NURS 302 6381 Transition to Professional Nursing Practice (2258)

NRNP 6645 Family Therapy: Comprehensive Psychiatric Evaluation

NRNP 6645 Family Therapy: Comprehensive Psychiatric Evaluation Part 1

Write a Comprehensive Psychiatric Evaluation documentation for a 38-year-old female patient who came in with a mood disorder.

Comprehensive Psychiatric Ev Comprehensive Psychiatric Evaluation Note and Patient Case Psychiatric notes are a way to reflect on your practicum experiences and connect them to the didactic learning you gain from your NRNP courses. Comprehensive psychiatric evaluation notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

For this Assignment, you will document information about a patient that you examined in a group setting during the last 4 weeks, using the Comprehensive Psychiatric Evaluation Note Template provided. You will then use this note to develop and record a case presentation for this patient.

Resources

Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare

· Review this week’s Learning Resources and consider the insights they provide about clinical practice guidelines.

· Select  a group patient for whom you conducted psychotherapy for a mood disorderduring the last 4 weeks. Create a Comprehensive Psychiatric Evaluation Note on this patient using the template provided in the Learning Resources. There is also a completed template provided as an exemplar and guide. All psychiatric evaluation notes must be signed by your Preceptor. When you submit your note, you should include the complete comprehensive psychiatric evaluation note as a Word document and pdf/images the completed assignment signed by your Preceptor. You must submit your note using Turnitin. Please Note: Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Grading Policy.

· Then, based on your evaluation of this patient, develop a video presentation of the case. Plan your presentation using the Assignment rubric and rehearse what you plan to say. Be sure to review the  Kalturasupport resources in the  Classroom Support Center found by clicking on the  Help

· Include at least five scholarly resources to support your assessment and diagnostic reasoning.

· Ensure that you have the appropriate lighting and equipment to record the presentation.

The Assignment

Record yourself presenting the complex case for your clinical patient.

Do not sit and read your written evaluation! The video portion of the assignment is a simulation to demonstrate your ability to succinctly and effectively present a complex case to a colleague for a case consultation. The written portion of this assignment is a simulation for you to demonstrate to the faculty your ability to document the complex case as you would in an electronic medical record. The written portion of the assignment will be used as a guide for faculty to review your video to determine if you are omitting pertinent information or including non-essential information during your case staffing consultation video.

In your presentation:

· Dress professionally and present yourself in a professional manner.

· Display your photo ID at the start of the video when you introduce yourself.

· Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information).

· Present the full complex case study. Be succinct in your presentation, and do not exceed 8 minutes. Include subjective and objective data; assessment from most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; current psychotherapeutic plan (include one health promotion activity and one patient education strategy you provided); and patient progress toward treatment goals.

· Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What was the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?

· Objective: What observations did you make during the psychiatric assessment?

· Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses in order of highest to lowest priority and explain why you chose them. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms.

· Plan: Describe your treatment modality and your plan for psychotherapy. Explain the principles of psychotherapy that underline your chosen treatment plan to support your rationale for the chosen psychotherapy framework. What were your follow-up plan and parameters? What referrals would you make or recommend as a result of this psychotherapy session?

· Reflection notes: What would you do differently in a similar patient evaluation? Reflect on one social determinant of health according to the HealthyPeople 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.

By Day 7

Submit your Video and Comprehensive Psychiatric Evaluation Note. You must submit two files for the evaluation note, including a Word document and scanned pdf/images the completed assignment signed by your Preceptor.

submission information – Part 1: Recording

To submit your video response entry:

1. Click on  Start Assignment near the top of the page.

2. Next, click  Text Entry and then click the  Embed Kaltura Media button.

3. Select your recorded video under My Media.

4. Check the box for the End-User License Agreement and select  Submit Assignment for review.

submission information – Part 2: Comprehensive Psychiatric Evaluation Note

Week (enter week #): (Enter assignment title)

Student Name

College of Nursing-PMHNP, Walden University

PRAC 6645: Psychopathology and Diagnostic Reasoning

Faculty Name

Assignment Due Date

Subjective:

CC (chief complaint):

HPI:

(include psychiatric ROS rule out)

Past Psychiatric History:

· General Statement:

· Caregivers (if applicable):

· Hospitalizations:

· Medication trials:

· Psychotherapy or Previous Psychiatric Diagnosis:

Substance Current Use and History:

Family Psychiatric/Substance Use History:

Psychosocial History:

Medical History:

· Current Medications:

· Allergies:

· Reproductive Hx:

Objective:

Diagnostic results:

Assessment:

Mental Status Examination:

Differential Diagnoses:

Reflections:

Case Formulation and Treatment Plan:

I confirm the patient used for this assignment is a patient that was seen and managed by the student at their Meditrek approved clinical site during this quarter course of learning.

