Essentials of Psychiatric Mental Health Nursing Concepts of Care in
Evidence-Based Practice: Chapter 1:
1. Anosognosia: A condition in which a person with an illness seems unaware of
the existence of his or her illness.
2. Anxiety: A feeling of discomfort and apprehension related to fear of impending
danger. The individual may be unaware of the source of his or her anxiety, but it
is often accompanied by feelings of uncertainty and helplessness..
3. Anticipatory grief: The experiencing of the grief process before the actual loss
occurs.
Anticipatory grieving is thought to shorten the grief response in some individuals
who are able to work through some of the feelings before the loss occurs. If the loss
is sudden and unexpected, mourning may take longer than it would if individuals
were able to grieve in anticipation of the loss.
4. Resolution of grief:: Length of the grief process is entirely individual. It can last
from a few weeks to years and is influenced by a number of factors.
5. Bereavement overload: The length of the grief response is often extended when
an individual has experienced a number of recent losses and when he or she is
unable to complete one grieving process before another one begins.
6. Coping skills: Coping behaviors that enhance one's adaptation.
These include enhancing knowledge, social affiliation with others, and problem-
solving.
7. Ego defense mechanisms: Used either consciously or unconsciously as
protective devices for the ego in an effort to relieve mild to moderate anxiety.
They become maladaptive when an individual uses them to such a degree that
the defense mechanism interferes with the ability to deal with reality, with
interpersonal relations, or with occupational performance.
8. Examples of ego defense mechanisms:: Compensation, conversion, denial,
displacement, identification, dissociation, regression, intellectualization,
introjection, isolation, projection, rationalization, reaction formation, repression,
sublimation, and undoing.
9. Fight-or-flight syndrome: Physical reactions triggered by the sympathetic
nervous system that prepare the body to fight or to run from a threatening
situation
10. Grief: Subjective state of emotional, physical, and social responses to the loss
of a valued entity
Loss may be real or perceived.
11. 5 stages of grief in order:: Denial, Anger, Bargaining, Depression, and
Acceptance.
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, Essentials of Psychiatric Mental Health Nursing Concepts of Care in
Evidence-Based Practice: Chapter 1:
12. 5 stages of grief: Not all individuals experience each of these stages in
response to a loss, nor do they necessarily experience them in this order. Some
individuals' grieving behaviors may fluctuate, and even overlap, among the stages.
13. Stage 1: Denial: This is a stage of shock and disbelief. The response may be
one of "No, it can't be true!" The reality of the loss is not acknowledged. Denial is a
protective mechanism that allows the individual to cope within an immediate time
frame while organizing more effective defense strategies.
14. Stage 2: Anger: "Why me?" and "It's not fair!" are comments often expressed
during the anger stage. Envy and resentment toward individuals not affected by the
loss are common. Anger may be directed at the self or displaced on loved ones,
caregivers, and even God. There may be a preoccupation with an idealized image
of the lost entity.
15. Stage 3: Bargaining: "If God will help me through this, I promise I will go to
church every Sunday and volunteer my time to help others." During this stage,
which is usually not visible or evident to others, a "bargain" is made with God in an
attempt to reverse or postpone the loss. Sometimes the promise is associated with
feelings of guilt for not having performed satisfactorily, appropriately, or sufficiently.
16. Stage 4: Depression: During this stage, the full impact of the loss is
experienced. The sense of loss is intense, and feelings of sadness and depression
prevail. This is a time of quiet desperation and disengagement from all association
with the lost entity. This stage differs from pathological depression in that it
represents advancement toward resolution rather than the fixation in an earlier
stage of the grief process.
17. Stage 5: Acceptance: The final stage brings a feeling of peace regarding the
loss that has occurred. It is a time of quiet expectation and resignation. The focus
is on the reality of the loss and its meaning for the individuals affected by it.
18. Concepts identified by Maslow: A "hierarchy of needs" and self-actualization
as fulfillment of one's highest potential
19. Neurosis: A psychiatric disturbance characterized by excessive anxiety that
is expressed directly or altered through defense mechanisms. It appears as a
symptom, such as an obsession, a compulsion, a phobia, or a sexual dysfunction
20. A common characteristics of people with neuroses:: They are aware that
they are experiencing distress.
They are aware that their behaviors are maladaptive.
They are unaware of any possible psychological causes of the distress.
They feel helpless to change their situation.
