic experience, to help him deal with his
uncomfortable symptoms.
It is crucial to comprehend John's past, traumatizing events, and present symptoms in
order to adjust the nursing care plan to his unique requirements. By taking care of these issues,
the care plan may concentrate on delivering specific treatments designed to reduce his
symptoms, enhance his general wellbeing, and support his road to recovery.
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Identification of Nursing Diagnoses
In developing a comprehensive nursing care plan for John, a hypothetical patient with
post-traumatic stress disorder (PTSD), it is crucial to utilize NANDA nursing diagnoses to
identify his specific needs. This step allows for a systematic and evidence-based approach to
addressing the complex symptoms and challenges associated with PTSD.
One nursing diagnosis applicable to John's case is "Post-Trauma Syndrome." This
particular diagnosis of John is characterized by various symptoms that are observed in
individuals who have encountered a traumatic event. The rationale behind this diagnosis is to
acknowledge and address the psychological, emotional, and behavioral manifestations resulting
from the traumatic experience (American Psychiatric Association, 2013). Through this diagnosis,
nursing interventions can be tailored to promote emotional healing, enhance coping mechanisms,
and support the overall recovery process.
Another relevant nursing diagnosis for John is "Anxiety related to traumatic event."
PTSD often manifests with heightened anxiety levels, which can significantly impact an
individual's daily functioning and quality of life. This diagnosis recognizes the impact of anxiety
on John's well-being and provides a framework for implementing interventions that target
anxiety reduction and management (American Psychiatric Association, 2013). By addressing his
anxiety symptoms, the care plan aims to enhance his sense of calmness, promote relaxation, and
enable better emotional regulation.
Supporting evidence from the literature reinforces the validity of these nursing diagnoses
for patients with PTSD. Citing from a study by Gradus et al. (2015), individuals with PTSD
majorly have symptoms related to post-traumatic stress, including intrusive thoughts, avoidance
behaviors, and hyperarousal. Most of these symptoms do match the nursing diagnosis of "Post-
Trauma Syndrome" and emphasize the importance of addressing the multifaceted impact of
trauma on an individual's well-being.
Furthermore, it is important to note research by Forbes et al. (2015) which puts into the
limelight the prevalence of anxiety symptoms in individuals with PTSD. The study demonstrates
that anxiety is a significant component of the disorder, affecting emotional regulation, decision-
making processes, and daily functioning. This evidence supports the inclusion of the nursing
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diagnosis "Anxiety related to traumatic event" in John's care plan, as it recognizes the specific
anxiety-related needs arising from his traumatic experience.
By utilizing these nursing diagnoses, the care plan can effectively address the unique
needs of John as a patient with PTSD. Each diagnosis provides a framework for developing
tailored interventions that target the specific symptoms and challenges he experiences. The
evidence-based rationale behind these diagnoses ensures that the care plan is grounded in current
knowledge and best practices in the field of psychiatric nursing.
Development of Nursing Interventions
The following extensive set of nursing interventions may be created to meet John's
unique requirements based on the nursing diagnosis for him, a fictional patient with post-
traumatic stress disorder (PTSD). Evidence-based procedures and established standards in the
area of psychiatric nursing support these therapies.
(CBT) Cognitive Behavioral Therapy
For those with PTSD, cognitive behavioral therapy (CBT) is a suggested strategy. It
emphasizes on assisting patients in recognizing and confronting unhelpful thoughts and actions
connected to the traumatic incident. The precise procedures and methods used in CBT consist of:
a. Psychoeducation: Inform John on the causes of PTSD, its signs and symptoms, and the
benefits of CBT as a therapeutic strategy. He gains insight through this schooling on the
relationship between his ideas, feelings, and actions.
b. Cognitive Restructuring: Assist John in identifying and reframing negative or distorted
thoughts related to the traumatic event. Encourage him to challenge and replace these thoughts
with more balanced and realistic ones.
c. Exposure Therapy: Gradually expose John to feared situations or triggers associated
with the trauma in a safe and controlled manner. This exposure helps him confront and process
the traumatic memories, reducing avoidance behaviors and anxiety.
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d. Coping Skills Training: Teach John various coping strategies, such as relaxation
techniques, grounding exercises, and problem-solving skills. These skills empower him to
manage stress, regulate emotions, and enhance overall coping abilities.
Varied number of research has shown that CBT is useful in treating PTSD. Bisson et al.'s
(2013) meta-analysis, for instance, found that adult CBT therapies substantially decreased PTSD
symptoms.