Preceptor signature: ________________________________________________________

Date: ________________________

WK 3 NURS 691B:Improving Care for Recurrent Breast Cancer Patients

WK 3 NURS 691B: Improving Care for Recurrent Breast Cancer Patients

This part of your paper includes the summary of the project, main points and findings, the significance of the project to the advanced practice nursing profession, and recommendations for future research. Address the following:

1. Address your recommendations and implications for clinical practice.

2. Provide a summary of study and discuss any limitations of the study.

· Suggest directions for future research.

· Consider changes in theoretical constructs

· Provide suggestions for public policy and/or changes in practice.

3. Tie the theoretical framework to the overall product.

4. Conclude with an overall wrap-up to the paper.

Your paper should be 4–5 pages in length, not including the cover or reference pages. You must reference a minimum of two scholarly sources in your paper.

Use current APA format to style your paper and to cite your sources.

Improving Care for Recurrent Breast Cancer Patients: A Microsystem Approach

Among the provisions in the readings this week, the chapter in the Clinical Microsystems Greenbook that corresponds the most to my project topic of recurrent breast cancer is the chapter on improving care to the patients with chronic illness. Recurrent breast cancer is a complex and chronic ailment that requires regular and all-encompassing care management. The chapter provides the framework on how to enhance the care of patients at the microsystem level: in interdependent teams of small size (healthcare professionals) where the provision of care is personalized. It is notable that this concept especially applies to recurrent breast cancer, whereby patients may have long-term follow-up, need management of various symptoms, and may need adjustment of the treatment plans.

The microsystem approach focuses more on the patient engagement that is important in the repeated breast cancer management. Patients have to deal with constant treatment and emotional issues, and therefore, it is essential to think about how they see the situation and include their own preferences in the course of treatment. As one example, through regular reassessment of physical and emotional needs and engaging patients with the decision-making process, clinicians will be able to create more efficient plans of care that would be based on the unique needs of a particular patient (Fathiya et al., 2023).

More than that, the focus on the usage of data on monitoring the process and the improvement of processes constantly is noted in the chapter, and it can be directly applied to my project. In case of recurrent cases of breast cancer, information regarding the effectiveness of treatments, recurrence, and, in general, the quality of life may be gathered and frequently analyzed to adjust clinical methods and guarantee the best roles. With the help of this microsystem concept, healthcare teams will greatly transform their collaboration to meet the many needs of recurrent breast cancer patients in terms of structure and functioning as well as to finally improve patient outcomes.

This reading has applied strong footing in implementing change in my project because it puts importance on individualized care, collaboration between teams, and application of data-driven changes, which all play an important role in enhancing care and treatment of breast cancer episodes.

References

Fathiya, L. Y., Siswanto, A., Diah, P., & Chlara, Y. P. (2023). Empowerment-Based Palliative Care to Improve Psychological Well Being and Quality of Life in Women with Breast Cancer.  International Journal of Scientific Multidisciplinary Research (IJSMR),  1(8), 1085-1102. http://repository.um-surabaya.ac.id/id/eprint/8341

Integrating Theoretical Frameworks in Breast Cancer Care

The variables that I will use as far as my change project is concerned include the Health Belief Model (HBM) and Bio-Psychosocial Model. The two frameworks will inform the implementation of the project because it will target both psychosocial support to women along with the recurrent breast cancer and clinical treatment.

In order to initiate the implementation of this change project, certain steps have to be undertaken:

1.Assess Patient Perceptions: With the aid of the Health Belief Model, evaluate the perceptions of women and the likelihood of their recurrence as well as the value of treatment. Eliminate the obstacles that hinder the responses to both psychosocial and clinical care (Mehrabizadeh et al., 2024). As an example, not every woman will embrace the practice of psychosocial care, as it does not seem to bring benefits. With specific education, one can change this attitude and promote the involvement of both sides of care.

