Case Study Questions (Case Study Sample)

QUESTION 1
Fear and anxiety are related mental states of the mind and there is a very subtle difference between the two. Both fear and anxiety are body’s method of reacting to threat, motivational conflict, or a danger in order to trigger some adaptive responses to tackle them. Some authors believe that the two are indistinguishable, while some believe the two are distinct phenomena (Manfred, 2013.p.145). Anxiety is a disturbance that translates to an inner turmoil in the state of the mind. It is accompanied by a change in the neurobiological behavior that includes pacing, somatic complaints and muscular symptoms (Lang, Davis, & Öhman, 2000.p.140). Anxiety is a response to an internal threat, such as an anticipation of a future threat. Anxiety is a feeling of uneasiness that is projected to a situation that is only seen as menacing. Fear on the other hand, is a response to a real perceived threat. Whereas anxiety is a response to an imagined internal treat, fear is a reaction to an external threat (Dias, Banerjee, Goodman, & Ressler, 2013.p.348). Fear is a reaction to a specific stimulus that results into a defensive behavior as a way of a coping mechanism. Other authors agree that fear and anxiety overlap and that anxiety is a form of fear which prepares the individual to plan and prepare for the future (Blomqvist,, 2013.p.119). It triggers the flight-fight response as a way of escaping from a threat. The fear response is modulated by the conditions of learning and cognition (Holmes, et al., 2013.p.224).
Fear and anxiety can manifest as two distinct clinical disorders. Anxiety disorder has three facets: generalized anxiety disorder, panic disorder and a phobic disorder. As a disorder, anxiety may be caused by substance abuse, use of caffeine, alcohol consumption or withdrawal from certain drugs (Holmes, et al., 2013.p.225). Anxiety disorder is normally accompanied by other mental disorders such as eating disorders, major depressive disorders and bipolar disorders. The symptoms of anxiety disorder include physical tension, psychological apprehension, physical tension and a dissociative personality (Manfred, 2013.p.146). Fear as a clinical disorder is characterized by increased heart rate, vasoconstriction of the peripheral blood vessels, increased levels of blood glucose, abnormal disturbances and an increased heart rate. If prolonged, these physiological changes may turn pathological requiring intervention (Dias, Banerjee, Goodman, & Ressler, 2013.p.350).
References
BIBLIOGRAPHY \l 1033 Blomqvist, M., Ek, U., Fernell, E., Holmberg, K., Westerlund, J., & Dahllöf, G. (2013,). Cognitive ability and dental fear and anxiety. European Journal of Oral Sciences , 121(2), 117 - 120. DOI: 10.1111/eos.12028.
Dias, B., Banerjee, S., Goodman, J., & Ressler, K. (2013). Towards new approaches to disorders of fear and anxiety. Current opinion in neurobiology , 23(3), 346 - 352. DOI: 10.1016/j.conb.2013.01.013.
Holmes, A., Camp, M., Martin, K., Lederle, L., & Gaburro, S. (2011). S.24.02 Genetic variation driving fear and anxiety. European Neuropsychopharmacology, 21, S224 DOI: 10.1016/S0924-977X(11)70337-6.
Lang, P., Davis, M., & Öhman, A. (2000). Fear and anxiety: animal models and human cognitive psychophysiology. Journal of Affective Disorders, 61(3), 137 - 159. DOI: 10.1016/S0165-0327(00)00343-8.
Manfred, K. (2013). Blocking fear and anxiety. Deutsches Ärzteblatt international , 110(9), 145. DOI:http://dx.doi.org.ezproxy.cdu.edu.au/10.3238/arztebl.2013.0145 .
QUESTION 2
Mary is definitely experiencing a stressful situation in her life. There is a lot of information that I would want to know from Mary. In a typical history taking, I would obtain information of her demographics. I would as well want to know her perspective of what she feels is disturbing her. Assuming I had not known of her young family and her recent divorce, I would want to know from her story what are the possible stressors and causes of anxiety. It would appear that what I would consider a source of stress in her life may not be exactly her worries. I would need to know how Mary would cope with the fact that she does not have a partner and what she is planning to do about it. Would she want to get another partner or would she want to wait? Understanding the patient’s needs either immediate or projected are one way of assisting them to cope with the existing stressful situation they are facing (Bob, 2004.p.45). Next, I would want to know about the genesis of her current situation and in the order of events. This would help to identify a solution based on what is rally important to the least important. I would obtain information about her past medical and psychiatric history. Has there been a stressful situation in her life different from the one she is facing? If yes, how did she cope with it? I would as well want to know about her family background. Has there been any history of a psychiatric illness among family members or siblings? Fear and anxiety disorders could be genetic (Berengarten, 2000.p. 13). I would want to know about any history of substance or drug use or abuse she has had before. Hard drugs usage or withdrawal is associated with increased chances of having anxiety attacks and difficulty in coping with a stressful situation (DiLoreto, 2001.p.18). I would obtain information about her social history. How she interacts with her colleagues, workmates, other family members are useful when it comes to stressful situations. I would as well want to know if she has any social support network. One important are is her occupational history. Being a young woman, barely 27 years and with a young family she underwent a divorce. She works as care assistant in an aged care facility; definitely she does not enjoy a stable job and may not earn enough to fend for the family. I would like to know how she plans to provide for her family and if she is thinking of searching for a better job. A meticulous initial interview will provide all the essential information that is needed to identify Mary’s problems and to prescribe appropriate solutions.
References
BIBLIOGRAPHY \l 1033 Berengarten, S. (2000). When Nurses Interview Patients. The American Journal of Nursing , 50(1), 13 - 15 DOI: 10.2307/3467625.
Bob, P. (2004). Conducting sensitive patient interviews. Nursing standard (Royal College of Nursing (Great Britain) , 18(38), 45. PMID: 15199710 NLM UID: 8508427.
DiLoreto, S. (2001). The challenging patient interview. Patient Care , 35(2), 18 .
QUESTION 3
In interviewing Mary, I would use the therapeutic communication technique. It entails twenty-five entities that are appropriate in her case. Silence is one of the tenets of therapeutic communication technique. It encourages the patient to open up and talk out his/her situation. It directs the patient to discuss the issue at hand, and enables the patients to think through their problems as well as organizing their thoughts. Accepting with positive gestures makes the interview non-judgmental without necessarily in agreement with everything what the patient says. Giving Mary recognition will acknowledge awareness and her respect as an individual. Offering oneself and giving broad openings help to ease tension in the patient and improves her feeling of inclusion in her care process. Next is offering general leads and seeking clarification on the time and the sequence of events makes the patient feel as part of the process too(Kleier, 2013.p. 110). Meanwhile, I would be making observations and encouraging the patient to describe her perceptions in order to understand the patient. I would as well encourage a comparison and restatement of the main issues the patient raises. Reflection is a significant aspect of the therapeutic communication technique. It makes the patient accept her feelings and ideas as part of herself. It encourages the patient not to subscribe to the feelings of others but to become a person in her own right. Focusing onto a single point and exploring-delving further into an idea-while at the same time ensuring that the patients wishes are withheld help to obtain all the relevant information without intruding into the patients confidentiality. Therapeutic communication plan makes room for the patient’s right to get the facts that pertains to her situation. It builds trust and gives the patient a wide array of information necessary to make a decision and to come to a logical and a rational conclusion. Seeking clarification on a vague idea is not only important to the nurse, but also the...