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Crisis Intervention in community health nursing MSc nursing II year.pptx
A crisis is defined as a critical event that overwhelms an individual's coping mechanisms, leading to emotional and psychological instability. Various forms of violence against children and women are significant global issues, with prevalence affecting health and well-being, necessitating prevention strategies and crisis intervention. Effective crisis intervention aims to provide immediate support, facilitate coping and recovery, and prevent long-term problems.
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Crisis Intervention in community health nursing MSc nursing II year.pptx
- 1. Presented by, R.Sushma, MSC (N)II Year, Community Health Nursing, CON-SRIPMS, CBE.
- 2. Any stressfulevent or hazardous situation has the potential for precipitating a crisis. The event or situation that comes at the end of the series of stressors making the situation more than individual can candle. A crisis differs from stress in that a crisis resulting from the failure of individual’s usual coping mechanism or the lack of usual resources or both.
- 3. A crisis(derived from the “krisis” which means critical) is any event that is, or is expected to lead to, an unstable and dangerous situation affecting an individual, group, community or whole society.
- 4. Crisis isa state of disequilibrium resulting from the interaction of an event with the individual’s or family’s coping mechanism, which are inadequate to meet the demands of the situation combined with the individual’s or family’s perception of the meaning of event.
- 5. Crisis occursin all individuals at one time or another and is not necessarily equated with psychopathology. Crisis are precipitated by specific identifiable events. Crisis are personal by nature, what may be considered a crisis situation by one individual may not be so for another. Crisis are acute, not chronic, and will be resolved in one way or another within a brief period. A crisis situation contains the potential for psychological growth or deterioration.
- 6. Maturational ordevelopmental Situational Social
- 7. Phase I Individual isexposed to a precipitating stressor Anxiety increases Previous problem solving techniques are employed Phase II When previous problem solving techniques do not relieve the stressors, anxiety increases further. Individual feel discomfort Feelings of confusion and disorganization prevail.
- 8. Phase III Theindividual view the problem from a different perspective, or even to overlook certain aspects of it. New problem solving tech may be used. Resolution may occur at this phase. Phase IV If resolution does not occur in previous phase, Anxiety may reach panic level. Cognitive functions are disorganized Emotions are labile Behavior may reflect the presence of psychotic thinking
- 13. Heavy burdenof free floating anxiety Depression Anger, guilt, tension, fear Neglects in performing activities Irrational & blaming others Panic Low self esteem Uncontrolled crying Lack of confidence Withdrawal behavior Irritable Unable to think realistically Impaired judgment Lack of self control
- 15. All formsof violence against people under 18 years old, whether perpetrated by parents or other caregivers, peers, romantic partners, or strangers. Globally, it is estimated that up to 1 billion children aged 2–17 years, have experienced physical, sexual, or emotional violence or neglect in the past year. (WHO) Experiencing violence in childhood impacts lifelong health and well-being.
- 16. In 2030Agenda for Sustainable Development is to “End abuse, exploitation, trafficking and all forms of violence against, and torture of children”. Evidence from around the world shows that violence against children can be prevented.
- 17. Maltreatment (includingviolent punishment) involves physical, sexual and psychological/emotional violence; and neglect of infants, children and adolescents by parents, caregivers and other authority figures, most often in the home but also in settings such as schools and orphanages. Bullying (including cyber-bullying) is unwanted aggressive behaviour by another child or group of children who are neither siblings nor in a romantic relationship with the victim. It involves repeated physical, psychological or social harm, and often takes place in schools and other settings where children gather, and online.
- 18. Youth violenceis concentrated among children and young adults aged 10–29 years, occurs most often in community settings between acquaintances and strangers, includes bullying and physical assault with or without weapons (such as guns and knives), and may involve gang violence. Intimate partner violence (or domestic violence) involves physical, sexual and emotional violence by an intimate partner or ex-partner. Although males can also be victims, intimate partner violence disproportionately affects females. It commonly occurs against girls within child marriages and early/forced marriages. Among romantically involved but unmarried adolescents it is sometimes called “dating violence”.
- 19. Sexual violenceincludes non-consensual completed or attempted sexual contact and acts of a sexual nature not involving contact (such as voyeurism or sexual harassment); acts of sexual trafficking committed against someone who is unable to consent or refuse; and online exploitation. Emotional or psychological violence includes restricting a child’s movements, criticizing, mocking, threats, discrimination, rejection and other.
- 20. Shaken babysyndrome usually occurs when a parent or caregiver severely shakes a child in frustration or anger, often because the child won't stop crying. Permanent brain damage or death may result. A serious brain injury resulting from forcefully shaking an infant or toddler. Symptoms include irritability, difficulty staying awake, seizures, abnormal breathing, poor eating, bruises and vomiting. Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick.
- 21. Internet crimesare unintentionally or intentionally, a minor access an internet chat room or web site. Child abduction or child theft is the unauthorized removal of a minor (a child under the age of legal adulthood) from the custody of the child's natural parents or legally appointed guardian.
- 22. INSPIRE: Identifies a selectgroup of strategies that have shown success in reducing violence against children. They are: Implementation and enforcement of laws; Norms and values; Safe environments; Parent and caregiver support; Income and economic strengthening; Response and support services; and Education and life skills.
- 24. Domestic violencecontinues through childhood & adolescence and follow a women into long-term relationship and into pregnancy. Studied shows that between 4% and 14% adult pregnant women experience physical violence from an intimate partner. Abuse during pregnancy has been linked with maternal health problems such as smoking, weight loss and substance use. The fetus also endangered, with spontaneous abortion, preterm delivery, fetal distress & lower birth weight often seen.
