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,Chapter
Nursing Care for Schizophrenic
Clients: Recent Advances and
Client-Centred Nursing Care
Perspectives
Ek-uma Imkome
Abstract
Schizophrenia is one of the leading causes of disability worldwide; psychiatric
disorders can result in impairments of perception, poor self-care, and decreased perfor-
mance in activities of daily living. Treatment and nursing care are vital options for clients
to improve their signs and symptoms, especially during the COVID-19 pandemic. The
planning of nursing care for individual schizophrenic clients is essential and will help
them have a satisfactory quality of life. Current nursing should be provided according to
the client’s needs and particular problems, such as the presence of comorbidities, amidst
the state quarantine. The current nursing care focuses on telenursing, with nurses
implementing information technology to provide the necessary care. Despite the physical
distancing, clients can access nursing services efficiently, with nurses being flexible
enough to continue their care provision during the COVID-19 pandemic.
Keywords: schizophrenia, telenursing, nursing care, client-centered, psychiatric
disorder
1. Introduction
The most common impairments of schizophrenic patients include delusions, illu-
sions, hallucinations, anger, hostility, and aggression. Nursing care for this population
should focus on patient-centered needs and individual problems. In addition, during
the coronavirus pandemic, telenursing should be provided to prevent infection and
adhere to social distancing rules. The practical nursing process application will reflect
the effective nursing outcomes.
When the global coronavirus SARS-CoV-2 (COVID-19) epidemic hit, nursing care
was pressed to switch to telenursing. Telenursing is primarily performed by the nurses
using a cell phone, computer, audio and video technology, or advanced digital and
optical communications, in order to deliver health care and provide remote, synchro-
nous (e.g., via live interactive videoconference) or asynchronous (e.g., the informa-
tion is stored electronically) care. This type of health care usually falls within care
management for emergent situations, coordination of care, and health maintenance
services. It is considered beneficial for both the patient and nurse; the patient benefits
1
, Schizophrenia - Recent Advances and Patient-Centered Treatment Perspectives
from increased access to health care services, while the nurse benefits from a more
flexible and less physically stressful work environment.
Telenursing is increasingly prevalent in the nursing domain because of a preoccu-
pation with cutting down on health care costs, an increase in the number of aging and
chronically ill individuals, and a rise in the coverage of health care to distant, rural,
minor, or sparsely populated regions. Telenursing, providing nursing care at a dis-
tance using new technologies, is identified as one alternative. Among its many bene-
fits, telenursing may help prevent a shortage of nurses, reduce distance and save
travel time, and keep patients out of the hospital. A greater degree of job satisfaction
has also been registered among telenurses.
Telenursing has been considered a potential solution to service delivery challenges
during the COVID-19 pandemic, mainly due to its compliance with physical distanc-
ing measures and stay-at-home orders implemented by several governments to curb
the spread of infection. Additionally, telenursing is benefit for the nurse to providing
telenursing care for victims in disasters in a simulated study for introducing of possi-
bility nursing interventions, telenursing education on nurses’ compliance with stan-
dard precautions during the COVID-19 pandemic [1], telenursing training based on
family-centered empowerment pattern on compliance with diet regimen in patients
with diabetes mellitus, education through telenursing can increase the quality of life of
COVID-19 patients [2], telenursing in COVID-19 times and maternal health:
whatsapp® as a support tool, telenursing on attachment and stress in mothers of
preterm infants, telephone-based telenursing on perceived stressors among older
adults receiving hemodialysis, telenursing on levels of depression and anxiety in
caregivers of patients with stroke, Treatment of Obesity Among Youth With
Intellectual and Developmental Disabilities: An Emerging Role for Telenursing [3],
Telenursing intervention increases psychiatric medication adherence in
schizophrenia outpatients [4]. Telenursing are ongoing to increase both nationally
and internationally. A primary role of telenursing is to channel clients towards appro-
priate levels of nursing care thereby reducing healthcare costs and freeing up
resources [5, 6].
The purpose of this chapter is two-fold. First, it describes the principle of caring
for a person with schizophrenia during the COVID-19 pandemic. Second, it aims to
describe the processes behind understanding the facilitators and barriers to
telenursing during the pandemic.
The principle of caring for a person with schizophrenia during the COVID-19
pandemic
This chapter provides an overview of telenursing and its application to nurses'
daily practical challenges. The principle of caring for a person with schizophrenia
during the COVID-19 pandemic is as below:
2. Cognitive and perceptive disorders (delusions, illusions, and
hallucinations)
2.1 Delusions
A delusion refers to a fixed false belief with no basis in reality in the psychotic
phase of an illness. A common characteristic of schizophrenic delusions includes the
direct, immediate, and total certainty with which the client holds these beliefs. A
person with schizophrenia is probably suspicious, mistrustful, and guarded about
2
