INTRODUCTION

Schizophrenia comes from Greek words meaning, “Split mind.”It causes

distorted and bizarre thoughts, perceptions, movements, emotions and
behaviors. It cannot be defined as a single illness; rather schizophrenia is
thought of as syndrome or disease process with many different varieties and
symptoms. It is usually diagnosed in late adolescence or early adulthood.
Rarely does it manifest in childhood. The peak incidence of onset is 15 to 25
years of age for men and 25 to 35 years of age for women.

Symptoms of Schizophrenia:

Positive or Hard Symptoms Negative or Soft Symptoms

Ambivalence Alogia
Associate looseness Anhedonia
Delusions Apathy
Echopraxia Blunted affect
Flight of ideas Catatonia
Hallucinations Flat affect
Ideas of reference Lack of volition
Perseveration
The types of Schizophrenia according to DSM-IV-TR;

Undifferentiated Type: demonstrates delusions, hallucinations,

disorganized speech, disorganized behavior, and does not demonstrate
behaviors usually observed in paranoid, disorganized or catatonic types.

Catatonic Type: features marked psychomotor disturbance that may

involve motor immobility (waxy flexibility), excessive motor activity, extreme
negativism, mutism, posturing, echolalia or echopraxia.

Disorganized Type: uses disorganized speech and behavior and exhibits

flat or inappropriate behavior: does not exhibit catatonic behaviors
(psychomotor or language mimic).

Paranoid Type: uses delusions of persecutory or grandiosity, or both, less

often noted are delusional themes of jealousy, religiosity, or somatization.

Residual Type: criteria for schizophrenia and subtypes listed above are not
met; there is continuing evidence of negative symptoms and two or more of
these characteristic symptoms (delusions, hallucinations, disorganized
speech, and gross disorganization).

Although there is no cure for schizophrenia, effective treatment exist that

can improve the long term course of the illness. With many years of
treatment and rehabilitation, significant numbers of people with
schizophrenia experience partial or full remission of their symptoms.
Treatment of schizophrenia usually involves a combination of medication,
rehabilitation, and treatment of other problems the person may have.
Antipsychotics medications are prescribed primarily for their efficacy in
decreasing psychotic symptoms. They do not cure schizophrenia; they are
used to manage the symptoms of the disease. The drugs reduce or eliminate
psychotic symptoms such as hallucinations and delusions. The medications
can also help prevent these symptoms from returning. Common
antipsychotic drugs include respiridone (Risperdal), olanzapine (Zyprexa),
clozapine (Clozaril), quetiapine (Seroquel), haloperidol (Haldol), thioridaxine
(Mellaril), chlorpromazine (Thorazine), fluphenazine (Prolixin), and
trifluoperazine (Stelazine).

Because many patients with schizophrenia continue to experience difficulties

despite taking medication, psychological and social rehabilitation is often
necessary. A variety of methods can be effective.Behavioral training
methods can also help them learn self-care skills such as personal hygiene,
money management, and proper nutrition.In addition, cognitive-behavioral
therapy, a type of psychotherapy, can help reduce persistent symptoms such
as hallucinations, delusions, and social withdrawal.

a. Individual and group therapy: It is supportive in nature, giving the

client an opportunity for social contact and meaning relationships.
Groups that focus on topics of concern such as medication
management, use of community supports and family concerns.

b. Family therapy: Family intervention programs can also benefit

people with schizophrenia. These programs focus on helping family
members understand the nature and treatment of schizophrenia, how
to monitor the illness, and how to help the patient make progress
toward personal goals and greater independence. They can also lower
the stress experienced by everyone in the family and help prevent the
patient relapsing or being re hospitalized.

c. Social skills training: Social skills training helps people with

schizophrenia learn specific behaviors for functioning in society, such
as making friends, purchasing items at a store, or initiating
conversations.

According to the record of CVMC psychiatry department as of Jan. - Dec. of

2009 there were 95 male patients admitted in the psychiatric and among
those patients there were 36 cases of schizophrenia and its prognosis is
much higher as of today’s because as of now from Jan. - July of 2010 there
were 71 patients admitted and among them there were 53 cases of
schizophrenia. And its prognosis is increasing in number. In female ward as
of Jan. – Dec. of 2009, there were 38 patients admitted and among those
patients, there were 21 cases of schizophrenia. From Jan. – July of 2010,
there were 43 patients admitted in female ward, and among those patients
there were 26 cases of schizophrenia. There are 697,543 cases of
schizophrenia in the Philippines, 75% are males and the rest are females.
And 51 million people worldwide suffer from schizophrenia in which males
have the most number of percent.

