Challenge of psychiatric rehabilitation for patients with long-term hospitalizations using the Nirje’s normalization principles as a valuation standard: two case studies

Abstract

This research investigates the current care of hospitalized, chronically mentally ill persons to determine to what extent current hospitalization supports Nirje' s principles of normalization. We propose that care-providers try to incorporate rehabilitation programs that help the patients acquire the pattern and rhythm of living necessary for them to live in the community in their daily hospital life rather than to fit the patients into hospital rules or schedule. Therefore, care-providers must look back on their own views of the humanity, disabled people, and support and may have to change them if necessary. It is important that care-providers do not give up having psychiatric patients not give up restoration of normal social living. To develop such individual attempts into rewarding activities, it is necessary to set goals in the hospital and to let an interdisciplinary team work to achieve them. Moreover, the situation is expected to change if efficient care management is implemented to support psychiatric patients in the community. High-quality care to realize independent living of patients in the community including collection and distribution of information, management of symptoms, assistance for self-care, and psychological education is provided at hospitals that maintain the idea of, and strong belief in, providing high-quality care for returning patients to the community. The findings of this study will provide insights into how to design better hospitalization and/or community care for the mentally ill.

The Development of the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS<sup>©</sup>)

“…According to the research by Steven et al [36], many of the patients with chronic psychiatric disease were sexually active. Therefore, it is appropriate that PsyNACS © include sexual behavior of patients as critical assessment data, recognizing the importance of sexuality human living without ignoring their desire [37].…”

Collaborative agencies and quality discharge support for the long-term care inpatients with mental illness

“…Consequently, appropriate support for patients is considered unlikely. It is necessary to set goals in the hospital and to let an interdisciplinary team work to achieve them (12), particularly focusing on goal setting as the most important for the discharge support.…”

Prioritizing Patient Assessment Data (PAD) Using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©

“…Sexual behavior problems sometimes occur because of erroneous judgment placed on its importance owing to the psychiatric symptoms in psychiatric units. According to the study by Steven et al [33], many of the patients with chronic psychiatric disease were sexually active, therefore it is important that sexuality is considered "important" in planning nursing care of psychiatric patients in all practice units [34].…”