Abstract
Cognitive behavioral therapy (CBT) is widely regarded as an effective treatment for obsessive-compulsive disorder (OCD) and is usually provided on an outpatient basis. A minority of individuals need a more intensive/ inpatient service, which is particularly important for patients who cannot be managed as outpatients owing to the nature or extent of their symptoms. Inpatient treatment is generally provided by a multidisciplinary team and psychiatric nurses play a specific and prominent role as they are afforded a unique assessment and intervention opportunity by virtue of their 24-hour presence on the unit. However, there are few facilities, reports of multidisciplinary approaches, or descriptions of the role of nursing staff as cotherapists for CBT-oriented treatment of inpatients with OCD. The present paper therefore reports the developed nursing guidelines for inpatients with OCD in line with the progress of CBT at Chiba University Hospital in the context of Japan being a country in which CBT is under development. In addition, availability of the guidelines, better means of managing severe OCD and key issues for dissemination of CBT in Japan are discussed.
Highlights
Obsessive-compulsive disorder (OCD) is characterized by recurrent intrusive thoughts, images, or urges that typically cause anxiety or distress and by repetitive mental or behavioral acts that the individual feels driven to perform, either in response to an obsession or according to rules that he or she believes must be applied rigidly [1]
This paper described our development of nursing guidelines at Chiba University Hospital, highlighting how psychiatric nurses act as cotherapists in inpatient cognitive behavioral therapy (CBT) for patients with OCD as part of a multidisciplinary team
Our guidelines focus on a specific nursing intervention for OCD patients receiving inpatient CBT, but our intervention requires no special techniques in psychiatric nurses because most of them are similar to standard nursing care plans for OCD based on NANDA International processes, which generally focus on anxiety, fear, disturbed thought processes and ineffective coping [21]
Summary
Obsessive-compulsive disorder (OCD) is characterized by recurrent intrusive thoughts, images, or urges (i.e., obsessions) that typically cause anxiety or distress and by repetitive mental or behavioral acts (i.e., compulsions) that the individual feels driven to perform, either in response to an obsession or according to rules that he or she believes must be applied rigidly [1]. The present article aims to describe the nursing guidelines, which were developed at Chiba University Hospital in Japan for inpatients with OCD receiving CBT-oriented treatment. Discussions were repeated until all investigators had the same understanding of nursing for OCD patients receiving inpatient CBT, in order to achieve a highly reliable classification of the data. Mainly for nurses providing patient care, were developed as follows: Adaptation and Assessment Phase Nursing Goal: Patient will be able to adapt to a hospital environment, identify a specific problem and have realistic expectations of treatment. Intensive Treatment Phase Nursing Goal: The patient will be able to explore more effective ways to cope with problems, increase pleasurable activities and facilitate self-care in daily life. Review the progress of treatment goals and encourage the patient to set new goals following discharge
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