This statistics shows that males have the greater risk to develop psychiatric
disorder such as schizophrenia because of their lifestyle and keeping their
emotions.

We have chosen this case for the reason that we want to gain more
knowledge about the disorder and also to enhance the knowledge we
learned in Psychiatry Nursing in relation to it’s application in actual setting.

MENTAL STATUS EXAMINATION AND

PSYCHIATRIC NURSING ASSESSMENT

A. Appearance

 The patient dressed neatly and appropriately for his age but not
with the weather. He sees to it that he is clean, has taken a bath,
changed his clothes and brushed his teeth before going out
Nurse-Client interaction. He seems always alert and maintains
eye contact whenever possible. He maintains a good posture and
steady gait. He experienced shaking of legs as a side effect of
haloperidol. Generally he is well-nourished. He appears to be his
stated age.

B. Speech

 He talks in moderate and loud, his words are clear but

sometimes stuttered. He skips from 1 topic to another, when he
answered the question “marunong kang magsulat kuya?” he
answered “opo ma’am, kumakanta at sumasayaw pa ako ma’am
ah.” He talks non-stop, his responses are not minimal by yes or
no, and rather he elaborates answers to questions asked. Most of
the time the content of his words is relevant. He doesn’t
manifest neologism.

C.Level of Consciousness
  He is responsive and not confused. He was able to sustain
attention but sometimes distracted with other patients when
they talk very loud. He answers questions accurately and can
follow simple instructions such as to sit down and carry the chair.

D. Emotional Status

 Most of the time he is happy but sometimes he cries in silent

because he always remember her sister E. he verbalized that
“sana andito siya, para kunin na niya ako dito.”

E.Cognitive Functioning

 He is oriented with person, place and time. He knows his full

name, and his sister’s name. He is aware of the present day,
month and year. He knows his birthday. He was able to spell
children, can count 1-100 and can name days of the week and
months of the year correctly. And also do simple calculation.

F.Abstract Thinking

 When he was asked to interpret the common proverb “Kung

mayroong itinago, May madudukot” he provides a little
explanation which is “Nu indulin mu ti kwarta, adda maalam.” He
also explained “Aanhin pa ang damo kung patay na ang kabayo”
with “Awanen a ma’am, natay met diay kabayo nga mangan
kuma.”

 During the working phase we also asked him to explain the

massage of the song “ kanlungan”, he answered” Para sa akin
po, ang ibig sabihin ng kantang yan ay, isang buhay lang ang
meron tayo at dapat nating pahalagahan ito dahil kapag tayo’y
namatay, mga ala-ala nalang ang maiiwan”.He can’t interpret
the meaning thus concrete thinking is present.

G. Insight and Judgment

 When we asked “Nu adda ti mapidut mu nga pera anya ti

aramidam?” He answered “isublik a ma’am ngem nu singko
haanen panggatung ku latta ti sigarilyo kun”. While in the ward,
he still engages in smoking and even exchanges his things with
cigarette. Hence, he has a poor judgment.

 He manifests good insight since he accepts the responsibility for

his actions. He verbalized “Napabarkada kasi ako noon ma’am,
naninigarilyo ako at umii,om ako ng hard liquor un bang gin
 ma’am. He also verbalized “Behave na ako ma’am, kapag
nakalabas na ako ma’am di na ako maninigarilyo at iinom ng
alak.”

H. Memory

 Recent: when he said “nagluto ako ng nilagang saging noon

ma’am, nung si ma’am Alona pa ang student nurse ko eh”.

 Immediate: when he immediate knew his student nurse’s

name, he stated that “si ma’am Alona Foronda ang student
nurse ko ma’am”.

 Remote: when he said “ naalala ko ma’am nung natanggal si

Estrada bilang Pangulo, naimpitch pa nga siya eh, ang pumalit si
GMA pero nandaya naman siya dahil dun sa Hello Garsi!”