2.Provide Holistic Care: The Bio-Psychosocial Model combines clinical care along with emotional and social support. Coming up with a care plan to consider the physical, psychological, and social components of care (Kahan et al., 2022) is necessary. As an example, the patients who reported the anxiety regarding recurrence ought to be given some emotional support, in addition to healthcare provisions, to better their overall experience and increase adherence.

3.Evaluate Barriers and Facilitators: Determine aspects that can hinder patient interaction, including financial or social support, etc. To improve patient outcomes, these factors should be dealt with. A synergistic cooperation with social workers or counselors could assist in lessening these barriers so as to provide better integration of care.

4.Monitor and Adjust the Model: Keep track of the results of the initiative and make adjustments in the interventions. It will involve following the qualitative changes in life quality and coordination of care with references to the patients and healthcare providers.

Adhering to these steps, the project will design a complete, patient-based care model covering both emotional and physical demands of women having recurrent breast cancer, thus enhancing their quality of life and outcome of their treatment.

References

Mehrabizadeh, M., Zaremohzzabieh, Z., Zarean, M., Ahrari, S., & Ahmadi, A. R. (2024). Narratives of resilience: Understanding Iranian breast cancer survivors through health belief model and stress-coping theory for enhanced interventions.  BMC Women’s Health,  24(1), 552. https://link.springer.com/article/10.1186/s12905-024-03383-7

Kahan, Z., Szanto, I., Dudas, R., Kapitany, Z., Molnar, M., Koncz, Z., & Mailath, M. (2022). Breast cancer survivorship programme: follow-up, rehabilitation, psychosocial oncology care. 1st Central-Eastern European professional consensus statement on breast cancer.  Pathology and Oncology Research,  28, 1610391. https://pmc.ncbi.nlm.nih.gov/articles/PMC9200958/

Improving Recurrent Breast Cancer Care: Problem Identification Using the PICOT Framework

i. Clinical Setting and Problem Description

The clinical practice that will be used in this identification of a PICOT problem is an oncology clinic involved in the treatment of recurrent breast cancer. The clinic offers follow-up services to the patients diagnosed with breast cancer, those who have recurred cancer even after undergoing anticancer treatment. The given field is an important sphere of oncology, and controlling recurring breast cancer has several challenges including complicated treatment plans, the psychological distress on individuals, and monitoring them on a regular basis to check the occurrence of a recurring condition.

The clinic covers a big metropolitan area with massive population that includes people with specific needs of treating cancer. The patients are mainly adults over the age of 40 but a significant proportion is of those who have already had before the breast cancer treatment but are currently experiencing the reoccurrence. It is also observed that the clinic has a high concentration of people who are found at the lower end of the socioeconomic ladder, or have having difficulties in accessing care; thereby aggravating their health issues. Also, underserved minority groups are highly represented and this leads to the fact that such people experience cultural and linguistic barriers related to access to care.

It is possible to single out a number of recurrent issues in the clinic, such as the absence of individual care plans offered to the patients, coordination among various healthcare services, as well as the overall inability to manage the emotional and psychological aspects of patients with recurring breast cancer. The emotional load of recurrence is very problematic to many patients, and the mental health needs of many patients are simply provided with no attention but rather concentrated on the clinical treatment. The other significant concern is the problem of the constant monitoring of recurrent breast cancer treatment that can be addressed only with constant surveillance and advanced diagnostic equipment.

ii. Problem Statement and Target Population

The identified problem is insufficient care and treatment of recurrent breast cancer in the clinic. These comprise lapses in clinical as well as emotional support to the patients, which means poor outcomes in both survival rates and quality of life. A total number of adult women diagnosed with recurrent breast cancer and their families, which are frequently involved in the process of care, should become the target population of this problem.

The scale of this issue is not narrow enough so that it can be approached only through a single perspective; this is clinical, psychological, and socio-cultural. Clinically, the issue is the difficulty in coping with a long-term disease, the need to pay constant attention to it, treating side effects, and developing an individual treatment strategy. The psychological aspect consists of the emotional burden on patients who could be affected by anxiety, depression, and hopelessness concerning their cancer returning. Lastly, at a social level, the issue consists of socio-economic position, care accessibility issues, and cultural challenges among heterogeneous populations as well.

