An extended essay demonstrating the candidate’s ability to evaluate
how the application of theoretical knowledge gained during the course
influences and effects the provision of quality nursing care as
applied to a client with a mental health problem.
The aim of this assignment is to explore the application of theory to
practice with regards to a client with a mental health problem.
In order to effectively care for clients, nurses need to regularly
evaluate their knowledge and assess this knowledge increases the
quality of mental health nursing care. The client chosen for this
assignment was a female, 39 year-old suffering with agoraphobia. She
was a single Asian origin, but living in a council flat in London with
her father and sisters. The duration of the clients' illness was
approximately nine years, since about 1987. For the purpose of the
reader, this essay will be written in the first person, as it will
make the assignment more coherent. I worked with the client in the
community for the duration of my placement. Therefore, for two months
I had regular contact with the client everyday.
The client needed nursing intervention because she needed help in
coping with her agoraphobia. Due to this phobia she was reliably
housebound and could not successfully carry out her activities of
daily living. Her father did the shopping and housework.
In addition to this the client's functioning was impaired due to other
physical problems. She suffered from epilepsy and she had a tumour
growing in the left hemisphere, which affected her right-sided
“A phobia is a fear of a specific of a specific object or scenario”
“A phobia is s persistent irrational fear of a specific object,
activity or situation.”
(Wilson and Kneisl 1996).
The client's usually identifies her phobia as unrealistic but she
still perceives it as anxiety provoking.
Agoraphobia is associated with a fear of open spaces. Clients fear
leaving their homes and thus their social interactions are severely
affected. (Wilson and Kneisl 1996).
The client I worked with also suffered from depression and in addition
to her other problems. There are common features in clients with
agoraphobia, (Wilson and Kneisl 1996).
The client's agoraphobia was triggered according to her by her
epilepsy and mobility problems due to the tumour. She had suffered
severe fits outside in public and from there had developed a fear of
going outside. She became very anxious when thinking about or going
outside her flat. Her anxiety symptoms that she experienced at the
idea of confronting her phobia just served to reinforce isolation.
So; from these various problems the client identified four main needs:
1. Coping with her agoraphobia and anxiety
2. Accepting her tumour
3. Learning to manage her epilepsy