Question

Discussion Topics, Mohr

Chapter 24, Somatoform, Dissociative, and Sexual Disorders

Discussion Topics	Learning Objective
1. Mary is a 64-year-old woman who complains of chronic pain in her left arm, shoulder, and back. She has been through many diagnostic tests and no physical cause for the source of her pain can be found. How do you feel about clients who constantly complain about various physical symptoms? How do you react when a client constantly complains about such symptoms? Do you think that your reaction to the clients interferes with developing a therapeutic relationship? What do you believe about clients who have physical complaints but no demonstrated physiologic reason for them?	1, 2
2. Josephine is a 21-year-old woman who was sexual abused from the ages of 8 to 12. She has just been diagnosed with dissociative identity disorder. What kinds of feelings do you experience when you think about working with clients who have been victims of severe physical or sexual abuse? How might these feelings affect your nursing care? Reflect on times when you have been forgetful or not paying attention. How did these experiences make you feel when you realized they had occurred? What nursing diagnosis would be appropriate to use with this patient? What interventions do you believe are needed (use the textbook for support)?	5, 6, 7
3. During a patient interview, you are required to obtain information about a client’s sexual history. Have you experienced a situation in which a client shared concerns about sexual issues with you? How did you feel? Were you comfortable listening? Did you seek advice about how to respond to the client? What are your feelings about people who are homosexual or bisexual? How do your feelings influence your role as a professional nurse? Have you ever had a problem, concern, or question related to sexual behavior? If so, how did you resolve it? Did you talk with anyone? In whom did you choose to confide? What was it about that person that made you feel comfortable discussing your concerns?

Answer 1

Answer: The patient may be having extreme and unbearable pain, this is the reason she has complaint about the chronic pain. Some people have pain due to mental illness i.e. somatic disorders.

In the diagnosis there is no specific reason for the pain has been identified that means the patient is not suffering from any of the disease but she is still having pain.

There can be various reason for the pain not only the disease but may be the patient is taking excessive stress or work load or might be she is tired and due to rear and tear of muscles she is experiencing pain.

One of the major reason can be that she is suffering from somatic symptoms disorders where patient is mentally ill and experiences pain. This somatic disorders is related to the anxiety disorders, many patients having somatic disorders suffers from anxiety disorder. For the treatment this kind of patients are generally given therapy which includes the stress relief etc. There should be strong relationships between the healthcare professionals and the patient so that the patient can be assured that she is going to be fine. This is mental disorder so it is not easy to tackle with the patient. We need to gain the trust to increase the therapeutic effect.