The problem of recurring breast cancer cannot be ignored, since it is relevant enough to be explored and carefully planned in terms of interventions. Due to the challenges of managing cancer recurrence effectively, its issue has numerous aspects that have to be handled comprehensively and multidisciplinary. By creating an evidence-based project, it will be possible to work on these dimensions and develop a more effective care model that does not only look at clinical treatment of a patient but also his/her emotional well-being and provide care to more people, especially underserved populations.

iii. Significance of the Evidence-Based Project

Recurrent breast cancer is one of the biggest issues in the field of oncology. The recurrent cancer is one of the areas where the know-how is lacking due to the changes in the treatment protocols. This renders it an extremely important subject of evidence-based practice (EBP) and intervention. These gaps will be important in the improvement of clinical outcomes and the quality of life of the patients with recurrent breast cancer through this project.

Among the key clinical gaps revealed based on the observations, the lack of coordination among various healthcare providers can be pointed out. Although the oncologists are concerned with medical management, patients usually lack adequate services regarding the provision of emotional counseling, symptom management, and primary care/specialist integration services. Most patients in the clinic have complained of a lack of consistency in follow-up visits as well as psychological support to enable them to bear the psychological stress associated with recurrent cancer. This failure to coordinate care is why it usually creates an uncoordinated treatment plan that makes the patient feel not supported, medically and psychologically.

This evidence-based project is also important due to such studies as the importance of psychosocial support in cancer care in the research. Research has indicated that the survivors of breast cancer, especially those who have a recurring cancer, are at risk of depression, anxiety, and distress. A research study performed in one of the cities revealed that 4 out of 10 breast cancer victims show a high degree of psychological distress, and victims with the recurrence of cancer report more anxiety (Sohrabei et al., 2024). Neglecting these psychological needs will result in poorer clinical consequences, and the patient might fail to comply with the treatment regimen because of mental issues.

In addition, breast cancer is also characterized by intermittent and costly pre- and post-treatment regimes, which have to be carefully monitored and modified. Due to the availability of resources or a lack of coordination among the healthcare providers, the implementation of innovative diagnostic technologies and bespoke treatment programs might be obstructed (Hu, 2022). This points to the robustness of the system of care toward more holistic provision of support, which combines clinical and emotional assistance as a way to meet multidimensional needs of patients.

The studies on the management of recurrent breast cancer have been numerous, but that does not say that they are perfect, as there are still loopholes in projecting the most comprehensive study on breast cancer management. Evidence-based models have proven that multidisciplinary teams are capable of increasing patient outcomes by applying both the physical and the emotional requirements of patients (Franzoi et al., 2025). Nevertheless, they are not always implemented consistently into various clinical environments, therefore failing to provide an opportunity to achieve better patient satisfaction and clinical outcomes.

The nursing profession will be added to this evidence-based project by improving the quality of care for patients with recurrent breast cancer, filling in the care gaps, facilitating coordination with other healthcare providers, and adding psychosocial support for the patients in the care plan. This way, it will conform to the objectives of the nursing profession, such as holistic care practice, patient-centered practice, and better patient outcomes.

References

Hu, K. (2022).  Psychological distress and breast cancer: a bidirectional link. Karolinska Institutet (Sweden). https://search.proquest.com/openview/de7854730fe5d3da28536a211c7197ae/1?pq-origsite=gscholar&cbl=2026366&diss=y

Sohrabei, S., Moghaddasi, H., Hosseini, A., & Ehsanzadeh, S. J. (2024). Investigating the effects of artificial intelligence on the personalization of breast cancer management: a systematic study.  BMC cancer,  24(1), 852. https://link.springer.com/article/10.1186/s12885-024-12575-1

Franzoi, M. A., Janni, W., Erdmann-Sager, J., Kline-Quiroz, C., Schäffler, H., Pfister, K., … & Luis, I. V. (2025). Long-Term Follow-Up Care After Treatment for Primary Breast Cancer: Strategies and Considerations.  American Society of Clinical Oncology Educational Book,  45(3), e473472. https://ascopubs.org/doi/abs/10.1200/EDBK-25-473472