UNIVERSITY OF SANTO TOMAS

COLLEGE OF NURSING

COURSE SYLLABUS
Mental Health and Psychiatric
Course Title: School Year: 2016-2017
Nursing

Course No. NCM 105 Semester: 2nd

Psy 1, Chem 111, Biosci 2,
7 Units (5 units lecture + 2 units
No. Of Units: Prerequisite: TFN, HA, NCM 100,NCM 101,
RLE )
NCM 102, NCM 103, NCM 104
Ma. Georgina Manzano
La.Arnie Lazalita
Faculty Beryl Battad Schedule:
Geralynne Medrana
Junnile Paat

COURSE DESCRIPTION:

A one semester course which deals with the concepts and principles in the nursing care management of
patients with problems in psychosocial adaptation and adjustment across the lifespan in varied settings.

COURSE OBJECTIVES:

Course At the end of the course the students should be able to :

Objectives 1. Utilize the nursing process in implementing comprehensive, safe and quality care
of patients and families experiencing psychosocial adjustment/adaptation
problems.
2. Exercise beginning skills in the management of the clients care in relation to
resources in a therapeutic environment.
3. Implement innovations, revisions/ improvements in client care to maintain safe
and quality standards of care.
4. Execute health teaching strategies, based on assessed and anticipated needs
and/or problems, to help create a therapeutic regimen for clients.
5. Value the importance of therapeutic use of self and the Thomasian core values
of competency, commitment and compassion in nurse-client relationship
6. Collaborate effectively with clients, families and members of the health team and
allied professionals using appropriate and accurate means of communication and
documentation.
7. Utilize relevant research evidences to improve health care delivery
8. Implement ethico-moral principles, legal standards and provisions, and
organizational policies and procedures relevant to implementing strategies of
care.
9. Demonstrate leadership potentials in various learning and collaborative activities
related to nursing practice.
10. Demonstrate commitment to professional standards of nursing through on-going
personal and formative development activities.

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Major Demonstrates in-depth knowledge and skills fundamental to psychiatric nursing practice,
Competency utilizing effective communication techniques, therapeutic use of self and critical thinking
based on actual clinical and evidence-based data, in formulating a specific nursing
assessment for a well planned nursing management of clients with psychosocial
adaptation and adjustment including pharmacotherapeutics.

Value Objectives: 1. Apply knowledge & skill in utilizing varied approaches in the assessment of
clients with specific psychosocial alterations in any health setting.
- Lecture-demonstration
- Class discussion
- AV presentation of Mental Status Assessment
- Case Presentations
- Problem Based Learning

2. Utilize critical thinking in the analysis and formulation of nursing diagnoses

specific to the clients mental health problems.
- Class discussion
- Individual case presentation of client assessment

3. Integrate pertinent concepts, scientific principles, research findings in nursing and

related disciplines in the analysis of all assessment data to accurately identify
clients problems.
- Case presentation of client assessment
with scientific & evidence-based rationalization
- Class discussion

4. Apply the principles of pharmacology and psychodynamics in the management of

clients with varied psychosocial alteration conditions in any health setting.
- Class discussion
- Oral reporting

5. Implement culture-specific variations in health assessments, planning and

implementation of nursing interventions through comprehensive and critical
evaluation
- Class discussion
- Oral Reporting/Case presentation

6. Critically evaluate and apply research findings in formulating nursing strategies

and decisions pertinent to client care management in any setting
- Class discussion
- Case presentation
- Bibliography sharing

COURSE OUTLINE:

UNIT CONTENT OUTLINE TIME ALLOTMENT

UNIT 1 I. Scope of Psychiatric Nursing Practice DAY 1
A. Definition of Psychiatric Nursing (Travelbee) 2 hours/
B. Evolution of psychiatric nursing practice 1meeting
C. Review the Scope of Practice:
1. patient
2. mode of nursing intervention
3. outcome of nursing intervention
D. Functions and Responsibilities of the Nurse in primary,

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 secondary and tertiary levels of care.
E. Nursing Roles
Generalist Roles:
Milieu therapist
Counselor
Teacher
Collaborator
Parent Surrogate
Technician
Responsible Citizen and agent of change
Promoter of Mental Health
Participant in Research
Clinical Specialist Roles:
Psychotherapist
Clinical Supervisor
Administrator
Educator
Consultant
Researcher