I. Physiologic and Self Care Considerations

 The patient stated that he eats 3 times a day with 2 snacks, takes
a bath everyday, changes his clothes daily and brushes his teeth
thrice a day. He usually sleeps for 8 hours and takes a nap at
daytime as a side effect of the drug. He takes his medicine at
morning and night. The patient knows proper hygiene and
complies with the medications.
 OBJECTIVES

GENERAL OBJECTIVES:

At the end of the case presentation, we the presenters aim to share to our
audience the knowledge that we have gained about schizophrenia, the skills
required to manage the patient and the attitude that we must obtain to
become an effective and efficient nurse to the patient that we may
encounter in the future.

SPECIFIC OBJECTIVES:

Specifically, we aim to:

 Define what is schizophrenia disorder

 Enumerate the different types and the signs and symptoms manifested
in the disorder.

 Determine the patient ‘s psychiatric health history

 Discuss the patient’s mental status

 Review the Anatomy and physiology of the disorder

 Trace the psychopathology of the disorder

 Interpret the laboratory result of the patient

 Formulate Nursing care Plan utilizing the nursing process

 Discuss the medication of the patient

 Interplay the nurse patient interaction

 PSYCHIATRIC NURSING HISTORY
A.GENERAL INFORMATION
Patient’s initial: A.DG

Age: 39 years old

Gender: Male

Marital Status: Single

Address: Magapit, Lallo Cagayan

Birthday: October 16, 1969

Birthplace: Lallo, Cagayan

Religion: Roman Catholic

Dialect: Tagalong, Iloko, English

Educational Attainment: High School Graduate

Occupation: Vendor

Date of Admission: March 9, 2009

Chief complaints: He claimed that “sinira ko yung parlor ng ate ko, sa

pagwawala ko,pinagpapatay ko ang manok namin,
‘di ako makatulog ng ilang araw”. And “lagi syang
nagsasalita mag-isa” as been added by his sister
w/c is his companion when he was admitted.

Final Diagnosis: Schizophrenia UT, In relapse

Attending physician: Dr. Jerry Sagabaen

Dr. Leonara Juliana

Source of information: Patient, Patient’s chart and Staff

 B. PSYCHIATRIC HEALTH HISTORY

1. PSYCHIATRIC HISTORY
Patient ADG stated that he had experienced episodes of depression when their
parents left them and he was still in elementary level. He stated that “ may balak
akong magbigti, uminom ng acetone, maglaslas at magpasagasa sa dami ng iniisip
kong problema. Pero hindi ko nagawa ang mga yun dahil sa ate ko, sobra kasi ang
pag aalaga nya samin.” He also stated that “ may time na nagbabago ang ugali ko
hindi ako nambubugbog pero pumapatay ako ng manok kung saan saan ko
tinatapon, minsan sinusunog ko na lang, minsan tumawa ako mag isa, nagsasalita
ako mag isa”.

A week before patient ADG was admitted he claims that “sinira ko yung parlor ng
ate ko sa pag wa wala ko, pinagpapatay ko ang manok namin, at ‘di ako makatulog
ng ilang araw”.and his sister added “ lagi syang nagsasalita mag isa”, in w/c his
companion when he was admitted.

MEDICAL HISTORY
According to patient ADG when was still a child he experienced colds, cough and
fever. He stated that “ kwento ng ate ko, naglalagay ang nanay ko ng dahon ng
oregano sa noo ko noon, pati yung dahon ng saging sa may tiyan ko pag may
lagnat ako eh. Pero pag malalana ang sakit ko gamot nlang ang binibigay nila sa
akin gaya ng Biogesic”. He added that he had not incurred any type of surgery. He
only sustained superficial wound on the temporal area of his face and his left and
right eyebrow after he made his co- patients (R.P., S. V., M. F., and R. F.) get mad
because of his being talkative.

2. PERSONAL AND SOCIOECOMIC HISTORY

According to patient ADG, he only finished secondary level with the age of
20. He stated that “ mabarkada kasi ako noon. Naninigarilyo ako( Malboro
and Philip 3sticks/day) at umiinom ako ng alak (Gin) pag may occasion lalo
na pag birthday ng barkada ko”. He also said that he had been in live-in
relationship with Ms. P for 5 yrs. and Ms. L for 3 yrs. He stated that “ ayaw na
ayaw kong magpakasal, mas gusto kong ibahay nalang ang babae.”

