Dit is een toetsonderdeel van de keuzecursus Psychische kwetsbaarheid.
In deze eindopdracht ging ik aan de slag met klinisch redeneren rondom een patiënt met een psychische kwetsbaarheid. Gedurende de onderwijsweken staat er wekelijks een thema centraal waarover één of twee casussen beschreve...
,Inleiding
In dit verslag ga ik aan de slag met klinisch redeneren rondom een patiënt met een psychische
kwetsbaarheid. Ik heb het thema afhankelijkheid gekozen en ik werk de casus cannabis uit.
2
,Inhoudsopgave
Inleiding..................................................................................................................................................2
Stap 1: Gevalsbeschrijving......................................................................................................................5
1.1 Gegevensverzameling...................................................................................................................5
1.1.1 Algemene gegevens...............................................................................................................5
1.1.2 Gegevens over afhankelijkheid..............................................................................................5
1.1.3 Medische gegevens...............................................................................................................5
A 1.1.4 SBAR van acute situatie......................................................................................................6
1.2 Raamwerk klinisch redeneren......................................................................................................8
1.3 Prioritering factoren.....................................................................................................................8
1.3.1 Cannabisverslaving................................................................................................................8
1.3.2 Stress.....................................................................................................................................8
1.3.3 Persoonlijkheidsproblematiek...............................................................................................8
1.3.4 Gezin......................................................................................................................................8
1.4 Beschrijvende diagnose................................................................................................................8
Stap 2: Verpleegproblemen....................................................................................................................9
2.1 Meet- en screeningsinstrumenten...............................................................................................9
2.1.1 Meten van Addicties voor Triage en Evaluatie (MATE)..............................................................9
2.1.2 Drug Use Disorders Identification Test (DUDIT).....................................................................9
2.1.3 General Self-Efficacy Scale (GSE)............................................................................................9
2.2 Verpleegproblemen (met behulp van PES).................................................................................10
2.2.1 Stress...................................................................................................................................10
2.2.3 Risico op terugval.................................................................................................................10
2.2.3 Inadequate coping...............................................................................................................10
2.2.4 Ontwenningsverschijnselen.................................................................................................10
2.3 Prioritering verpleegproblemen.................................................................................................10
2.3.1 Stress...................................................................................................................................10
2.3.2 Risico op terugval.................................................................................................................11
2.3.3 Inadequate coping...............................................................................................................11
2.3.4 Ontwenningsverschijnselen.................................................................................................12
Stap 3: Interventies..............................................................................................................................13
3.1 Toegepaste of mogelijk toepasbare interventies........................................................................13
3.1.1 Medische interventies.........................................................................................................13
3.1.2 Psychosociale interventies...................................................................................................13
3.1.3 Farmacotherapeutische interventies...................................................................................13
3
, 3.2 Verpleegkundige interventies.....................................................................................................14
3.2.1 Stress...................................................................................................................................14
3.2.2 Risico op terugval.................................................................................................................14
3.2.3 Inadequate coping...............................................................................................................15
3.2.4 Ontwenningsverschijnselen.................................................................................................15
3.3 Betrekking patiënt bij besluitvorming.........................................................................................16
Stap 4: Rollenspel.................................................................................................................................17
4.1 Uitvoering interventie.................................................................................................................17
4.2 Evaluatie uitgevoerde interventie...............................................................................................17
Uitvoering interventie...................................................................................................................17
Effect op de zorgvrager.................................................................................................................18
Stap 5: Conclusie..................................................................................................................................19
5.1 Toepassing van uitkomsten in de verpleegkundige beroepspraktijk..........................................19
5.2 Reflectie op leeruitkomsten........................................................................................................19
Literatuurlijst........................................................................................................................................20
Bijlage 1: Casus Cannabis......................................................................................................................23
Bijlage 2: Acute situatie........................................................................................................................24
Bijlage 3: Raamwerk klinisch redeneren...............................................................................................25
Bijlage 4: Meet- en screeningsinstrumenten........................................................................................26
GSE Scale..........................................................................................................................................26
DUDIT...............................................................................................................................................39
Bijlage 5: Feedback rollenspel..............................................................................................................40
Bijlage 6: Toepassing van uitkomsten in de verpleegkundige beroepspraktijk.....................................42
Bijlage 7: Reflectiemethode Korthagen................................................................................................43
Bijlage 8: Reflectie op leeruitkomsten..................................................................................................44
Fase 1................................................................................................................................................44
Fase 2................................................................................................................................................44
Fase 3................................................................................................................................................44
Fase 4................................................................................................................................................44
Fase 5................................................................................................................................................45
Bijlage 9: Peer-review...........................................................................................................................46
Verbeterpunten...............................................................................................................................46
Sterke punten...................................................................................................................................46
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