- 25. Violence againstwomen – particularly intimate partner violence and sexual violence – is a major public health problem and a violation of women's human rights. Estimates published by WHO indicate that globally about 1 in 3 (30%) of women worldwide have been subjected to either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.
- 26. Most ofthis violence is intimate partner violence. Worldwide, almost one third (27%) of women aged 15-49 years who have been report that they have been subjected to some form of physical and/or sexual violence by their intimate partner. Violence can negatively affect women’s physical, mental, sexual, and reproductive health, and may increase the risk of acquiring HIV in some settings. Violence against women is preventable. The health sector has an important role to play to provide comprehensive health care to women subjected to violence, and as an entry point for referring women to other support services they may need.
- 27. Intimate partnerviolence refers to behaviour by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviours. Sexual violence is "any sexual act, attempt to obtain a sexual act, or other act directed against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting. It includes rape, defined as the physically forced or otherwise coerced penetration of the vulva or anus with a penis, other body part or object, attempted rape, unwanted sexual touching and other non-contact forms".
- 29. Phases Types of prevention GoalIntervention Pre crisis Primary Health promotion Disease prevention Education Anticipatory guidance, reduce factors that increase vulnerability, reduce hazards in some events, reinforce positive coping strategies, mobilize social support and other resources Crisis Secondary Reduction of stress load, cure or restoration of function Assist with reaction to the event & functioning, allow behaviour, dependence, grief, set goals with client, refer to resources Post crisis Tertiary Rehabilitation & maintenance Promote interdependence, reinforce newly learned behaviour, lifestyle changes, coping strategies, explore application of learned behaviour to new situation, identification and use of additional resources.
- 31. Crisis interventionrefers to the methods used to offer immediate, short term help to individual who experience an event that produces emotional, mental, physical and behavioral distress or problems.
- 32. Crisis interventionis an active entering into life situation of a person, family or group who is experiencing a crisis, to decrease the impact of crisis event and to assist the individual to mobilize his resources and regain equilibrium -Parad et al (1975)
- 33. To decreaseemotional stress and protect the crisis victim from additional stress. To assist the victim in organizing and mobilizing resources or support system to meet unique needs and reach a solution for the particular situation that precipitated the crisis.
- 34. To assistthe individual in recovery from the crisis and to prevent serious long term problem To reduce the intensity of an individual emotional, mental, physical and behavioral reaction to a crisis. To help the individual return to their level of functioning before the crisis.
- 35. To reducethe intensity of an individual’s emotional, mental, physical, and behavior reaction to a crisis. To help the individual’s return to their level of functioning before the crisis.
- 36. Be specific,use concise statement, and avoid over whelming the patient with irrelevant questions or excessive detail Encourage the expression of feelings. A calm, controlled presence reassures the person that the nurse can help Listen for facts and feelings, seeking clarification, paraphrasing and reflection are effective strategies.
- 37.
- 38. Pediatric Geriatric Adolescent Psychosomatic patients People who attempted suicide Violent victims Accident victims Family crisis High risk families Severe depression & anxiety Marital conflicts Suicide thought Drug abuse Inter group staff issues Client management issues
- 39. Provide theindividual with the opportunity to communicate by talking less. Being attentive to verbal and non-verbal cues. Pleasant, interested, intonation of voice. Maintaining good eye content, posture and appropriate social distance if in a face to face situation. Remaining undistracted, open honest, sincere Asking open ended questions Asking permission, never acting on assumptions Checking out sensitive cross-cultural
- 40. The lengthof time for crisis intervention may range from one session to several weeks, with average being four weeks. Crisis intervention is not sufficient for individuals with long standing problems and it may range from 20 minutes to 2 or more than 2 hours.
- 41. Hospitals: Outpatients unit,inwards emergency room settings Mental health care centre: Community setting: Home visit Outreach centers Telephonic counseling & hotline: Information calls Suicide prevention and crisis intervention centers Schools, office, private practice
- 42. Crisis hotlineworkers Crisis counselor Emergency responders Disaster relief worker Mental health professionals
- 43. Catharsis Clarification Suggestion Reinforcement of behavior Supportof defence Raising self-esteem Exploration of solution
- 44. Immediate crisisintervention ( rapport, gather information, short term assessment, immediate crisis intervention) Second phase ( assessment of needs, plan for recovery) Third phase ( return to healthy life, prevent future victimization)
- 45. Assessment Planning and implementation Evaluation Health education Individual approach Generic approach Generalapproach Environmental manipulation
- 46. Crisis isan internal disturbance that results from stressful event or a perceived thread to self integrity. Crisis are dealt with by crisis intervention, it is an community based form of brief therapy that addresses resolution of a current stressful life events in ways aimed at helping the person develop a new, broader area of coping skills.
- 47. Bijayalakshmi Dash(2017)- “A comprehensive textbook of community health nursing”, 1st edition, published by Jaypee brothers medical publishers (p) ltd. Shebeer P Basheer (2019)- “A concise textbook of advanced nursing practice”- 2nd edition, published by EMMESS medical publishers Mary C.Townsand (2015)- “ Psychiatric mental health nursing”- 8the edition, published by F.A.Davis company, Philadelphia. Jhaxeq-0205 (2013)- “ Crisis Intervention” retrieved from www.slideshare.com on 28/2/24.
- 48. Biegel ED,Johnsen CA, Dyches H & Guos (2001), assessing the impact of community based medical crisis services on preventing hospitalization. Ennis E, Walker E. Experiences of a community crisis intervention service issues Ment health nurse-2020 (43:2)96-102 doi:10.1080/01612840.2021.1953650. pmid: 34370614.