Nursing Education for Mental Illness Management and Recovery 

Illness Management and Recovery In Nursing Education

    It is becoming widely recognized that people with severe mental
illness can participate actively in their own treatment. Illness management
skills, ranging from greater knowledge of psychiatric illness and its treatment
to coping skills and relapse prevention strategies, play a critical role in
people’s recovery from mental illness. 

    While patient preparation to use some of
these strategies is available in some settings, no empirically supported
programs (such as the Arthritis Self Management Program) are in widespread use
(Mueser et al., 2002). This represents the level of development of these
services. 

    Other challenges face the mental health field in fully development
of an appropriate patient education (psychoeducation) model. A nationally
representative sample of adults with a self-reported mental health problem were
found to have lower literacy than did other adults, even when education and
other predictors of literacy were controlled. 

    Low literacy is likely to limit
the accuracy and validity of standardized diagnostic and outcome measures and
to mean that written and educational materials are not understood by the
patients. In addition, people with low literacy may be unable to understand
medication labels or follow their often-complex medical regimens (Sentell &
Shumway, 2003). 

Measurement Instruments for Psycho Education In Nursing

    A performance based measure of medication management for persons
with schizophrenia (Medication Management Ability Assessment or MMAA) uses role
play of simulated prescribed medication regimens and asks the patient to hand
the required pills (dried beans) to the tester at the appropriate time. MMAA
requires 15 minutes to administer. 

    Its I-week test retest reliability was 96.
In general, patients under medicated significantly in this test, with patients
performing less well than normal controls and those with more severe cognitive
deficits per forming worst. Next steps in development of the MMAA include
comparison with drug blood levels, and prospective and intervention trials to
determine its sensitivity to changes in psychiatric symptoms (Patterson et al.,
2002).

    While research is very important to progress in treating mental
health problems, there is a concern that ill subjects may not be able to
understand well enough to provide informed consent to research participation. 

    Buckles et al. (2003) have devised a test of the elements of informed consent
in the Code of Federal Regulations for a simple non treatment
research protocol and found that those with very mild and mild dementia could
answer them while those with moderate dementia could not . 

    Trials with more
complex designs including placebo randomization and serious adverse events may
be much more difficult to understand. The authors suggest developing such a
test for each trial, to provide an objective measure of this one element
(understanding) for informed consent. It should be noted that mildly demented
individuals benefited from repetition of the informed consent information. 

Main Aspects of Psycho Education In Nursing 

    In general, psycho education for persons with mental health problems
focuses on improving the patient’s and family’s illness management skills,
decreasing effective relapse and inter episode symptoms, and improving
functional outcome. Development and testing of interventions and measurement of
outcomes are at early stages of development.