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NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

Walden University NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

Whether one passes or fails an academic assignment such as the Walden University NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

The introduction for the Walden University NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

After the introduction, move into the main part of the NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

In the research according to (“The Psychiatric Interview and Mental State Examination” (n,d)), a psychiatric interview is a structured clinical conversation complemented by observation and mental state examination, supplemented by a physical examination which is the foundation of accurate psychiatric diagnosis through accurate history taking and assessment. The goal is to establish and build a therapeutic relationship with the patient of trust, and openness, in order to collect, organize, and synthesize detailed relevant information connected to the presenting problem, assess the personality of the patient, conduct a mental status examination, and assess psychopathology, write a diagnostic formulation, and list the differential diagnoses. In the research according to Savander et al (2021), the clinical goal of the psychiatric interview is to evaluate the patient’s problems and provide an evidence-based treatment grounded on the symptom-oriented diagnostic ICD-10/DSM-5 categories.

  1. History of the present illness (HPI)

According to “The Psychiatric Interview and Mental State Examination” (n.d.) research, rapport and the agenda are established at the beginning of the interview between the patient and the provider. During HPI, circumstances leading to the current condition are accounted for. D

etails of the relevant events, sequence of the responses, and symptoms should be provided. Help-seeking behaviors, recent interventions, and treatments are assessed.

  1. Family history

The family history should encompass any history of psychiatric or physical health problems including established or suspected diagnoses, and treatments received. It is important to know the family history because there are shared traits that cannot be seen containing information on health conditions that tend to run in families. These traits may increase hereditary conditions and diseases. Therefore, knowing medical history will help the healthcare provider to take action to reduce the risks.

  1. Suicide risk assessment

According to (Centers for Disease Control and Prevention), suicidal thoughts or actions are signs of extreme distress and should not be ignored, there the purpose of the interview is to prevent suicidal actions. In the research according to Oquen

NRNP 6635 The Psychiatric Evaluation and Evidence Based Rating Scales

do & Bernanke (2017), 800,000 people die by suicide each year, and for each suicide, as many as 20 more individuals have attempted suicide. The assessment and management of suicide risk is considered a core competency for psychiatrists, yet guidelines diverge in their recommendations and there is no universally accepted model. Risk assessment and management are best conceptualized as a process and not a single event that includes structured evaluation, intervention, and re‐assessment. Some patients suffer transient but intense suicidal thoughts, which are not captured at the time of assessment. Numerous factors contribute to suicide risk and can be divided into distal and proximal factors. Distal factors may include genetics, personality characteristics such as impulsivity and aggression, prenatal and perinatal circumstances, childhood trauma, and neurobiological disturbances. Proximal risk factors may include mental illness, physical illness, psychosocial crises, substance use, availability of lethal means, and exposure to suicidal behavior (Ryan and Oquendo 2020).

Explain the psychometric properties of the rating scale

Depression in earlier and later life stages is characterized by different factors and life events and it is a significant and common contributor to poor health, especially among older people. Geriatric Depression Scale (GDS) is a widely and frequently used scale developed specifically to assess, evaluate, and identify depression symptoms in the geriatric population (Nikmat et al., 2021). GDS is a mood-focused scale that can be used in any environment such as acute psychiatric or primary care, assisted living, or long-term care facilities. It was created for the elderly population depression testing, which helps PMHNP psychiatric assessment of affective and behavioral symptoms to rule out somatic and dementia illnesses.

When it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment

The rating scales are appropriately used during the research study and clinical practice to evaluate people with psychotic disorders, the HPI portion of the psychiatric interview/assessment, and ongoing monitoring of patient conditions. The scale is also an added tool for nurses to use in monitoring the effectiveness and outcome of both medical and nursing interventions. The PMHNP uses the scale to rank the severity of the symptoms which gives them an idea about how much the condition affects the patient and to track changes in the symptoms over time.

Conclusion

Psychiatric interview is crucial in the collection of critical information during the assessment, diagnosis, planning, treatment, and evaluation of patients with mental health conditions. The scales are designed to meet various needs including screening, diagnosis, and treatment monitoring. The geriatric population is vulnerable to depression related to age, socioeconomic status, low levels of neurotransmitters, family history of depression, and traumatic life events. According to Risal et al., (2020), GDS has been used in different cultures and it has proved to be a reliable and valid instrument for adult depression.