II. Standards of Psychiatric Nursing Practice DAY 1

A. Structure Criteria and Standards 3 hours /
Qualifications of the nurse 1 meeting
Personal
Professional
Functions of the Nurse
Collaborative functions and activities
Research/Innovative functions and activities
Organization and administration of nursing care services
Physical facilities and equipment
B. Process Criteria and Standards
1. Assessment
2. Analysis of Data
3. Planning
4. Implementation
5. Evaluation

C. Outcome Criteria and Standards

1. Progress and effects of Nursing Care

III. Mental Health - Illness Continuum DAY 2

A. Family process / Dynamics 3 hours/
1. nature versus nurture 1 meeting
B. Patterns of Behavior
1. Health- Illness
2. Conformity- Deviance
C. Concepts of Human Behavior
1. Needs
2. Frustrations and Conflict

IV. Therapeutic Nurse-Patient Relationship

Nurse-patient relationship vs. social relationship
Therapeutic Use of Self
Therapeutic Communication
characteristics
techniques

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 4. Phases in the nurse-patient relationship
5. Goals in the One-to-one relationship

V. Legal and Ethical Context of Psychiatric Nursing DAY 3

A. Patients Rights 2 hours/
B. Ethical Considerations 1 meeting
C. Legal Psychiatric Nursing Issues
DAY 4
VI. Health Status Assessment
3 hours/
1. Nursing History 1 meeting
2. Health Assessment
2.1. Mental Status Examination
2.1.1. Disturbances in:
1. appearance 7. Activity
2. thought 8. memory
3. feeling/affect 9. attention
4. sensory perception 10. judgment
5. perception 11. insight
6. orientation
3. Diagnostic Examinations
3.1 Psychological Tests and Assessment Tools
3.2 Laboratory Exams
4. Multi Axial Diagnosis

VII.Documentation in psychiatric nursing practice

1. problem-oriented recording
a. DAR
2. process recording
UNIT 2
I. Anxiety
Definition and manifestations DAY 5
Physiological Emotional 3 hours /meeting
Cognitive Behavioral
Etiology
Biological
Psychological
Socio-cultural
3. Levels of anxiety
Mild
Moderate
Severe
Panic
4. Psychotherapeutic management
a. Nurse-patient relationship
b. milieu
c. pharmacology
d. stress management
e. relaxation technique
II. Anxiety Responses and Patterns of Adaptation DAY 6
1. Ego Defense Mechanisms: 2 hours /
compensation rationalization meeting
displacement repression
denial regression
fixation projection
sublimation symbolization
reaction formation projection
identification symbolization
conversion introjection
isolation undoing
3. Security Operations:

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 selective inattention
somnolent detachment
preoccupation
apathy
3. Coping mechanism
adaptive
palliative
maladaptive
dysfunctional

III. Crisis and Crisis Intervention

A. Concept
1. Definition
2. Balancing Factors
3. Types of Crisis
4. Phases of crisis development
5. Crisis Characteristics
B. Crisis Intervention
1. Characteristics
2. Steps of Crisis Intervention
3. Types of Crisis Intervention

UNIT 3 Theories and Models of Psychiatric Treatment and Care DAY 8

3 hours/
I. Models of Psychiatric Treatment/ Care meeting
A. Psychoanalytic theory
B. Behavioral theory
C. Interpersonal theory
D. Biologic theory
E. Cognitive theory
F. Systems theory
G. Humanistic theory
H. Ecclectic approach

II. Treatment Modalities

1. Somatic Therapies DAY 9
1.1. Pharmacotherapy 2 hours/
a. antipsychotic meeting
b. antidepressants
c. anxiolytics
d. antimanic
e. anti-parkinsonism
f. sedatives and hypnotics
g. anticonvulsant
h. stimulants
1.2. Narcotherapy/ Narcosynthesis
1.3. Electroconvulsive therapy
1.4. Alternative / Complementary treatment

2. Psychotherapy
2.1. individual therapy
2.2. group therapy
2.3. family therapy
2.4. play therapy
3. Behavior Therapies
4. Cognitive Therapy
5. Milieu therapy
Definition
Brief History
Assumptions