Eye Movement Desensitization and Reprocessing (EMDR)
One other evidence-based strategy for PTSD is called Eye Movement Desensitization and
Reprocessing (EMDR). It entails employing bilateral stimulation to speed up the processing of
traumatic memories, such as eye movements or tactile sensations.
The specific actions and techniques involved in EMDR include:
a. Assessment and Preparation: Conduct a thorough assessment of John's traumatic
experiences and establish a therapeutic relationship built on trust and safety. Explain the EMDR
process to him, addressing any questions or concerns.
b. Resource Development and Installation: Help John identify and strengthen internal
resources, such as feelings of safety, resilience, and positive memories. This step enhances his
ability to cope with distressing emotions during EMDR sessions.
c. Desensitization and Reprocessing: Guide John through bilateral stimulation, such as
eye movements, while he focuses on specific traumatic memories. Encourage him to notice any
associations, emotions, or insights that arise during the process.
d. Closure: Ensure a proper closure to each EMDR session, allowing time for relaxation
and reflection. Discuss any new insights or changes experienced by John during the session.
EMDR has shown efficacy in easing PTSD symptoms and enhancing psychological
health. Cusack et al. (2016) conducted a comprehensive review and concluded that EMDR was
an effective therapy for people with PTSD.
Mindfulness-Based Interventions
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Those who have PTSD may benefit from mindfulness-based therapies like Mindfulness-
Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). These
methods encourage awareness of the present moment, acceptance of unpleasant emotions, and
impartial observation of ideas and feelings.
The specific actions and techniques involved in mindfulness-based interventions include:
a. Mindfulness Meditation: Teach John mindfulness meditation techniques, guiding him
to focus on his breath, bodily sensations, or sounds in the present moment. Encourage regular
practice to develop mindfulness skills.
b. Body Scan: Guide John through a body scan exercise, where he systematically directs
his attention to different parts of his body, noticing physical sensations without judgment. This
practice increases body awareness and relaxation.
c. Mindful Movement: Incorporate gentle yoga or walking meditation into John's routine,
emphasizing mindful awareness of body movements, sensations, and breathing. These activities
promote relaxation and grounding.
d. Daily Mindfulness Practice: Encourage John to integrate mindfulness into his daily
life, such as mindful eating, mindful walking, or brief moments of mindfulness during routine
activities. Increased awareness of oneself and presence are fostered as a result.
The effectiveness of mindfulness-based therapies in easing PTSD symptoms and
improving general wellbeing has been shown. Polusny et al. (2015) used a randomized
controlled experiment to show that mindfulness-based therapies may help military veterans with
PTSD symptoms.
In conclusion, developing nursing treatments for PTSD patients requires using techniques
that are supported by the latest research. The efficacy of cognitive behavioral therapy (CBT), eye
movement desensitization and reprocessing (EMDR), and mindfulness-based therapies in
symptom reduction and wellbeing enhancement has been shown. Nurses may provide complete
care that is specifically catered to the requirements of patients with PTSD by implementing the
particular behaviors, procedures, and treatments associated with these interventions.
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Evaluation and Monitoring
The effectiveness of nursing interventions for patients with PTSD should be regularly
evaluated and monitored to ensure optimal outcomes. Assessment and documentation play a
crucial role in this process. Regular assessment involves monitoring the patient's progress,
evaluating the effectiveness of interventions, and identifying areas that require adjustment in the
care plan. By using standardized assessment tools and monitoring changes in symptoms,
functioning, and well-being, nurses can objectively measure the impact of the interventions.
Documentation provides a record of the patient's treatment journey, facilitating communication
and collaboration among healthcare providers. It also enables the identification of trends,
patterns, and potential barriers to progress, leading to timely modifications and improvements in
the care plan.
Conclusion
In conclusion, a thorough and holistic approach should be included in the nursing care
plan for patients with PTSD. Nurses may cater to the special requirements of people with PTSD
by incorporating evidence-based therapies such Cognitive Behavioral Therapy (CBT), Eye
Movement Desensitization and Reprocessing (EMDR), and mindfulness-based therapy. To
determine the success of the treatments and make the required corrections, regular assessment
and monitoring are crucial. Nurses may follow the patient's progress, pinpoint areas for
development, and encourage the provision of high-quality treatment by diligently assessing and
documenting the patient. By encouraging resilience, symptom reduction, and an overall
improvement in patients' quality of life, implementing this treatment plan has the potential to
have a major influence on the wellbeing and recovery of PTSD patients.
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