According to him, he had been a vendor of ‘mani’ and juices like buko juice
for 4 yrs infort of the schools. This is to help his sister E to earn money. He
stated that “ pagmay sobra sa binebenta ko yung hindi nabili binibigay ko
lahat sa mga pamangkin ko at mga apo”.

According to him, they were left by his parents when he was in elementary
level. He stated that “ mas malapit ako sa ate ko kasi siya na ang nag alaga
samin, kaya ayaw na ayaw ko siyang saktan, kung pwede lang gagawin ko
ang lahat para sa kanya”.

3. HISTORY OF PRESENT ILLNESS

According to patient ADG one week before he was admitted, he stated that “
nasira ko ang parlor ng ate ko sa pagwawala ko, hindi rin ako makatulog
siguro mga limang araw na,pinag papatay ko din ang mga manok, tinatapon
ko pa nga ang mga yun ,minsan sinusunog ko na lang at nagsasalita ako
mag isa kung anu ano pinagsasabi ko”. He added that “mas lagi ko itong
ginagawa simula noong binagbintangan akong nirape ko ang anak ng ka live-
in ko noon, hindi nila alam na wala akong ginawa dahil tinuring ko din naman
tunay na anak yun”.

According to him, maybe because of these things and concern his sister E
accompanied him to be admitted in CVMV Psychiatric ward. In there, he was
admitted last March 9, 2009 with a diagnosis of Schizophrenia, UT In relapse.

4. DEVELOPMENTAL HISTORY
 According to patient ADG, his sister told him that when he was an
infant he was been breastfed, he also stated that “ kung anu ano daw
ang sinusubo ko noon.” He learned how to walk before he reaches his
first year of life. He also added that “marunong na daw akong mag
hawak ng kutsara at tinidor kaso nagkakalat naman ang mga pagkain
ko kaya yun lagi akong pinapagalitan daw ni nanay, yun ang sabi ni
ate E____.

 When he was 3 yr. Old, he was trained to urinate with the use of
“arenola”. But when he defecate, he just defecate anywhere at their
backyard at daytime and use “arenola” during night time, he said that
“ang sabi ni ate noong nagkekwento siya, ginigising ko ang nanay
pagnatatae ako ng gabi noon, umiiyak pa daw ako ng malakas pag ‘di
nila ako pinapansin”.

 When he was 5 yr. old, he said that “ tinutiruan akong magbilang noon
gamit ang tingting at mais,nagdodrawing ako ng linya noon, mga
bahay tapos kinukulayan ko, kahit ABC tinuturo sa akin.” He also
 added that “namimili daw ako ng kalaro ko noon, mas gusto ko daw na
kalaro ang mga lalake noon,yun ang sabi nila, bihira pa nga daw akong
magshort noon kaya yun nilalaro ang ari ko noon.”

 During his elementary life, he said that “sumasali nak ti sala ken
kinnantaan nu adda ti program ti iskwela mi”. He also added that “
nagkaroon ako ng puppy love, mas matanda sa akin. Naalala ko pa nga
noon inaabangan ko siya lagi, nagbibigay ako ng sulat”.

 During his High school life, he stated that “ nagkaroon na ako ng

Girlfriend pero nagbreak din kami kasi palaaway ako noon. Dito ako
natutong manigarilyo, uminom ng alak at bumarkada. Nagtagal ako sa
high school pero dahil sa ate ko tinuloy kong mag aral at mabuti na
lang nakatapos parin ako”. According to him, he was circumsized
during his high school life. He also added that when he was in high
school, he had his first sex at the age of 18. He has never had
homosexual experiences.

 At the age of 26, he stated that “ nagkaroon ako ng ka live-in noon si

P_____ at si L___ may mga dati na silang asawa. Si P_____ mahigit
limang taon na kami pero mas gusto nyang maglagi at magtrabaho sa
manila kaya yun iniwan niya ako. Tapos si L__ mahigit tatlong ataon
kami noon, may dalawa siyang anak tinuring ko na din mga anak yun
kahit hindi galing skin, nagkahiwalay lang kami noong pinagbintanagan
akong rereypin ko ang ank niya na saktong nadatnan niyang
naghuhubad sa harap ko”. He also added that “ nagtitinda ako ng mani
at mga juice sa harap ng skul noon, yung hindi ko nabenta
pinamimigay ko sa mga pamangkin at apo ko”.