References

“Centers for Disease Control and Prevention.” “Risk and Protective Factors.” Www.cdc.gov, 2021, www.cdc.gov/suicide/factors/index.html

Links to an external site..

Risal et al., (2020). Nepali Version of Geriatric Depression Scale-15 – A Reliability and Validation Study. Journal of Nepal Health Research Council, 17(4), 506–511. https://doi.org/10.33314/jnhrc.v17i4.1984

Ryan and Oquendo (2020). “Suicide Risk Assessment and Prevention: Challenges and Opportunities.” FOCUS, vol. 18, no. 2, Apr. 2020, pp. 88–99, 10.1176/appi.focus.20200011.

Nikmat et al., (2021). Psychometric Properties of Geriatric Depression Scale (Malay Version) in Elderly with Cognitive Impairment. The Malaysian journal of medical sciences : MJMS, 28(3), 97–104. https://doi.org/10.21315/mjms2021.28.3.9

Oquendo & Bernanke (2017). Suicide risk assessment: tools and challenges. World Psychiatry. 2017 Feb;16(1):28-29. doi: 10.1002/wps.20396. PMID: 28127916; PMCID: PMC5269494.

Savander et al (2021). “The Patients’ Practices Disclosing Subjective Experiences in the Psychiatric Intake Interview.” Frontiers in Psychiatry, vol. 12, 10 May 2021, 10.3389/fpsyt.2021.605760.

“The Psychiatric Interview and Mental State Examination” (n,d). Clinical Gate, 24 May 2015, clinicalgate.com/the-psychiatric-interview-and-mental-state-examination/.

Sample Answer 2 for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

! Thank you for this insightful post. I agree with you that psychiatric interview is the foundation of accurate psychiatric diagnosis through accurate history taking and assessment. The identified components of a psychiatric interview including history of the present illness (HPI), family history, and suicide risk assessment are critical. To obtain accurate information about these components, it is important for healthcare professionals and the patients to build therapeutic interpersonal relationships (Moreno‐Poyato et al., 2021). These relationships are fundamental element of all interactions in healthcare that foster building of positive provider-patient experiences. Therapeutic interpersonal relationships can also change and improve the experiences of patients.  Usually, therapeutic relationships demonstrate friendliness, warmth, empathy, authentic interest, and willingness to foster and provide support (Hargie, 2021). In turn, it facilitates interactions and communication. Therapeutic interpersonal relationships between care providers and patients are linked to enhanced patient satisfaction, high quality of life, compliance with treatment, and lowered healthcare costs. In the case at hand, it is important to ensure effective communication during psychiatric interview to enable the patient to be an equal associate in healthcare processes.

References

Hargie, O. (2021). Skilled interpersonal communication: Research, theory and practice. Routledge.

Moreno‐Poyato, A. R., Rodríguez‐Nogueira, Ó., & MiRTCIME. CAT Working Group. (2021). The association between empathy and the nurse–patient therapeutic relationship in mental health units: a cross‐sectional study. Journal of Psychiatric and Mental Health Nursing, 28(3), 335-343. https://doi.org/10.1111/jpm.12675

Sample Answer 3 for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

The Global Assessment of Functioning (GAF) is a numerical rating scale employed in psychiatric assessments to gauge a patient’s current level of impairment in psychosocial and occupational or educational functioning. This scale, ranging from 0 to 100, categorizes functioning into different levels. Normal function falls within the 70-to-100 range, while mild psychiatric symptoms are coded in the 70-to-80 range (Pedersen et al., 2020). Moderate symptoms fall between 60 and 70, and severe symptoms are coded as 50 and below. Higher levels of psychiatric support may be necessary as function decreases on the scale.

The GAF is particularly useful during the psychiatric interview when there is a need to assess the client’s overall functioning. It is appropriate to use this rating scale to evaluate a client’s psychosocial and occupational functioning, providing a quantifiable measure of their current state (Pedersen et al., 2020).  The scale becomes helpful for a nurse practitioner’s psychiatric assessment by offering a standardized way to communicate the client’s level of impairment to other healthcare professionals. This numerical representation allows for clearer communication and a shared understanding of the client’s functioning among members of the healthcare team.

