SCHOOL OF HEALTH SCIENCES (NURSING)

Mental Health Nursing

STRUCTURED ACTIVIT THERA! !LAN
Na"e# CHEONG AI $EI Stu%ent Nu"&er# S'(')*+(+G
Date# '+
TH
AUGUST *(') Le,turer# MS EMIL NG
Topic: Individual structured therapy
Structured activity for acute depression patients.
Type/ Nature of Structured Activity Therapy:
Recreational therapy physical activity (tennis)
Patient e!o"raphic Profile:
#hon" Sian" $on"
ate of %irth: &'
th
ece!%er ())&
A"e: && years old
Se*: +ale
+arital status: Sin"le
Preferred lan"ua"e: ,n"lish
Reason for see-in" treat!ent: .ell into depression after failin" A levels
A"e /roup: &0120 years old
Physical 3ealth Status:
e.". +o%ility4 +edical/
sur"ical history etc
(Provide at least t5o(&)
relevant data)
+o%ility: A%le to 5al- 5ithout assistance4 Steady
"ait
+edical history: 3ypertension
Sur"ical history: No sur"ical history to date.
+edication Alert:
(Na!e of the dru")
Penicillin and Tra!adol
+ental 3ealth Status:
(To evaluate the appropriateness of patients6 !ental health status to participate
the structured activity therapy)
Identify and %riefly discuss on five (') !ental health assess!ent data.
1MHNPC_April 2014
(. Appearance: Self1care is ne"lected as patient can %e seen 5ith
unshaved !oustache and unco!%ed !essy hair.
&. Appearance and %ehavior: Patient appeared to have inade7uate a!ount
of rest as it can %e seen fro! his lethar"ic loo- and droopy eyes. 3e is
al5ays avoidin" eye contact 5ith the others4 appears to %e loo-in" on
the floor at all ti!es.
2. 8ehavior: Patient is al5ays in a slouchin" posture4 5al-in" and sittin"
are often seen slouchin".
9. Speech: :hen conversin" 5ith patient4 he is al5ays replyin" one 5ord
ans5ers or havin" delayed responses. 3e has little spontaneous speech
and is al5ays !u!%lin" 5hen he spea-s.
'. Thou"hts: +r. #hon" !entioned that he feels hopelessness a%out his
future and ad!itted that he had not left his house for !any !onths. 3e
had also 5ithdra5n hi!self fro! his friends.
+ood and affect: Al5ays feelin" do5n4 especially in the !ornin" and at
ni"ht. 3e !entioned that he had thou"ht of co!!ittin" suicide so as to
not suffer so !uch and feel that he is hopeless to the people around
hi!.
Activity Therapy ;enue : Tennis court in Institute of +ental 3ealth
Nu!%er of patients participatin":
& patients and t5o nurse
The & staff includes ( staff nurse and ( enrolled nurse
( nurse 5ill pair 5ith ( patient and play a"ainst another pair
uration of activity pro"ra!:
T5ice a 5ee-4 ( hour for each session.
(' !inutes for 5ar!in" up4 9' !inutes for a "a!e of tennis
This activity 5ill carry on for (& 5ee-s (2 !onths) and the nurse 5ill evaluate the
effectiveness of the structured therapy for the patients.
1MHNPC_April 2014
Activity 5ill %e carried out after tea %rea- %ut %efore dinner at around 9p!1'p!
as the sun is not too hot.
No. of staff to %e involved in the activity: & nurses 5here ( of the! 5ill %e a staff
nurse and another to %e an enrolled nurse.
escri%e the role of each staff that involved in the activity:
Staff nurse to %rief patient a%out the activity and encoura"e hi! to participate.
,nrolled nurse to "ather e7uip!ent and ite!s needed for the activity.
8oth the staff nurse and enrolled nurse 5ill lead the patients for the 5ar! up
e*ercise and to e*plain the rules of the "a!e.
$earnin" o%<ectives/ Purpose of the activity therapy: ( +ini!u! ' )
At the end of this session4 the patients 5ill %e a%le to:
(. .ind an alternative to i!prove their !ood and use as a distraction therapy.
&. I!prove !ental health and lo5er the incidence of "ettin" into a depressed
!ood. It encoura"es patients to participate in activities and sociali=ation.
2. Pro!ote and !aintain positive self1estee!. It chan"es the 5ay ho5 the patient
loo- at hi! (%ody i!a"e) 5hich is lin-ed to hi"her levels of self1estee!.
9. ,ase the sy!pto!s of depression throu"h e*ercisin".
'. >se physical activity as a for! of distraction therapy.
?. Tri""er positive feelin"s in the %ody 5hich is acco!panied %y a positive and
ener"i=in" outloo- on life.
8rief description of the activity therapy:
+y patient has acute depression and !y structured activity plan is to use
physical activity to help hi! !ana"e depression. Physical activity is in the for! of
e*ercises such as playin" sports. It has %een sho5n that physical activity can
help alleviate the sy!pto!s of depression %y doin" !oderate e*ercises such as4
tennis4 s5i!!in"4 <o""in" and lo5 i!pact aero%ics. ,*ercisin" releases
endorphins have %een lin-ed to feelin"s of happiness. ,ndorphins tri""er a
positive feelin" in the %ody4 5hich is often acco!panied %y positive and
ener"i=in" outloo- of life. :hen encoura"in" !y depressed patient to do physical
activities4 it can 5ard of feelin"s of depression and %oost self1estee!. The
reason 5hy I included another patient to ta-e part in this activity is %ecause I
5ant to encoura"e social interactions.
urin" the tennis "a!e4 there 5ill %e ( nurse to ( patient and it 5ill for! a tea!.