According to the client, he never has any weight problems or any

inferiority problems.

ANATOMY AND PHYSIOLOGY

 LABORATORY AND OTHER DISGNOSTIC
EXAMS
RADIOLOGIC EXAMINATION

04-11-09
Interpretation:

Chest (PA)

Both lungs fields are clear and with normal vascular pattern. Heart and great
vessels are normal in size and configuration. Other chest structures are
unremarkable.

Impression:

No radiographic abnormality within the chest.

LABORATORY RESULT
RESULT

TEST RESULT NORMAL RESULT INTERPRETATION

Glucose 4.6 mmol/L 4.1-5.9 NORMAL

Cholesterol 5.2 1-5.2 NORMAL

Triglyceride 1.8 0-1.69 NORMAL

Direct HDLC 1.1 0-1.6 NORMAL

LDL 3.36 0-3.35 NORMAL

HDL .82 0-.91 NORMAL

UNIVERSITY OF CAGAYAN VALLEY

COLLEGE OF HEALTH
TUGUEGARAO CITY
 Grand case Presentation
On
Schizophrenia, UT In relapse
In partial fulfillment of the requirements in NCM 104
Related Learning Experience

Presented by:

Cloyd P. Sagundo

Bong-bong A. Taguinod

Jelanie T. Calimag

Karelle Kilgerinn Q. Discipulo

Alona Jane T. Foronda

Angelica M. Morales

Angelie M. De Polonia

Jenevie C. Sabban

Group D; Cluster A

Presented to:

Mr. Lourish B. Conag RN, MSN

Clinical Coordinator

College of Health
Nurse-Patient Interaction
 Insights/Observations

Nurse’s Verbalization Patient’s Response Therapeutic

Communication
Techniques And
Rationale

ORIENTATION PHASE

 Magandang hapon po  Magandang hapon din po  Greeting the client by name

Kuya Bubut, mukhang Ma’am! Syempre naman or noting efforts the client
Masaya po kayo ah? ma’am, ngayon lang po ulit has made all show that the
(Smiles) ako nailabas eh. (Smiles SN recognizes the client as
back) a person/individual.

 Suggesting Collaboration.
The SN seeks to offer a
 Sige po ma’am. relationship which the client
(Followed the instruction). can identify problems and
 Halina po kayo, upo po this improves ability to form
tayo doon. (leading to a place satisfactory relationship.
where NPI could take place)

 Giving information.
Informing the client of facts
increases his knowledge
 Opo Ma’am Alona. about a topic or lets the
(Smiles back) client know what to expect.
Establishing specific of the
relationship time, date,
 Kuya ako nga po pala si
place and duration of
Alona Jane Foronda,
meeting.
estudyante po ng UCV, taga
Isabela po, at ako po ay
makakasama nyo ngayon
Lunes hanggang Miyerkules
at hanggang sa susunod na
linggo po mula Lunes po ulit
hanggang Miyerkules po ng  Seeking information.
ganitong oras po alas dos ng Asking the client what she
hapon hanggang ala sais. wants to be called is one
(Smiles) way of letting the client feel
that the SN is interested in
him.
 Ano pong gusto nyong
itawag ko sa inyo? (Smile)  Offering one’s self could
 Bubut na lang po Ma’am, un lessen up the anxiety level
naman po tawag nila sakin of the client. With our
dito. (Smile back) knowledge that the client we
are handling have certain
points in their lives wherein
there ego was weak and
 Narito po ako para po
their self esteem were low.
kahit sa simpleng paraan na
With this, we should offer
aking magagawa ay
ourselves and devote some
mapasaya ko po kayo at
 Salamat po Ma’am. of our time to them for them
matulungan. (Smile)
(Smile back) to feel that somebody
supports them and that
people are ready to guide
them when they need
guidance.