Moreover, the GAF aids in treatment planning by highlighting areas of impairment that may require targeted interventions. For instance, if the GAF score indicates severe impairment, the nurse practitioner may consider more intensive treatment options, such as inpatient hospitalization or intensive community-based treatment (Pedersen et al., 2020). On the other hand, if the score suggests mild impairment, outpatient interventions or less intensive support may be appropriate. The GAF thus serves as a practical tool for guiding treatment decisions based on the client’s level of functioning.

In conclusion, the psychiatric interview is a crucial component of psychotherapeutic assessment, involving the gathering of a comprehensive history, assessing current symptoms, and exploring the client’s psychosocial context. The Global Assessment of Functioning (GAF) rating scale contributes to this process by providing a numerical representation of a client’s current level of impairment. Its use during the psychiatric interview aids nurse practitioners in evaluating and communicating the client’s functioning, informing treatment decisions, and ensuring a comprehensive and individualized approach to mental health care.

References

Pedersen, G., Urnes, Ø., Hummelen, B., Wilberg, T., & Kvarstein, E. (2020). Revised manual for the global assessment of functioning scale. European Psychiatry, 51, 16-19. https://doi.org/10.1016/j.eurpsy.2017.12.028

Toffel, S., Rodriguez-Roman, L., & Holbert, R. C. (2023). The psychiatric diagnostic interview and the DSM5. Reference Module in Neuroscience and Biobehavioral Psychology. https://doi.org/10.1016/b978-0-323-95702-1.00015-4

Sample Answer 4 for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

The psychiatric interview aims at exploring the symptoms the patient presents with that can help in making the right diagnosis. Mental health issues have mimicking symptoms and this may make it difficult to make the right diagnosis without obtaining fine and critical information about the patient’s history, present symptoms, and other underlying conditions (American Psychiatric Association, 2016). The interviews conducted among the patients with mental illnesses are guided by various assessment tools which help the therapist extract important information about the patient to rate the severity of their illnesses and determine the most effective treatment measure. The current study outlines the three important components of the psychiatric interview and the effectiveness of the patient health questionnaire (PHQ-9) in obtaining critical data from the client.

The three important components of a psychiatric interview include the family history, the history of present illness, the psychiatric history, and the suicide and violence risk evaluation. The family history helps the therapist determine the possibility of the present illness being linked to genetic predisposition. Besides, people having hard childhood experiences are likely to develop conditions such as depression and post-traumatic stress disorder (MedEasy, 2017). The childhood experiences can only be understood through the family history information. The psychiatric history focuses on the onset of the presenting symptoms in the patient. Such information is critical in the diagnosis process. At some point, people with mental illnesses are likely to develop suicidal ideation. Therefore, suicide and violent risks assessment help in rating the severity of the diseases and the risk of the client causing harm to self and others (Psychiatry Lectures, 2015). Patients with suicidal ideation are likely to be having severe mental health issues and require immediate and thorough intervention.

The patient health questionnaire (PHQ-9) helps in screening and diagnosis of mental illnesses. The tool covers the various aspects include changes in daily activities, eating habits, feeling hopelessness, and loss of interest or pleasure in doing things among others. Also, the tool analyzes the client’s concentration abilities and the ability to engage in a conversation (American Psychiatric Association, 2013). Finally, the tool provides information about the clients’ thoughts. The rating scale is useful when handling patients with depression.

Besides, the tool can only be used among the clients who can express themselves and give feedback to the therapist. The scale is also useful to the nurse practitioner’s psychiatric assessment since they are required to rate the questionnaires on a scale of 0 to 3. As a result, the nurse practitioner can then determine the level of depressive symptoms the patient has. Therefore, the tool is effective only for the already diagnosed people with depression. On the other hand, the nurses must go further to cover other elements not addressed in the assessment tool to gather comprehensive information about their patients.

Finally, the psychiatric therapists must be objective in their interviews to gather specific information from the clients. The patient health questionnaire (PHQ-9) tool involves nine questions that help in determining the severity of the depressive symptoms in a client. The tool captures various areas including the changes in moods, interests, and engagement in activities of daily living. The tools help in standardizing the interview process and so helping the advanced nurse practitioners to focus on the specific areas of interest and obtain relevant data that will guide the treatment plan development.

References

American Psychiatric Association. (2013). Section I: DSM-5 basics. In Diagnostic and statistical manual of mental disorders (5th ed., pp. 5–29). Author.