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 Therapeutic Community
history
treatment dimension
1. Activity therapy
Brief history
Goals and Therapeutic values
Specific therapies
occupational
recreational
music
art
educational
bibliotherapy
remotivation technique
2. Attitude therapies
active friendliness
passive friendliness
matter-of fact
kind firmness
no demand
UNIT 4 DAY 10
3 hours/ meeting
Care of Patients with Schizophrenia and Other Psychoses
1. Etiology
1.1 Biological Theories
1.2 Psychoanalytic
1.3 Family Theories
1.4 Vulnerability-Stress Model
2. Psychodynamics of Schizophrenia
3. Psychopathology of Schizophrenia
3.1.Manifestations
3.1.1. Bleulers 4 As
3.1.2. DSM IV-TR Criteria contrast with DSM V
4. Types of Schizophrenia
5. Psychotherapeutic Management
5.1 Psychopharmacology
5.1.1 Mode of Action
5.1.2 Side Effects
5.1.3 Nursing Responsibilities
5.2. Nurse-patient relationship
5.3. Milieu management
5.4. Discharge planning / health teaching
a. individual
b. family
5.5. Psychotherapy
5.6. Rehabilitation program
6. Other Psychotic Disorders
6.1. Schizoaffective Disorder
6.2. Delusional Disorder
6.3. Brief Psychotic Disorder
6.4. Schizophreniform Disorder
6.5. Shared Psychotic Disorder
UNIT 5
DAY 11 - 12
I. Care of Patients with Mood Disorders 5 hours for 2 meetings
Major Depression/ Mania
1. Definitions and Manifestations
1.1. Depressive Disorders
Major Depressive disorder
Dysthymia

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 1.2. Bipolar Disorders
Manic episode
Hypomanic episode
Bipolar : Type 1 and 2
Cyclothymic disorder
2. Etiology
1.1 Biological Theories
1.2 Psychoanalytic
1.3 Cognitive
1.4 Sociological
3. Psychodynamics of Depression/ Mania
4. Psychotherapeutic Management
4.1 Psychopharmacology
4.1.1 Mode of Action
4.1.2 Side Effects
4.1.3 Nursing Responsibilities
4.2. Nurse-patient relationship
4.3. Milieu management
4.4. Discharge planning / health teaching
a. individual
b. family
4.5. Psychotherapy
4.6. Rehabilitation program

II. Care of Clients with Suicidal Ideation

1. Themes of Suicide
2. Assessment of Suicidal Patients
2.1 Manifestations
2.2 Plan
2.3.Lethality Assessment
2.4.Rescue
3. Nursing Management

III. Care of Clients with Aggression

1. forms of aggression
2. etiology
a. biological
b. psychological
c. socio-cultural
3. phases of aggressive behavior
4. Psychotherapeutic management
a. nurse-patient relationship
b. milieu
c. pharmacology
5. psychotherapy
UNIT 6 DAY 13 -14
Care of Patients with Anxiety and Anxiety Related Disorders 5 hours/
I. Definition and Manifestations 2 meetings
1. Anxiety Disorders
1.1. Phobic Disorder
1.2. Generalized Anxiety Disorder
1.3. Panic Disorder
2. Posttraumatic Stress Disorder
3. Obsessive-Compulsive Disorder
4. Somatic Symptom Illnesses
2.1. Somatic Symptom Disorder
2.2.Pain Disorder
2.3. Hypochondriasis
2.4. Conversion Disorder
3. Dissociative Disorders

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 3.1. Dissociative Amnesia
3.2. Dissociative Fugue
3.3. Dissociative Identity Disorder
3.4. Depersonalization Disorder
4. Other anxiety-related behavioral problems
4.1. malingering
4.2. body dysmorphic disorder
4.3. factitious disorder
4.4. sleep disorder
5. Psychophysiologic responses

II. Etiology
1. Biological View
2. Psychoanalytic View
3. Interpersonal View
4. Behavioral View
III. Psychotherapeutic Management
1. Psychopharmacology
1.1 Mode of Action
1.2 Side Effects
1.3 Nursing Responsibilities
2. Nurse-patient relationship
3. Milieu Management
3.1. stress management
3.2. relaxation techniques
4. Discharge planning
5. Psychotherapy
UNIT 7 6. Rehabilitation program
DAY 15
Care of Patients with Substance Related Disorders 3 hours/ meeting
I. Etiology
1. Biological
2. Psychological
3. Socio-Cultural
II. Definitions
1. Substance Intoxication
2. Substance dependence
3. Substance withdrawal
4. Substance abuse
5. Substance tolerance
III. Pharmacokinetics and physiological effect
1.1. Alcohol
1.2. other substances
1.2.1. Barbiturates and Benzodiazepines
1.2.2. Narcotics
1.2.3. Stimulants
1.2.4. Hallucinogens
IV. Psychotherapeutic Management
1. Pharmacology
1.1 Mode of Action
1.2 Side Effects
1.3 Nursing Responsibilities
2. Nurse-patient relationship
3. Milieu Management
4. Discharge planning / health teaching
5. Psychotherapy
UNIT 8 Day 16
Care of Patients with Personality Disorders 2 hours
I. Etiology
1. Biological

