Schizophrenia: Analyze Critically The Health Issues (Essay Sample)

SchizophreniaStudent’s NameInstitutionDate
Schizophrenia
Schizophrenia is a dangerous and chronic mental disorder associated with severe social, physical and economic costs (Freedman, 2013). The disease is characterized by relapses and irregular recurrence (Sang-Hyuk L. et al., 2010). The diagnosis and outcome of this illness are still pertinent due to heterogeneity extended issue. Some of individual suffering from this disease may show rare relapse period, some present reduction and reversion period while others may have a continuous sequence with persistence symptom. Relapse and remission are mainly related with incomplete medication compliance or noncompliance. This research paper will focus on George who has been experiencing decline four times in the past and currently he is under assessment because of nonadherence to prescribed medication. He prefers using cannabis to treat his mental disorder rather than following psychiatrist’s prescribed medication of Risperidone. Nonadherence to psychiatric prescription is a worldwide challenge. This prevents patients from understanding the significance of their medication and undesirable effects on individuals, their relatives, and health care organization. Therefore, understanding and minimizing nonadherence is the primary challenge in providing quality care for people with mental disorder. Focusing on George’s conditions, various health factors may hinder him to adhere to Risperidone medication (Kane, 2011). Some of these factors include substance abuse such as continued use of cannabis, stigma from society, lack of insight, the persistence of side effects and medication belief. The aim of this paper is to analyze critically the health issues that ought to complicate the adherence of George to the arranged treatment of Risperidone and to provide nursing strategies that would help George to increase adherence to Risperidone medication prescribed by a psychiatrist.
Taking the recommended dose of medicine for the full course and at the appropriate time is essential to patients for them to experience a comprehensive benefit of treatment. However, about 50% of treatment for prolonged conditions are not administered as prescribed by physicians hence increasing the cost for patients and hospitals. It is challenging and arduous for identifying patients who are nonadherence. It is evident that nonadherence remains a general problem but is hidden with the personal consultation. Interventions are supposed to be developed to identify nonadherence among patients who have Schizophrenia (Sarah C. & Horne R., 2013). It is important to mention that antipsychotic treatment adherence is very vital in patients such as George with schizophrenia. Regular and Consistent medication has been confirmed to ameliorate the effects of this disorder and reduce relapse rates. Nevertheless, nonadherence to antipsychotic treatment remains the biggest challenge in Psychiatry. Some of the factors that are likely to hinder George’s adherence to his Risperidone medication are discussed below. Although various factors might complicate adherence of George to his medication, four of this factor have been examined and reviewed critically due to the words limit.
Discussion
One of the health factors that might muddle George adherence to his Risperidone medication is the abuse of cannabis. According to research carried out by CITATION Ber16 \l 1033 (Winklbaur, 2016), it was found that people who use marijuana frequently experience relapse and this is evident in George’s situation. Apart from deterioration and lack of adherence to medication, prolonged use of cannabis is related to low outcomes, high psychotic symptoms and poorer compliance to treatment. It is worth mentioning that comorbidity of schizophrenia and addiction to drugs such as cannabis is a significant obstacle for physicians to carry out successful and efficient treatment. The reason why George might be using cannabis as a hypothesis for self-medication is possible because he wants to reduce the side effect such as sleeping disorder, social withdrawal among other effects associated with risperidone medication. Since there is a close interdependence between misuse of substances such as cannabis with Schizophrenia, there is the need for George to be given a dual treatment of cannabis and Schizophrenia. George’s family should focus on his cognitive behavior and subject him to cognitive therapy. However, the physicians should focus more on stabilization of George’s psychotic symptoms by use of the newer agent such as risperidone. Thus, enhancement in neurocognitive performance may assist George to lay strategies to prevent the use of cannabis. Therefore, in order to support George to adhere to his medication of risperidone, the physicians should focus on integrated treatment that treats both mental disorder and addiction from cannabis which concurrently addresses schizophrenia and abuse of drugs. It should be noted that substantial input to the realization of the connection between Schizophrenia and use of drugs such as cannabis have been made, but there is still a problem in relations with better interventions programs.
The psychological factor is also an issue that might complicate George adherence to his prescribed medication of Risperidone. The psychological factors include his attitude, belief and other personal characteristics. It is worth mentioning that adherence to medicines depends on the attitude and belief of the patient. Since the time he was dragonized with Schizophrenia, George has never agreed. He believes that Schizophrenia is just a little disorder and this has made him be reluctant to take the prescribed medication. Moreover, George has a negative attitude towards the treatment of his ailment hence failing to adhere to prescribed medication (Francisco A. et al., 2012). He believes that cannabis is the best medication for his ailment. Over dependence on cannabis has made him have a bad attitude to other medication. Additionally, stigmatization is another psychological factor that reduces adherence to medicines. If the community isolates him because of his condition, he might decide to avoid using the medicine. Pharmacological strategies which can be used to improve George adherence to in this situation includes simplifying the regime of treatment and using long-acting injection (LAI) to reduce ingestion variability. LAI is a guarantee to both treatment delivery and advantages such as quick realization of nonadherence and reduce concern about daily treatment as compared to taking oral antipsychotic medication (Borah K. et al., 2008). LAIs is a better strategy for George’s situation because it improves his adherence to Risperidone treatment and he will have better improvement in medical and functional severity and reduction in hospital services thus reducing the rate of relapse.
Notably, impaired insight might be another factor which may cause George not to adhere to his psychiatric medication. Several studies reveal that poor insight is a dangerous factor for non-adherence (Francisco A. et al., 2012). There is a close relationship between insight and attitude towards medication. A good insight is associated with adherence while impair insight is associated with non-adherence (Montgomery, 2015). Lack of insight for Schizophrenia patient means that they don’t know the symptoms and consequences of their disorder. Studies also show that such people like George who usually ignore their diseases or the magnitude of their illness are likely to adhere less to their medication. George believes that his symptoms cannot be managed hence he is less motivated to follow medication. The best nursing strategy that can be offered to George in order to have illness insight about Schizophrenia is using psychoeducation to educate him, or his relative on how to understand the disorder, proper medication and inform them about the possible side effect that may occur during medication. Psychoeducation should not be offered just to George alone, but his family must be involved in the education to realize practical outcome. It is worth mentioning that psycho-educational intervention cannot yield positive results in improving George’s adherence without observing his behavioral components. Additionally, community treatment and supportive CITATION Zyg12 \l 1033 (Zygmunt M. et al., 2012). Similarly, another intervention that might insight George and make him adhere to his medication is relabel warning sign or symptoms instead of concentrating on promoting awareness for medication.
Furthermore, side effects associated with medication of Risperidone might affect George’s adherence to his medication. Psychiatric medication using risperidone has many side effects including dystonia which results in abnormal muscles contraction. For example, contraction of the neck muscles, which may cause tightening of the throat hence leading to difficulties in swallowing, breathing or even tongue protrusion. This may discourage George because the symptoms of dystonia occur more frequently with high severity. Other side effects associated using Risperidone medication is the likelihood of sexual dysfunction. This can lead to low medication adherence. For example, prolonged use of Risperidone can result in erectile and ejaculatory dysfunction. Additionally, postural hypertension, cardiac arrhythmias, metabolic syndrome complications such as weight gain can be side effects of using Risperidone. In order to avoid side effect associated with Risperidone medication, George might prefer to avoid the medication CITATION Mue10 \l 1033 (Muench, 2010).
In order to assist George to continue using his medication, the psychiatrist should understand his adverse effect profile of treatment (Roca M. & Olivares J., 2011). They should be watchful and vigilant for the incidence of adverse cond...