American Psychiatric Association. (2016). Practice guidelines for the psychiatric evaluation of adults (3rd ed.). https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760

MedEasy. (2017). Psychiatric history taking and the mental status examination | USMLE & COMLEX [Video]. YouTube. https://www.youtube.com/watch?v=U5KwDgWX8L8

Psychiatry Lectures. (2015). Psychiatry Lecture: How to do a psychiatric assessment [Video]. YouTube. https://www.youtube.com/watch?v=IRiCntvec5U

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Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

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Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource

Sample Answer 5 for NRNP 6635 The Psychiatric Evaluation and Evidence-Based Rating Scales

Three main areas of the psychiatric evaluation would be history of present illness, family history and mental status exam.  History of present illness can tell a lot about a patient such as, onset, duration, precipitating events, impact on daily functioning, or if alcohol or drugs were involved and more.  Family history can give a genetic component to patient’s diagnoses, history of suicide, drug use or abuse.  The mental status exam gives indications about mood, affect, speech, cognition, insight, or lack thereof, appearance and self-esteem by lacking in hygiene or eye contact.  These three components can give a reliable picture into the patient’s life and possible diagnoses.

The use of various assessment tools is helpful in measuring a wide range of psychiatric symptoms such as schizophrenia, anxiety, depression its severity and response to treatment.    The Brief Psychiatric Rating Scale (BPRS) was developed by Overall & Gorham in 1962 and is widely used (Overall & Gorham, 1962).   It is useful in rendering clinical judgment of psychopathology that is present rather than based on symptoms of disease.    This tool can also help gauge efficacy of treatment of those who have psychiatric issues over time and is usually part of clinical trials and research protocols.

Each symptom is rated on a 7-point scale that helps to determine severity of patient’s condition (Overall, 1988).   Results are rated from 1 not present, 2 very mild, 3 mild, 4 moderate, 5 moderately severe, 6 severe, 7 extremely severe.  The range of scores is from 18 to 126 for the 18 symptoms.   Obviously assessing results would indicate the higher the score the more severe disease and/or response to interventions and possibly requiring a change in treatment.

BPRS results have shown to be most discriminating when using assessment tools.  BPRS is reliable and valid in its varied forms, BPRS 7, BPRS-E, BPRS 24 and through research findings show that this tool has encouraging psychometric properties and can help monitor patients’ progress (Yee et al., 2017).   Various ways of researching levels of psychopathology help to improve treatment of disease.  Psychometric justification of BPRS indicates there is a need for further clinical trials to defend its legitimacy (Dazzi et al., 2016).

Appropriate time for using this tool is anytime the provider feels response to treatment might have changed or if severity of illness has changed (Acorn, 1993).  This tool is helpful for the NP to monitor patient condition and the value of interventions given the patient.  The importance of tools in the clinical setting is to show how psychotic disease can manifest in multiple ways and help providers see the various behaviors.

References

Acorn, S. (1993). Use of the brief psychiatric rating scale by nurses. The Journal of psychosocial nursing and mental health services, 31(5), 9–12. Retrieved June 8, 2022, from https://doi.org/10.3928/0279-3695-19930501-04

Dazzi, F., Shafer, A., &Lauriola, M. (2016). Meta-analysis of the Brief Psychiatric Rating Scale – Expanded (BPRS-E) structure and arguments for a new version. Journal of Psychiatric Research, 81, 140–151. Retrieved June 6, 2022, from https://doi.org/10.1016/j.jpsychires.2016.07.001

Overall, J. E., & Gorham, D. R. (1962). The Brief Psychiatric Rating Scale. Psychological Reports, 10(3), 799–812. Retrieved June 6, 2022, from https://doi.org/10.2466/pr0.1962.10.3.799

Overall, J. E., PhD. (1988). The brief psychiatric rating scale (BPRS): Recent developments in Ascertainment and scaling. Psychopharmacology bulletin, 24(1), 97–104. Retrieved June 6, 2022, from

Yee, A., Ng, B. S., Hisham Hashim, H. M., Danaee, M., &Loh, H. H. (2017). Cultural adaptation and validity of the Malay version of the brief psychiatric rating scale (BPRS-M) among patients with schizophrenia in a psychiatric clinic. BMC Psychiatry, 17(384), 1–10. Retrieved June 6, 2022, from https://doi.org/10.1186/s12888-017-1553-2