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 2. Psychological
3. Socio-Cultural
II. Manifestations and Psychodynamics according to classifications
1. Cluster A : Paranoid, Schizoid, Schizotypal
2. Cluster B : Antisocial, Borderline, Narcissistic, Histrionic
3. Cluster C : Dependent, Avoidant, Obsessive- Compulsive
III. Psychotherapeutic Management
1. Nurse-patient relationship
2. Milieu Management
3. Discharge planning / health teaching
UNIT 9 4. Psychotherapy

Care of Patients with Sexual Disorders Day 17

I. Etiology 3 hours
1. Biological
2. Psychological
3. Socio-cultural
II. Definitions and Manifestations
1. Review of the Sexual Response Cycle
2. Sexual Dysfunction
2.1. Sexual Desire Disorders
2.2. Sexual Arousal Disorders
2.3. Sexual Orgasm Disorders
2.4. Sexual Pain Disorders
3. Paraphilias
Pedophilia Voyeurism
Incest Sadism
Frotteurism Masochism
Fetishism Transvestic Fetishism
Exhibitionism
4. Gender Identity Disorders
III. Psychotherapeutic Management
1. Nurse-patient relationship
2. Milieu
3. Pharmacology
4. Discharge planning / Health teachings
UNIT 10 5. Psychotherapy

Care of Patients with Cognitive Disorders Day 18

I. Definition, manifestations and causative factors 2 hours
1. Delirium
2. Dementia
1.2.1. Reversible Dementia
1.2.2. Irreversible Dementia
Alzheimers
Parkinsons Disease
Huntingtons Disease
Diffuse Lewy Body Disease
Creutzfeldt-Jakob disease
Picks Disease
Vascular or Multi-infarct dementia
Alcoholic Dementia
Transient Ischemic Attack
II. Psychotherapeutic Management
1. Nurse-patient relationship
2. Milieu
2.1. stress
2.2. safety
2.3. wandering
3. Pharmacology

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 4. Discharge planning / health teachings
5. Psychotherapy
Reminiscence therapy
Life review
Activity therapies
UNIT 11
Care of Clients with Childhood and Adolescent Disorders
I. Etiology Day 19
I.1. Biological 3 hours
I.2. Psychological
I.3. Social and Cultural
II. Resiliency
III. Forms of Mental and Behavioral Conditions
1. Mental Retardation
2. Pervasive Developmental Disorder
3. Learning Disorder
4. Language Disorder
5. Disruptive Disorder
a. Conduct disorder
b. ADHD
c. oppositional defiant
6. Motor Disorder
7. Tic Disorder
8. Elimination Disorder
9. Separation Anxiety
10. Mood Disorder
IV. Psychotherapeutic Management
1. Nurse-patient relationship
2. Milieu
3. Pharmacology
4. Psychotherapy
a. play therapy
5. Discharge planning / Health teachings
a. individual
UNIT 12 b. family

Care of Patients with Eating Disorders

I. Etiology Day 20
1. Biological 2 hours
2. Psychological
3. Socio-cultural
II. Manifestations
1. Anorexia Nervosa
2. Bulimia Nervosa
3. Male eating disorder
4. Pica
III. Psychotherapeutic Management
1. Nurse-patient relationship
2. Milieu
3. Pharmacology
4. Discharge planning / health teachings
4.1. individual
4.2. family
5. Psychotherapy
UNIT 13 5.1. family therapy

Care of Patients who are victims of Abuse and Violence

I. Etiology Day 21-22
I.1. Biological 5 hours
I.2. Psychological

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 I.3. Social - Cultural
II. Forms of Abuse and Violence
1. Domestic Violence
Child, partner and elderly
2. Community Violence
Rape, sexual harassment, torture, ritual abuse and mind
control
III. Psychodynamic
1. Characteristics of the victim and abuser
2. Effects of Abuse and Violence
IV. Stage of Recovery
a. Impact
b. recoil
c. reconstruction / reorganization
V. Psychotherapeutic Management
1. Nurse-patient relationship
2. Milieu
3. Acute crisis management
\ 4. Psychotherapy
UNIT 14 5. Discharge planning

Care of the Caregivers

I. Overview Day 23
I.1. The Caregivers 2 hours
I.2. Reason for the caregiver role
I.3. Definition of the caregiver role strain
II. Manifestations of caregiver role strain
Physical
Psychological / emotional
Social
Spiritual
III. Psychotherapeutic management
1. nurse-patient relationship
2. milieu
3. pharmacology
4. psychotherapy

