Chapter X PROGNOSIS AND RECOMMENDATIONS

A. Prognosis

Category

Poor

Fair

Good

Justification

1. Onset of illness

Age of Onset of illness was 19 years old on her late adolescence. According to Shives, 2008, the onset of schizophrenia may occur in late adolescence or in early adulthood, usually before age 30.

2. Duration of Illness

Ms. MB has been diagnosed with schizophrenia, disorganized last August 30, 1985 under Dr. Enriquez. She was already 33 years old. She was then discharged on March 29, 1995. Because of social stigma and noncompliance to prescribed medicines, she was readmitted last June 14, 2005 with the diagnosis of Schizophrenia, Undifferentiated.

3. Predisposing Factor

On her maternal side, her grandmother died due to a mental illness. She was 19 years old that time which is one of the risk factors to have schizophrenia. Her symptoms developed since then up to her first admission. She is a woman, and women are generally affected in their twenties or early thirties. She developed an introvert personality.

4. Precipitating Factor

Her condition was triggered by the separation of her parents while she is still in her 3rd year in college. Her father abandoned their family to go abroad together with the mistress. Because of this, she started to alter her behaviors. First, she became very introvert and because of influences around her, she was able to do unacceptable things in the society like taking prohibited drug specifically the marijuana, drinking alcoholic beverages, smoking cigarette, and going home late.

5. Willingness to take medication or compliance to treatment

Ms. MB was readmitted due to noncompliance to the prescribed medicines for her. She refused to take them but accepted to be admitted once again for the course of

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regimen

treatment.

7. Family Support

Patient has inadequate family support. Her father is out of reach and she has no updates regarding him since the time he left. Her mother was already dead. She was seldom visited by other family members and not being visited by relatives and friends.

The patient has a poor prognosis. The patient has a poor prognosis because of early onset of the disease and the duration of her condition is very long. By 19 years old, she already has manifested symptoms but it was only in her 33th year that she was able to be admitted at the hospital. Now, she is already 58 years old and still admitted. She has no more support system and her only hope is from the staff nurses and physicians in the hospital. Assistance is still needed for her to be encouraged in taking her medicines for her treatment because she is not complying with it.

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B. Recommendations

For Individual: Individual Teaching client and family about proper coping mechanism is important. Knowing how to handle problems in life in a positive manner and maintaining good relationship between each other. Developing ones self really start at the beginning especially in taking good care of ourselves. Performing proper hygiene and good grooming is the vital part of all because it upholds the overall maintenance of all and this will lead to positive perspectives in life. It reflects not just in physiologic aspect in life but also psychologically, mentally, emotionally, and most of all spiritually. Determination to pursue life and balancing every action that we are going to decide. The holistic approach in dealing our day to day living must be accompanied by a logical thinking, positive approach and most of all self-awareness. It is great having a support when facing what could be an uphill battle to reach a goal. Having someone or somebody in our lives will uphold the clients development in facing and dealing problems in life. Through the client support system she will be able to obtain encouragement and advice that will help the client combat a depressive and stressful environment. Support of friends and
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loved ones is essential for her recovery. Educating her about bipolar disorder, surrounding her with people you can count on, and leading a healthy wellness lifestyle. With good coping skills and a solid support system, she can live fully and productively and keep the symptoms of bipolar disorder in check. Having hope to ones self will leads to a good symptom management, it is possible to experience long periods of wellness. Believing that she can cope with mood disorder is both accurate and essential for her recovery. Depression and manicdepression often follow cyclical patterns. Although you may go through some painful times and it may be difficult to believe things will get better, it is important not to give up hope and good perspectives in life. Personal Responsibility. Its up to you to take action to keep your moods stabilized. This includes asking for help from others when you need it, taking your medication as prescribed and keeping appointments with your health care providers. Self Advocacy is very important in becoming an effective advocate for herself so she can get the services and treatment she needed, and make the life she want for herself. Education is a vital part in learn all she can about her illness. This allows her to make informed decisions about all aspects of her life and treatment. Working toward wellness is up to her. However, support from others is essential in maintaining her stability and enhancing the quality of her life. Significant Others

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Teaching client and family about Schizophrenia is important. They must understand Importance of maintaining prescribed medication regimen and regular follow-up.

Teaching client and family about Schizophrenia is necessary. Understanding the illness, the need for continuing medication and the uncertainty of prognosis are key issues.

Encouraging the family to enroll patient in support groups will help the client and his family. Client can receive support an encouragement from others who struggle with depression, and family members can offer support to one another.

Establishing the right support system can be a good way to help manage Schizophrenic patients. Support circle may include family members, friends, or members of the mental health community, including support groups. In order to let people help her, they will need to know as much as they can about how her feelings and what specific things they can do to help you from day to day. Avoid disturbances in family functioning which can provide additional risk factors.

The family should understand that persons with schizophrenia should not be locked away from the society and is not needed to be institutionalized.

The goal is to reverse negative use of the feature, improve self- image and help client gain competence and self mastery. The nurse can help client to find a therapies through mental health centers in specific communities.
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Community

Encourage the community to provide support to people with the condition as the client. Client can receive support and encouragement from others who struggle with depression, and family members can offer support to one another.

The goal is to reverse negative use of the feature, improve self- image and help client gain competence and self mastery. The nurse can help client to find a therapies through mental health centers in specific communities.

Most patients are treated in the community with antidepressant medication, and some receive psychotherapy or counseling. Hospitalization may be necessary in cases with associated self-neglect or a significant risk of harm to self or, rarely, others.

The community people should understand the person who has the illness and not to discriminate them.

The community should understand that schizophrenic persons should not be locked away from the society and is not needed to be institutionalized.
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