FUZZY TAKAGI-SUGENO-KANG FOR MENTAL HEALTH CONSULTATION RECOMMENDATIONS

The condition of students experiencing trauma makes consultation a necessity, there is no mental health examination that can be accessed by students, parents, psychologists, student affairs using the fuzzy Takagi-Sugeno-Kang method so it is necessary to be able to create a recommendation system for student mental health consultations by using fuzzy Takagi-Sugeno-Kang. In accordance with the case given, each student with a neurosis score of 8, psychoactive substances 11, psychotic 10 and post stress trauma disorder 13 had a mental health symptom level of 24.28, meaning they were at a moderate level. With a mental health recommendation system, it can be handled earlier so that learning activities can run according to the desired achievements.

Emergency Department Re-Presentations Following Intentional Self-Harm

<p>Repeat intentional self-harm (ISH) episodes are strongly correlated to suicide. Intentional self-harm for this thesis includes suicide attempts, deliberate self-harm and suicidal ideation. The aim was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Descriptive and inferential analyses were undertaken using the Statistical Programme for Social Science (SPSS). Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present ED with intentional self-harm. Such care needs to be provided in a safe way with the intent on reducing the distress experienced by people who intentionally self-harm.</p>

Emergency Department Re-Presentations Following Intentional Self-Harm

<p>Repeat intentional self-harm (ISH) episodes are strongly correlated to suicide. Intentional self-harm for this thesis includes suicide attempts, deliberate self-harm and suicidal ideation. The aim was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Descriptive and inferential analyses were undertaken using the Statistical Programme for Social Science (SPSS). Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present ED with intentional self-harm. Such care needs to be provided in a safe way with the intent on reducing the distress experienced by people who intentionally self-harm.</p>

Caring for People with Mental Health Problems Who Present at the Emergency Department: a Nurse Educator's Journey

<p><b>The New Zealand Emergency Department (ED) nurse is faced daily with the challenge of caring for patients of all ages with a wide variety of presenting complaints. Courses are available for ED specialty work such as trauma and paediatric assessment. However, as this thesis argues, it is difficult to access updated and ongoing education in relation to caring for people with mental health problems who present to the Emergency Department. In addition to this education deficit are the challenges of providing care in an overcrowded ED environment. Such factors contribute to a perceived lack of confidence and sometimes ambivalence or frustration on the part of nursing staff in caring for this group. This may result in an inconsistent standard of care for the the person with a mental health problem unless such issues are addressed.</b></p> <p>The aim of this research paper was to explore the education needs of ED nurses when caring for people with mental health problems. A literature review was undertaken to investigate the broad education strategies available to overcome these challenges. Diverse approaches were identified such as workshops, clinical guidelines, and mental health consultation-liaison roles. Research was also identified that examined ED nursing attitudes and their learning needs in relation to mental health.</p> <p>This paper concludes with a discussion of recommendations for the New Zealand setting with the intention of developing a more confident and competent nursing workforce, who are better prepared to care for the person with a mental health problem.</p>

Caring for People with Mental Health Problems Who Present at the Emergency Department: a Nurse Educator's Journey

<p><b>The New Zealand Emergency Department (ED) nurse is faced daily with the challenge of caring for patients of all ages with a wide variety of presenting complaints. Courses are available for ED specialty work such as trauma and paediatric assessment. However, as this thesis argues, it is difficult to access updated and ongoing education in relation to caring for people with mental health problems who present to the Emergency Department. In addition to this education deficit are the challenges of providing care in an overcrowded ED environment. Such factors contribute to a perceived lack of confidence and sometimes ambivalence or frustration on the part of nursing staff in caring for this group. This may result in an inconsistent standard of care for the the person with a mental health problem unless such issues are addressed.</b></p> <p>The aim of this research paper was to explore the education needs of ED nurses when caring for people with mental health problems. A literature review was undertaken to investigate the broad education strategies available to overcome these challenges. Diverse approaches were identified such as workshops, clinical guidelines, and mental health consultation-liaison roles. Research was also identified that examined ED nursing attitudes and their learning needs in relation to mental health.</p> <p>This paper concludes with a discussion of recommendations for the New Zealand setting with the intention of developing a more confident and competent nursing workforce, who are better prepared to care for the person with a mental health problem.</p>