--------------------------- end -------------------------------------------------

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 INSTRUCTIONAL LEARNING MODEL AND STRATEGY:

Professors Input: - Mediated lecture

- Powerpoint /VideoPresentations
- Integrating discussion of case studies and oral
presentations
- Critical analysis of case presentations and clinical
pathways
- Demonstration/workshop facilitation

Enabling Activities: - Case Studies/analysis

- Case Presentations/Oral Reports
- Extensive reading / research journal
- Library work

Interactive, Collaborative - Case Presentations/Discussions

Activity - Sharing of experiences in RLE
- Critical Case analysis
- Group research on evidenced-base strategies of care
Integrating Activity
- Group work on the formulation of Clinical Pathway
- Reading of actual cases
- Observation of actual patients (RLE)

COURSE REFERENCES:

Textbook and other For Basic Reading:

References Keltner, Norman, Schwecke, Lee Hilyard,
Bostrom, Carol. Psychiatric Nursing.
Mosby Inc., 5th Ed., 2010.
Videbeck, Sheila L. Psychiatric Mental
Health Nursing. Lippincott Williams and
Wilkins, 5th Ed., 2014.
Shives, Louise Rebraca, Isaacs, Ann.
Basic Concepts of Psychiatric-Mental
Health Nursing. Lippincott Williams and
Wilkins, 5th Ed., 2002.
Stuart, Gail W., Laraia, Michele T.
Principles and Practice of Psychiatric
Nursing. Mosby Inc., 9th Ed., 2012.

For Extended Readings:

List of Journals :Available at UST Health Sciences Library

1. Journal in Psychiatric Nursing and Journal in Nursing Research
2. Kaplan, Harold, Sadock and Grebb Synopsis of Psychiatry, William &
Wilkins Co., 2000
Online Databases:
BENAVIDES PROJECT
http://ethesis.ust.edu.ph/docuvu
CINAHL

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 http://www.cinahl.com
CIPPA (Computerized Index to Philippine Periodical Articles)
http://rizal.lib.admu.edu.ph/cippa/cippa.asp
EBSCO
http://search.epnet.com
GOOGLE SCHOLAR
http://scholar.google.com.ph/
JSTOR
http://jstor.org
MIGUEL BENAVIDES LIBRARY ONLINE DATABASES

Instructional Media LCD

Laptop
Videos

COURSE POLICIES and REQUIREMENTS:

Course Policies Expected level of knowledge

This subject builds on the knowledge of the mental health concepts
taken up in N102 (criteria of mental health, stress and adaptation, crisis,
nurse client relationship and communication), therefore the students are
expected to review the prerequisite information.

Attendance
Students are expected to attend at least 80% of the class days and
100% of the RLE hours. Deficiencies in the RLE will be made up according
to the existing policy of the college on absences/tardiness.
Requirements
To earn the credit units, a passing grade of 75% must be obtained after
completion of all lecture and RLE requirements.
Missed exams/quizzes/requirements should be taken/submitted within
the week upon the return of the student to class. A certification letter from
parent or guardian or a medical certificate from the universitys health
service department is required.
Failure to take make-up exams or submit requirements within 1 week
after the deadline will be given the ff rating: lowest grade in the said
test/requirement minus 10, unless a prior arrangement has been made due
to extraordinary reason.
School policies apply to cheating, plagiarism and
related infractions

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Course Requirements RLE Requirement:
RLE Grade:
Professional Competencies 60%
Other Learning activities 40%
- 2 Process Recordings (1 initial and 1 on - going interaction process
analysis)
- 1 Activity Plan (plan of activity therapy to be facilitated by a student.
Draft of the activity to be submitted at least 3 days
before the scheduled activity)
- Nursing Care Plan
- 1 Small Group Tutorial case discussion(for group discussion to
work out relevant cues, hypothesis and use varied
resources to meet identified learning needs.)
- 1 Bibliography obtained from a nursing journal, printed or electronic,
no older than 5 years. This should address a research problem
related to the current clients condition.(To be typewritten on a size 8
x11 paper font 12.)
- 1 Case presentation ( a comprehensive group discussion of an actual
clients condition, nursing problems and
management)

Computation of Grades Classroom requirement:

Class Standing: 70%
- Quizzes 50%
To be given at the end of every unit. 65% correct items= 75 (grade).
- Class Participation / Project/ Assignment- 10%
(Refer to Course Format)
Long Exam : 30%

Lecture grade = Class standing + Long Exam

Overall NCM 105 grade:

(Lecture grade x 5 units) + (RLE grade x 2 units)
7

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