BMSWBI (HKU Centre on Behavioral Health) Physical Distress Daily functioning Affect –positive affect state –negative affect state Spirituality –Tranquility –Disorientation –Resilience
Physical Distress Headache Dizziness Insomnia Blurred vision Sore throat and/or hoarse voice Difficulty in breathing Palpitation Chest pain Stomach Discomfort Diarrhea Constipation Coldness of hands or feet Back pain Fatigue
Affect Happy Relaxed and at ease Grateful Contented Carefree ( 安心 ) Full of confidence Fortunate Tender and loving
Negative Affect State Lonely Nervous Insecure Emotionally upset Annoyed and irritable Worried Angry Fearful Sad Helpless Each day seems like a year
Daily Functioning Physical strength Concentration Sleeping Appetite Memory Daily work/doing household chores Energy level Dealing with difficulties Work motivation Feeling on getting up
Tranquility I can be content with whatever comes. I can face life with a moderate state of mind. I feel calmness and harmony deep in my heart. I can take something up, or let go of it. I can deal with difficulties methodically
Disorientation I have lost direction in life. I don’t know how to love myself. I don’t understand why predicaments ( 困 境 )come to me. I blame heaven for being unfair to me. I lack the vitality( 動力 ) of life.
Resilience To me, facing a predicament is a challenge and a learning opportunity. I am grateful to people around me for all the things that they do for me. Predicaments can make me stronger.
Common Problems Insomnia (mean: 4.89, SD: 3.38) Tiredness (mean: 4.22, SD: 2.04) Memory (mean: 4.22, SD: 2.53) Concentration (mean: 4.22, SD: 2.57) Affect: worried (mean: 5.22, SD: 2.82) Spirituality: “I don’t know how to love myself”
Physical Activity and Mental Health
Physical activity is one of the ten leading health indicators used by United States government since 2000 to promote public health. adults who engage regularly, preferably daily, in moderate physical activity for at least 30 minutes per day –U.S. Department of Health and Human Services, 2000
Physical activity is associated to a relief in symptoms of depression and anxiety and it also seems to be beneficial in enhancing self-esteem, producing more restful sleep, and helping people recover more quickly from psychosocial stressors –(Landers, n.d.).
Physical activity induces positive moods, such as positive feelings towards others, positive feelings about life, enjoyable interaction with others, joy, elation, bodily well-being, positive body image, self- esteem, achievement, and excitement; and appeared to result in increased happiness –(Hills & Argyle, 1998).
Pat.Days Max heart rate (bpm) Max time (mins) Average depression score (0-10) Average anxiety score (0-10) Subjective feeling after physical activity A5128304.44.8 joy, elation, relaxation B7120204.95.1 relaxation, elation, better self esteem C4111107.50Relaxation D2120500No change
Nursing Care Plan (Body) Monitor patient’s medication compliance and the effectiveness of medications on level of functioning Provide balanced diet and monitor intake & body weight Teach physical exercise Teach breathing exercise Teach methods to promote sleep Monitor and redirect patient in maintaining daily grooming and hygiene Assist patient in developing a plan for increasing participation in physical exercise
NCP (Mind): Reduce Suicide Risk Communicate empathy for unbearable psychological pain Address vital frustrated psychological needs Mollifying the vital frustrated psychological needs Increase threshold for suffering Discuss possibilities other than death Establish a balanced perspective of psychological needs
NCP (Mind): Reduce Depression Administrate the 抑鬱症問卷, Evaluate the results and give feedback to patient Encourage patient to share feelings of depression Assist patient in developing awareness of cognitive messages that reinforce helplessness and hopelessness
NCP (Mind): Reduce Depression Assign patient to keep a record of daily events and associated dysfunctional cognition and emotions. Challenge dysfunctional thoughts for accuracy, and identify alternative cognitive interpretations that are more positive and realistic Reinforce positive, reality-based cognitive messages that enhance patient’s self confidence and increase adaptive action
NCP (Mind): Reduce Depression Educate patient about depression and accepting some sadness as a normal variation in feeling Assign patient to write at least one positive affirmation statement daily regarding self and the future Verbally reinforce patient’s positive self- statements
NCP (Mind): Reduce Depression Challenge patient to focus on capabilities rather on disabilities Recommend self-help books on coping with depression Provide social-recreational activity Assist patient in developing a plan for increasing participation in recreational activities
Provide Spiritual Care
Nursing Care Plan (Spirit) Arrange religious services Discuss meaning of life Discuss meaning of death Discuss pain and suffering Promote transcendence (reframing pain in ways that normalize and confirm the humanity of our clients while also suggesting that pain itself has a healing function) (Levington C., & Gruba-Mccallister F., 1996)
Culture relevant positive intervention Psychological de-centering (selflessness) Letting go of fixations Personal transformation The capacity to endure, even accept, suffering or misfortune To construct and reconstruct meaning To maintain peace of mind, spirit, and sense of direction, even in the face of misfortune
Proverbs Therapy Accepting life as being unpredictable Tolerating hardship Letting-go of the self and expectations on other Self-affirmation and empowerment Finding meaning in suffering How to love oneself
MEDITATION Concentrative meditation –focuses the attention on the breath, an image, or a sound Mindfulness meditation –sits quietly and simply witnesses whatever goes through the mind, not reacting or becoming involved with thoughts, memories, worries, or images D. Coleman and J. Gurin (Eds.) (1993). Mind-Body Medicine: How to use your mind for better health. Yonkers, NY: Consumer Reports Books.