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Chris Lee by Mind Map: Chris Lee

1. Risk factors of mental illnesses

1.1. Psychosocial problems

1.2. Physical illness

1.3. Medication

1.4. Family history

2. Personal information

2.1. Work

2.1.1. stressed

2.1.2. work late after midnight

2.1.3. architect in large company

2.2. Family

2.2.1. parents and elder brother: lives in Australia

2.2.2. elder sister: lives apart in HK

2.3. Age

2.3.1. 25

2.4. Background

2.4.1. live in HK

2.4.2. normal childhood & education

3. Scenario 2

3.1. Progress

3.1.1. diagnosis schizoprenia definition, characteristic, risk factors, complications subtypes Comparison

3.1.2. socially isolated

3.1.3. seldom talk

3.1.4. more suspicious to others

3.1.5. persisting auditory hallucination

3.2. Psychiatric acute unit

3.2.1. Treatment pharmacological Risperidone non-pharmacological Cognitive behavioral therapy Family intervention Skill training Contingency management Counseling Psychodynamic psychotherapy Token economy Transcranial magnetic stimulation Motivation intervention Art therapy Supportive therapy Cognitive remediation Adherence therapy Psychoeducation

3.2.2. Nursing care Manage Side effects of drugs Social Isolated Suspicious Voice

3.2.3. Rapport building Communication and involve Family members

3.2.4. Discharge plainning medication management education follow up with medication intake activities of daily living identify needs education, explanation & documentation areas rehabilitation Enhance coping Foster socialization Enhance self-esteem Reduce relapse episodes community support types services family support Consideration Encourage family involvement Education physical health care recognize physical illness & seek medical care comfortable with talking to GP regular physcial checkups provide information to access services basic needs financial residential services

4. Scenario 1

4.1. Chief Complaints

4.1.1. insomnia for 3 days

4.1.2. delusion

4.1.3. stress

4.1.4. auditory hallucination

4.1.5. delusions

4.2. Hospitalisation

4.2.1. ordinance voluntary hospitalization 7 day notice of discharge application compulsory observation (F123: detention 7 days) voluntary Extended compulsory observation (F4: detention 21 days)

4.2.2. communcation Strategies Be respectful If hallucination: don't argue with /pretend to understand If paranoia: maintain body space Don't assume low intelligence Don't lie Skills Listening Non-verbal communcation Silence Reflecting skills Paraphrasing Summarizing Questioning

4.2.3. Assessment Admission assessment admission notes Assessment on physical and mental condition Assessment on psycho-social and functional status Brief psychiatric rating scale stress insomnia sleeping history mental status examination

4.2.4. management Hallucination Use simple wordings Provide a quiet non-stimulating environment Avoid giving choices. It would increase anxiety Provide reality orentation Obtain feedback frequently Arrange psychiatric consultation Make sure medication taken correctly Delusion Educate patient's family on delusion Reduce triggering factors Encourage reality-based activities Use gesture instead of touch Don't argue with patient's belief Consider restraint if indicated Stress Avoid unnecessary stress Alter situation Adapt to stressors Spend time on releasing stress Healthy lifestyle Safety problem Apply restraint reduce noise/ stimulation Risk assessment Well-trained staff Reassure patient use firm & clear statement to stop violence Insomnia acupressure medication dietary measures exercise good sleep hygiene combination therapy