Transp Adolescence

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Special Populations in Psychiatry

Adolescent Psychiatric NursingBy : Tri Anjaswarni, S.Kp. M.Kep.

Disampaikan dalam Kuliah Mata AjarMental Health Nursingpada

Program Studi Ilmu Keperawatan Fakultas Kedokteran Universitas

Brawijaya Malang

Learning Objectives

After studying this chapter the student should be able to :

1. List the developmental tasks of adolescence.

2. Compare the various theiretical views of adolescence3. Identify the major areas that should be included when assessing

adolescents

4. Describe maladaptive responses evident in adolescence

5. Analyze nursing intervenstions useful in working with adolescents

6. Evaluate nursing care provided for adolescents

A. Introduction

Adolescence is a time of transition an age when the person is not yet an

adult but is no longer a child.

Difficult periode for adolescence

Terjadi berbagai perubahan perilaku terkait dengan perkembangan yang

terjadi pada diri remaja

Penekanan bidang garap pada masa remaja adalah berfokus pada

perkembangan personal (person development).


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Nurse Specialist of psychiatric

menangani anak remaja dengan berfokus pada proses menjadi dewasa

berhubungan dengan aspek social, emotional, dan physical dalampenyesuaiannya di keluarga, sekolah dan kelompok umur sebaya.

membantu anak remaja untuk memperoleh kesuksesan

B. Developmental Stage

Havighurst

identified the following tasks that should be accomplished

during adolescence :

1. Achieving new and more mature relations with age mates

of both sexes

2. Achieving masculine or feminine social roles

3. Accepting physical build and using the body effectively

4. Achieving emotional independence from parents and

other adults

5. Preparing for marriage and family life

6. Praparing for career

7. Acquiring a set of values and an ethical system as a guide

to behavior and developing an ideology


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C. Theoretical Views of Adolescence

N

o

Theory Description

1. Biological Theory Emphasis is on physical growth, behavior, and the environmentwhich influence feeling, thoughts and action.

Transform the young person physically from a child into a

reproductively mature adult.

The changes fall into two categories : hormonal & somatic

2. Psychoanalytical

Theory (Freud)

Puberty is called the genital stage, in which sexual interest is

awakened

The genitalia mature(sexual exploration and maturation)

The release of sex hormones increases.

Upset the balance between the ego and id

New solutions must be negotiated3. Psychosocial Theory

(Modified by :

Erickson, Sullivan andothers)

Adolescents attempt to establish an identity within the social

environment

Emphasize the effect of social factors on developmental processes

Ego identity or relationship between a persons self perception and

how a person appears to athers

The stage of Identity V.S Identity diffusion

To coordinate self security, self esteem, intimacy, general activity

and sexual satisfaction in relationships.

4. Attachment Theory Focuses on the quality of attachments

Insecure attachments as risk factor that can result in maladaptiveresponses to loss or trauma.

5. Cognitive Theory Adolescence is an advanced stage of cognition (cognitive

functioning)

Formal thought : The ability to reason goes beyond the concrete to

more abstract thinking ( concrete objects to symbols or

abstractions)

This develops continuously from the concrete thinking of

childhood to abaout age 2.

6. Cultural Theory View adolescence as a time when a person believe that adult

privileges are deserved but are withheld.

This stage end when society gives full power and status of an

adult.

7. Multidimensional Th Adolescence is seen as adaptation on continuum of development.

Less emphasis on age and more on the development level and

timing of biological, psychological, & environmental influences.


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D. Assessing the Adolescent

The data collection should include the following information :

1. Appearance

2. Growth and development

3. Biophysical status (illness, accidents, disabilities)

4. Emotional status (relatedness, affect, and mental status : mood and thought

disorder, and suicidal).

5. Cultural, religious and socioeconomic background

6. Performance of activities of activity of daily living (home, school, work)

7. Patterns of coping (ego defenses such as denial, acting out, withdrawal)8. Interaction patterns (family, peers, society)

9. Sexual behaviors (nature, frequency, preference, sexuality transmitted

diseases)

10. Use of drugs, alcohol and others addictive substances (tobacco, caffein)

11. Adolescents perception and satsfaction with health.

12. Adolescents health goals

13. Environment (physical, emotional, ecological)

14. Available human and material resources (friends and school and

community involvement)

Dikumpulkan dari anak remaja & orang lain yang signifikan

interview,

(examinations),

(observations),

(reports).

outcome

identifikasi anak remaja (usia belasan tahun) yang berresiko tinggi

mempunyai masalah.


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Gambar 1

Profile of the high-risk adolescent

tipe perilaku anak remaja yang harus diperhatikan:1. Body Image

2. Identity

3. Independence

4. Social Role

5. Sexual Behavior

HomeActing out

Secretive-ness

High-Risk

Adolescent

FunctionalSleep

problems

EatingProblems

Psychosomati

c

SchoolTruancy

Undeachiem

ent,

Disruptivebehavior

Antisocial

BehaviorsDelinquency

,Troublewith law

MedicalChronicillness

Handicap

MoodDepressionAnxiety

Hostility

PeersLack ofFrience

Antisocial

friends

Substanc

e AbuseRegular

useLarge

amounts

SexualPromiscuit

y

Pregnancy

SexualAbuse

Appearanc

e

Poor

hygiene

Disregard

for dress


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E.Maladaptive Responses

1. Inappropriate Sexual Activity

2. Unwed Motherhood

3. Suicide

4. Runaways

5. Conduct Disorders

6. Violence

7. Drug Use

8. Hypochondriasis

9. Weight Problems

10. Occult Involvement

11. Parental Divorce

F.Nursing Diagnoses

Diagnosis berdasarkan DSM-IV psychiatric illness

G.Nursing Intervention useful in Working With Adolescents

Using Modality Therapy

1. Health Education

2. Family Therapy

3. Group Therapy

4. Individual Therapy

5. Medication Management

6. Talking with Adolescents

7. Parents of the Adolescent

H. Evaluate Nursing Care

Documents

Transp Adolescence