 Encouraging description of
perceptions helps the SN to
understand the client.
Encouraging the client to
describe ideas fully may
relieve the tension the client
is feeling and she might be

 Magandang hapon po kuya 
Bubut, kumusta na po? (Smile)
 Halina po kayo, upo po
tayo dun. (Leading to a place
where NPI could take place)
 Nakakapagpahinga naman
po ba kayo kuya ng maigi?
 Ano naman po
napanaginipan nyo?
 Ganun po ba? (Silence)
Activity: singing the song
“kanlungan”
 Kuya sa sarili nyo pong
WORKING PHASE
Magandang hapon din po
Ma’am ok lang naman po ako.
(Smiles back)
 (Just followed the instruction
given)
 Opo Ma’am. Mahimbing nga
po ang tulog ko. Nanaginip nga
po ako eh.
 Nakauwi na raw po ako at
kasama ko na raw po mga
kapatid ko.
 Opo. (Silence)
 Para sa akin po, ang ibig
sabihin ng kantang yan ay,
 Greeting the client indicates
that she is being recognized by
the SN as a person.
 Suggesting collaboration. The
SN seeks to offer a relationship
in which the client can identify
problems in living with others,
grow emotionally and improve
ability to form satisfactory
relationships.
 Showing concern by asking the
clients condition would let the
client feel that he is
being cared about.
 Exploring helps in examining
the real issue and gathering
more information. Any
concern of the patient can be
better understood if exploring
in depth.
 Silence gives the client time to
organize thing direct the topic
of interaction or focus on
issues that are more important.
 Encouraging description of
perceptions helps the SN to
understand the client.
Encouraging the client to
describe ideas fully may
relieve the tension the client is
feeling and he might be less
likely to take action on ideas
that are harmful or frightening.
 pananaw, ano po ibig ipahiwatig isang buhay lang ang meron  Giving recognition gives self-
na kantang yan? tayo at dapat nating confidence to the client.
pahalagahan ito dahil kapag
tayo’y namatay, mga ala-ala
nlang maiiwan.  Giving recognition gives self-
confidence to the client.

 Just smiles back.

 Building contracts to the client
such as good grooming could
 Wow ang galing po ah. help both SN and the client on
(Smile) the next meeting activities for
 Hindi naman po ma’am. more cooperation, good
(Smiles back) dealing and effective
communication.

Activity: playing touching ball…  Opo Ma’am. (Smiles back)

 Ang galing nyong maglaro

kuya ah, napagod po ba kayo?  Consistent approach and
(Smile) appraisal should be expressed
by SN for the client to feel that
 Sa lunes po ulit bago he is worthy and that he makes
naming kayo kukunin sa someone life happy being with
susunod na lunes po dapat her.
nakaligo na kayo,
nakatoothbrush, nakapalit ng
damit at nakainom na po kayo
ng gamot nyo. Malinaw po ba
yun? (Smile)
 Recapitulation would refresh
the client’s mind about the
recent conversations that has
 Sige po Ma’am asahan ko transpired the last meeting.
 Sige po kuya Bubut, po ulit kayo mam ha. Salamat
ihahatid ko napo kayo sa loob. din (Smiles back)
Sa lunes po ulit? Maraming
salamat po kuya Bubut, sa oras.  Giving the patient the
(Smile) necessary information would
let the patient to ask particular
questions if there are any for
her to lessen anxiety and to
particularly feed him the
Second week activity: information on what to expect.
playing binggo
 Giving recognition gives self-
confidence to the client.

 Opo Ma’am.
 Diba po kuya Bubut napag
usapan natin nung isang lingo  Encouraging description of
na ngayon tayo maglalaro ng perceptions helps the SN to
bingo. understand the client.
Encouraging the client to
describe ideas fully may
relieve the tension the client is
feeling and she might be less
 Bale po ang larong ito ay likely to take action on ideas
 Opo mam, masaya po kung that are harmful or frightening.
may nakalaan na premyo kung
ganun.( smiling)
sino man ang mananalo.
 Seeking information regarding
one’s strengths would let the
patient recognize the good part
After the game: in him.