Then they 5ill play a"ainst another tea! that consists of another nurse and
patient. The rules and re"ulations of the "a!e 5ill %e e*plained and fa!iliari=ed
5ith the patients on the first 5ee- (& sessions of tennis).
Rules and re"ulations of tennis:
A coin toss or spin of the rac7uet deter!ines 5ho has the ri"ht to serve4 receive
serve or select a side of the court on 5hich to %e"in play. Additionally4 the 5inner
1MHNPC_April 2014
of the toss or spin can defer the decision to the opponent and allo5 the! to
choose his/her preferences. If the choice of service or receiver is chosen %y the
5inner of the coin toss or rac7uet spin4 the opponent "ets to choose 5hich side
of the court to start on
@uoted fro! iSport Tennis.
Teachin" !aterials to %e used for activity e.". (%oard "a!es / cards / stic-ers /
radio etc.)
A Su%!it an Appendi* of the dia"ra!s/ photos/ pictures of the teachin" !aterials
1. Tennis rac-ets
&. Tennis %alls
3. & face to5els for the & patients to 5ipe s5eat
9. Sports outfit
'. 8ottled 5ater for hydration
6. Patient health 7uestionnaire for! (effectiveness of the pro"ra! evaluated
after 2 !onths)
B%servations !ade durin" i!ple!entation of the activity therapy: ( +ini!u! 2 )
1. I!prove!ent of !ood and patient is feelin" confident a%out self.
&. Increased social interactions 5ith nurses and another patient.
2. ecreased episodes of %ein" depressed.
9. Increased attention span and a%le to have !ore spontaneous
conversations.
'. Patient ver%ali=es that he feels an i!prove!ent in !ood and feel !ore
confident.
#risis +ana"e!ent Plan: Su""est t5o (&) crisis !ana"e!ent interventions in the
event of e!otional insta%ility of patients.
(. To stop the activity i!!ediately4 return %ac- to 5ard and encoura"e
patient to voice out concerns a%out 5hat is %otherin" hi!. This 5ill help
the nurses understand hi! %etter and rectify the pro%le! identified.
&. Allo5 patient to !ana"e their feelin"s and sta%ili=e first4 then provide
reassurance and encoura"e!ent to !otivate the! to "et %ac- on trac-.
,valuation of the structured activity therapy:
Identify t5o (&) !easurea%le tools to evaluate the effectiveness of the structured
activity therapy.
(. Patient health 7uestionnaire scorin" syste! (P3@1)). The P3@1) is a
!ultipurpose instru!ent for screenin"4 dia"nosin"4 !onitorin" and
!easurin" the severity of depression.
&. Patient1nurse conversation to see 5hether there is any i!prove!ent in
!oods. The nurses that are in char"e of the patient 5ill %e a%le to notice
the i!prove!ents and effectiveness of the therapy.
1MHNPC_April 2014
References: ( APA referencin" )
A Su%!it a !ini!u! of three (2) Cournal articles
(. Datia4 /. #.4 ,d"ar4 . /.4 $i%ia4 . . #.4 /uil"er!e4 8.4 Nayeli4 +.4
Evonne4 N. ..4 Pa%lo4 +. 3.4 Santia"o4 3. +.4 ,li=a%eth4 3. #. F Cor"e4 S.
(&0(2). Physical Activity and Reduced Ris- of epression4 Results of a
Longitudinal Study of Mexican Adults, 2&(?)4 ?0)1?('.
doi:(0.(02G/a00&)&G?
&. $ind5all4 +.4 /er%er4 +.4 Consdottir4 I. 3.4 8Hr<esson4 +.4 F Ahl%or"4 /.4 Cr.
(&0(24 Nove!%er (I). The Relationships of #han"e in Physical Activity
:ith #han"e in epression4 An*iety4 and 8urnout: A $on"itudinal Study of
S5edish 3ealthcare :or-ers. Health Psychology.Advance online
publication. doi: (0.(02G/a002990&
2. $ynette4 $. #. F .ran-4 +. P. (&009). The %enefits of e*ercise for the
clinically depressed. Prim are ompanion ! linical Psychiatry, ?(2).
Accessed on (&
th
Au"ust &0(9
9. epression 3ealth #entre: ,*ercise and epression. (&0(94 .e%ruary ().)
Retrieved fro! http://555.5e%!d.co!/depression/"uide/e*ercise1
depression
Accessed on (9
th
Au"ust &0(9
'. iSport Tennis: Tennis rules and re"ulations. (n.d.). Retrieved fro!
http://tennis.isport.co!/tennis1"uides/tennis1rules1re"ulations
Accessed on (9
th
Au"ust &0(9
?. #arin" for so!eone 5ith depression: epression can touch all of us.
(&0((4 Culy &I.) Retrieved fro!
http://555.netdoctor.co.u-/diseases/depression/carin"forso!eone5ithdep
ressionJ0009I&.ht!
Accessed on (9
th
Au"ust &0(9
1MHNPC_April 2014
A--en%i.
1. Tennis rac-et
&. Tennis %alls
3. Face towels
4. Sports outfit
Bottle water
1MHNPC_April 2014