They experience no loss of contact with reality.
2/7
Evidence-Based Practice: Chapter 1:
1. Anosognosia: A condition in which a person with an illness seems unaware of
the existence of his or her illness.
2. Anxiety: A feeling of discomfort and apprehension related to fear of impending
danger. The individual may be unaware of the source of his or her anxiety, but it
is often accompanied by feelings of uncertainty and helplessness..
3. Anticipatory grief: The experiencing of the grief process before the actual loss
occurs.
Anticipatory grieving is thought to shorten the grief response in some individuals
who are able to work through some of the feelings before the loss occurs. If the loss
is sudden and unexpected, mourning may take longer than it would if individuals
were able to grieve in anticipation of the loss.
4. Resolution of grief:: Length of the grief process is entirely individual. It can last
from a few weeks to years and is influenced by a number of factors.
5. Bereavement overload: The length of the grief response is often extended when
an individual has experienced a number of recent losses and when he or she is
unable to complete one grieving process before another one begins.
6. Coping skills: Coping behaviors that enhance one's adaptation.
These include enhancing knowledge, social affiliation with others, and problem-
solving.
7. Ego defense mechanisms: Used either consciously or unconsciously as
protective devices for the ego in an effort to relieve mild to moderate anxiety.
They become maladaptive when an individual uses them to such a degree that
the defense mechanism interferes with the ability to deal with reality, with
interpersonal relations, or with occupational performance.
8. Examples of ego defense mechanisms:: Compensation, conversion, denial,
displacement, identification, dissociation, regression, intellectualization,
introjection, isolation, projection, rationalization, reaction formation, repression,
sublimation, and undoing.
9. Fight-or-flight syndrome: Physical reactions triggered by the sympathetic
nervous system that prepare the body to fight or to run from a threatening
situation
10. Grief: Subjective state of emotional, physical, and social responses to the loss
of a valued entity
Loss may be real or perceived.
11. 5 stages of grief in order:: Denial, Anger, Bargaining, Depression, and
Acceptance.
1/7
, Essentials of Psychiatric Mental Health Nursing Concepts of Care in
Evidence-Based Practice: Chapter 1:
12. 5 stages of grief: Not all individuals experience each of these stages in
response to a loss, nor do they necessarily experience them in this order. Some
individuals' grieving behaviors may fluctuate, and even overlap, among the stages.
13. Stage 1: Denial: This is a stage of shock and disbelief. The response may be
one of "No, it can't be true!" The reality of the loss is not acknowledged. Denial is a
protective mechanism that allows the individual to cope within an immediate time
frame while organizing more effective defense strategies.
14. Stage 2: Anger: "Why me?" and "It's not fair!" are comments often expressed
during the anger stage. Envy and resentment toward individuals not affected by the
loss are common. Anger may be directed at the self or displaced on loved ones,
caregivers, and even God. There may be a preoccupation with an idealized image
of the lost entity.
15. Stage 3: Bargaining: "If God will help me through this, I promise I will go to
church every Sunday and volunteer my time to help others." During this stage,
which is usually not visible or evident to others, a "bargain" is made with God in an
attempt to reverse or postpone the loss. Sometimes the promise is associated with
feelings of guilt for not having performed satisfactorily, appropriately, or sufficiently.
16. Stage 4: Depression: During this stage, the full impact of the loss is
experienced. The sense of loss is intense, and feelings of sadness and depression
prevail. This is a time of quiet desperation and disengagement from all association
with the lost entity. This stage differs from pathological depression in that it
represents advancement toward resolution rather than the fixation in an earlier
stage of the grief process.
17. Stage 5: Acceptance: The final stage brings a feeling of peace regarding the
loss that has occurred. It is a time of quiet expectation and resignation. The focus
is on the reality of the loss and its meaning for the individuals affected by it.
18. Concepts identified by Maslow: A "hierarchy of needs" and self-actualization
as fulfillment of one's highest potential
19. Neurosis: A psychiatric disturbance characterized by excessive anxiety that
is expressed directly or altered through defense mechanisms. It appears as a
symptom, such as an obsession, a compulsion, a phobia, or a sexual dysfunction
20. A common characteristics of people with neuroses:: They are aware that
they are experiencing distress.
They are aware that their behaviors are maladaptive.
They are unaware of any possible psychological causes of the distress.
They feel helpless to change their situation.
They experience no loss of contact with reality.
2/7