 Marami kayong nakuhang

premyo kuya ah?
 Bale po magkakaroon po
tayo ng socialization sa
miyerkules, ano pong
nararamdaman nyo pay may
mga ganitong activities?
 Mahilig po ba kayong
makisali sa mga palaro tuwing
may socialization?
 Wow galing po mabuti
naman po kung ganun.
 So dapat po paghandaan
natin para sa ganun manalo po
tayo ulit sa mga palaro.
 So kuya Bubut napag-
usapan na nga po natin na
magkakaroon nga tayo ng
socialization at marami po
tayong activities na gagawin,
aasahan ko po na talagang
makikilahok ka ha.
 Sige po kuya Bubut
hanggang bukas po ulit. (Smile)
 Hello po kumusta na po 
kayo? (Smile)
 Wow, ang ganda po ng 
damit mo ah, talagang
pinaghandaan nyo po ang
socialization natin ah.
 Hindi naman gaano marami
ma’am.(smiling)
 Opo.Masaya, excited na nga po
ako eh, bukas na lang po
sabado na. Kakanta po ako
tapos sasayaw. (laugh)
 Opo ma’am, palagi nga po
akong nanalo eh.
 Opo. (laugh)
 Opo ma’am.
 Opo, siyempre ma’am (Smile)
TERMINATION PHASE
Ok lang po Ma’am. (Smile
back)
Siyempre naman po ma’am.
 Giving recognition gives self-
confidence to the patient.
 Suggesting collaboration. The
SN seeks to offer a relationship
in which the client can identify
problems in living with others,
grow emotionally and improve
ability to form satisfactory
relationships.
 At the end of every NPI, we
must some up what has
transpired for the patient to
recognize that what has been
talked about were all relevant.
 Greeting the client indicates
that she is being recognized
by the SN as a person.
 Noting the efforts the client
has made all show that the
SN recognizes the client as
a person/individual thus the
client gives a feeling of self-
confidence.
 Suggesting collaboration.
 Hali na po kayo ate,
doon po tayo. (Leading to the
socialization area.
 Kuya galingan nyo po
mamaya sa mga palaro natin
ah, tutulungan ko po kayo.
(Smile)
 Ano pong ipapakita
ninyong talent po para sa
program natin.
 Gusto nyo po bang
dalawa tayong sasayaw at
kakanta.
***During the
socialization, I consider people and events
continually observed my
patient actively
The SN seeks to offer a
relationship in which the
 Just followed instruction client can identify problems
given. in living with others, grow
emotionally and improve
ability to form satisfactory
relationships.
 Offering one’s self could
lessen up the anxiety level
of the client. With our
knowledge that the client we
are handling have certain
points in their lives wherein
 Opo ma’am. there ego was weak and
their self-esteem were low.
With this, we should offer
our selves and devote some
of our time to them for them
to feel that people are ready
to guide them when they
need guidance.
 Seeking information
regarding one’s strength
would let the patient
recognize the good part in
him.
 Suggesting collaboration.
The SN seeks to offer a
relationship in which the
client can identify problems
in living with others, grow
 Kakanta po ako tapos emotionally and improve
sasayaw ma’am. ability to form satisfactory
relationships.
 We should also consider
nonverbal cues the patient
shows for this would help us
determine the congruency of
data that the patient gives
us. Observing also the
 Opo ma’am para po mas reactions of the patient to a
masaya. (laugh) certain stimuli would let us
determine if he responds
appropriately or not.
 Encouraging expression.
The SN asks the client to
in light of his own values.
Doing so encourages the
 participating with the client to make his own
games that our group has appraisal rather accepting
prepared. the opinion of others.

 Giving the patient the

necessary information
would let the patient to ask
particular questions if there
are any for him to lessen
 Kuya Bubut ito na po anxiety and to particularly
ang huling araw na feed him the information on
makasama mo ako bilang what to expect.
ma’am mo, ano pong
nararamdaman nyo?

 Consistent approach and

appraisal of positive results
should be expressed for the
 Masaya po kasi marami na
 Pagkatapos po namin ay client to feel worthy and to
akong premyo, pero
may ibang grupo na naman gain cooperation in the
malungkot din kasi aalis na
po kayong makakasama kaya succeeding interactions.
kayo.
magiging masaya po ulit
kayo, diba po? (Smile)

 Mabuti naman po kung

ganun ma’am. Para
makalabas po ulit kami.
 So sana po kuya may
(Smiles back)
natutunan po kayo sa amin
kahit papaano po maraming
salamat din po na naging
parte po kayo ng buhay ko.
At marami po akong
natutunan po mula sa inyo.
Maraming salamat po kuya
Bubut. (Smile)

 Maraming salamat din po

ma’am. (Smile back)