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Nursing

The Psychiatric Evaluation and Evidence-Based Rating Scales

The Psychiatric Evaluation and Evidence-Based Rating Scales

The examination, assessment, and diagnosis performed on the patient drive psychiatric mental health. As a result, these steps are critical to becoming a successful nurse practitioner in this field. A mental health nurse practitioner must develop effective and appropriate plans to ensure that patients are correctly diagnosed and treated. The client-provider relationship is important in mental health because it is the foundation of a positive rapport with the patient. Assessment tools are used not only to examine the patient’s health, needs, and the extent of care required but also to create comfort and respect for the client. In this paper, I will discuss the three components of a psychiatric interview that I believe are important, as well as the psychometric properties and appropriateness of using the Hamilton Anxiety Rating Scale (HAM-A).

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In a psychiatric interview, I believe the care provider’s responsible for understanding the patient and any problems contributing to the current mental health status. As a result, the most crucial elements are family history, medical history, and current status. Because most mental health disorders have a genetic component, family history is considered (Allegrini et al., 2020). Assessing a patient’s familial history provides insight into the types of problems a particular individual is prone to, resulting in an accurate diagnosis and appropriate treatment. For example, suppose a patient reports having heart palpitations, anxiety moods, and some depression symptoms, and their mother, grandmother, or aunt has been diagnosed with anxiety. In that case, it is important to consider whether the client has a genetic predisposition to the problem (Allegrini et al., 2020).

Furthermore, genetics can influence the efficacy of treatment strategies and specific psychiatric behaviours such as suicidal ideation and attempts. As a result, knowing the patient’s family history is just as important as knowing the patient’s symptoms because it could be the key to proper diagnosis and treatment on the other hand, medical history d, is especially important in understanding the patient’s past experiences and the possibility that they are contributing to the current condition. The patient’s medical history carries a lot of weight because it provides a clear and honest picture of the patient’s condition and establishes grounds on which strategy should be implemented and which should not (Fernandes et al., 2017).

Additionally, their care provider can learn about the patient’s medication history, current medications and supplements, allergies, and unintended drug reactions. Because of the addictive nature of certain medications, such as Diazepam, certain patients cannot be given them. Providers use medical history to develop treatment plans, particularly regarding prescriptions (Wheeler et al., 2017). Furthermore, the provider can learn about other health professionals involved in the client’s care with whom she may be able to collaborate.

The current status will be an important factor when interviewing a psychiatric patient. The current status will describe the patient’s signs and symptoms, as well as their coping mechanisms and medication adherence. The provider may be aware that certain medications are prescribed to a patient or that a particular report about receiving; for example, smoking cessation, is included in their medical history; however, without hearing these reports but the patient’s current status, the information may be worthless or even dangerous. The provider must listen to and understand each symptom experienced by the patient, as well as inquire about their coping mechanisms, such as substance abuse, medication adherence, any recent changes, and their health needs (Fortney et al., 2017). This information guides the treatment process, ensuring the patient is fully involved and their safety is prioritized.

The Hamilton Anxiety Rating Scale (HAM-A) has clinician-rated psychometric properties. The HAM-A tool’s main purpose is to assess the severity of anxiety symptoms. The tool can be used with all age groups, including children, adolescents, and adults. The HAM-A was one of the first tools developed to assess the severity of anxiety symptoms (HAM-A Hamilton Anxiety Scale, n.d.). It is widely used in clinical symptoms and research. The tool contains 14 entries that describe potential anxiety symptoms. The items are listnumericallyder and describe specific feelings that peopsufferingfer from anxiety experience. The scale assesses somatic anxiety, which refers to physical complications caused by anxiety, and psychic anxiety, which refers to psychological distress and mental agitation. Each of the 14 items is scored on a scale of 0 to 4, with 0 representing absence and 4 representing severe. The lowest possible score is 0, and the highest is 56. Greater than 17 indicates mild to severe anxiety, 18-24 indicates moderate-severe anxiety and 25-30 indicates moderate ry severe anxiety (Hamilton Anxiety Rating Scale (HAM-A), n.d.).

This tool is suitable for use in a psychiatric interview. It was designed for patients with anxiety neurosis to scare them and consider the clinical rating of the severity of their anxiety. The HAM-A questionnaire is not a diagnostic or screening tool. It only determines the severity of anxiety and should thus be used only for people who have already been diagnosed with the disorder (Hamilton Anxiety Rating Scale) (HAM-A, n.d.). It can also be used to assess a patient’s response to treatment. The scale is very important in providing an “overall measure of global anxiety,” as it includes cognitive and emotional symptandalso autonomic symptoms.

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References

Allegrini, A. G., Cheesman, R., Rimfeld, K., Selzam, S., Pingault, J. B., Eley, T. C., & Plomin, (2020). The p factor: genetic analyses support a general dimension of psychopathology in childhood and adolescence. Journal of child psychology aPsychiatrytry, 61(1), 30-39.

Fernandes, B. S., Williams, L. M., Steiner, J., Leboyer, M., Carvalho, A. F., & Berk, M. (2017). The new field of ‘precision psychiatry. BMedicineine, 15(1), 1-7.

Fortney, J. C., Unützer, J., Wrenn, G., Pyne, J. M., Smith, G. R., Schoenbaum, M., & Harbin, H. (2017). A tipping point for measurement-based care. Psychiatric services, 68(2), 179- 188.

HAM-A Hamilton Anxiety Scale. (n.d.). Psychiatric Times. https://www.psychiatrictimes.com/view/ham-hamilton-anxiety-scale

Hamilton Anxiety Rating Scale (HAM-A). (n.d.). https://dcf.psychiatry.ufl.edu/files/2011/05/HAMILTON-ANXIETY.pdf

Wheeler, A. J., Scahill, S., Hopcroft, D., & Stapleton, H. (2018). Reducing medication errors at transitions of care is everyone’s business. Australian prescriber, 41(3), 73.

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Question 

Review this week’s Learning Resources and reflect on their insightsovide regarding psychiatric assessment and diagnosis.
Consider the elements of the psychiatric interview, history, and examination.
Consider the assessment tool assigned to you by the Course Instructor( Mini-Mental State Examination (MMSE)
Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important.

The Psychiatric Evaluation and Evidence-Based Rating Scales

The Psychiatric Evaluation and Evidence-Based Rating Scales

Explain the psychometric properties of the rating scale you were assigned( Mini-Mental State Examination (MMSE)

Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.

Required reading: