NR 508 Week 7: Grand Rounds

NR 508 Week 7: Grand Rounds – This week you will post the VoiceThread presentation you created in Week 6 to this discussion board for your peers and lead a discussion throughout the week. Keep the discussion interesting, professional, and focused to the medication and topic.

Please see Course Resources for Voice Thread directions and use the media/edit button to insert your Voice Thread presentation to this thread.

Three responses to a peer’s presentations are due by Thursday 11:59 p.m. MT of Week 7, the answers to five questions in three different presentations (total of 15) and all follow-up posts to your presentation due by Sunday at 11:59 p.m. MT at the end of Week 7.

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NR 508 Week 7: Grand Rounds

Mental health awareness has become a serious focus in the past decade for modern healthcare- through tragedy and media coverage, the average person is becoming more and more aware of just how prevalent mental health and psychological disorders are and the damage/pain/suffering they can cause. Unfortunately, much of this awareness has patients with mental disorders in a skewed and terrible light- giving up and coming providers, such as ourselves, to become advocates and educators to reverse the stigmas and build the steps to effectively take care of these people.

Combination therapies for disorders, such as Generalized Anxiety disorder, are definitely on the rise as potential solutions. I believe combination therapies are becoming more and more prevalent because the concept of mental health is complex by itself. Many disorders come with multiple secondary psychiatric alterations- i.e it is very common for someone to have depression along with anxiety and visa versa- it often becomes a ‘which came first,’ the depression or the anxiety… or more accurately ‘which is worse’ and we will treat that one primarily. Providers and even patients are seeing advertised combination pharmalogical therapies that are made to help strengthen a medication that is already established. While this is important because as doses increase with medications, so the does the risk of adverse reactions, it is important that as providers we do not simply and immediately go to the solution of polypharmacy practices- rather look to non pharmacological methods to supplement and build lifestyle and holistic care to a medication. What many people do not realize is that anxiety and other mental health disorders are chronic and do not merely go away with pharmacological therapy; it is a lifetime of adjustments, relapse and work. Medications are necessary as they provide the solution to the actual chemical problems within our bodies, however these are not definitive aids but simply temporary symptomatic therapies (Kim & Kim, 2018).

 

The presentation you gave on GAD was very nicely done and I appreciated you sharing your knowledge. Both you and Lori did a wonderful job supporting the need for non pharmacological modalities as a solution for mental disorders and to be honest I just wanted to add a few points. While researching a bit more into your topic and in response to your proposal for more combination therapies- I thought I would go with my heart and discuss a nontraditional combination therapy- a pharmacological and a non pharmacological relationship therapy. The study discussed that the National Institute of Health and Care Excellence (NICE) in the United Kingdom prioritized the non-pharmacological interventions ahead of the pharmacological (Kim & Kim, 2018). Relaxation therapy- massage, meditation, etc- in addition to an antidepressant or anti anxiety medication, has been shown to be more effective then medications alone. The study discussed that Mindfulness-Based-Stress-Reduction (MBSR) was declared to be more effective than Cognitive Behavior Therapy and medications, and provided evidence of a greater reduction of overall comorbid emotional problems and worry (Kim & Kim, 2018). The study even discussed a randomized controlled study that concluded active relaxation was more successful for GAD than the pharmacological treatment.

I think the best thing about adding non-pharmacological concepts to pharmacological interventions, is teaching the younger generation how to manage themselves. Non pharmacological therapies such as relaxation and MBSR helps not only the active problem (i.e. anxiety) but teaches the individual coping mechanisms, patience and a way to control their reactions and their body. In doing my research, I even reviewed an article that was discussing the use of saffron as a boosting agent to antidepressants and a method to improve mood in major depressive disorder patients!

In our world of advanced technology and medication, I want to put out there that we as providers do not need to ignore one world or the other (modern versus homeopathic/natural. We need to marry the two for the best possible treatment plans for our patients- in safety, limiting adverse reactions, and focus on improving overall health by allowing us to individualize patient care.

 

Thank you for your post, I found it very interesting as working both in the ER and the OR, anxiety is something I see from almost every patient in some form or another.

The answers to your quiz postings are:

1. C
2. D
3. A
4. B
5. D

 

References:

Kim, H., & Kim, E.J. (2018). Effects of relaxation therapy on Anxiety disorders: A systematic review and meta-analysis. Archives of Psychiatric Nursing. 32(2). 278-284. DOI: http://doi.org/10.1016.japnu.2017.11.15