Electroconvulsive Theory

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For the purpose of this assignment the experience of attending Electro-Convulsive Therapy will be discussed. It will include rationale for the procedure, an account of the procedure and the student nurses reflection on the experience using Gibbs’ model of reflection (Jasper 2003). Electroconvulsive therapy (ECT) is a medical treatment for severe mental illness in which a small, carefully controlled amount of electricity is introduced into the brain. This electrical stimulation, used in conjunction with anaesthesia and muscle relaxant medications, produces a mild generalised seizure or convulsion (Mankad et al 2010).

The rationale for ECT is to provide relief from the signs and symptoms of mental illnesses such as severe depression, mania, and catatonic schizophrenia. ECT is indicated when patients need rapid improvement because they are suicidal, at risk of self-harm, refuse to eat or drink or are non compliant with prescribed medication. ECT will only be prescribed after adequate trials of other treatment options have proved to be ineffective or the condition is considered potentially life threatening (NICE 2010). A programme of ECT refers to no more than 12 treatments, prescribed by a consultant psychiatrist, following a psychiatric examination of the patient with a mental disorder for which use of ECT is indicated (Mental Health Commission 2009).

A programme of 6 ECT treatments was prescribed for an 82 year old client presenting with severe clinical depression. Depression refers to a wide range of mental health problems characterised by the absence of a positive affect, low mood and a range of associated emotional, cognitive, physical and behavioural symptoms (NICE 2009). Previously this lady had tried pharmacological inter...

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... Health Act 2001 Mental Health Commission, Dublin
• NICE (2009) Depression in Adults: the treatment and management of depression in adults. National Institute for Clinical Excellence, London
• NICE (2010) Guidance on the Use of ECT Technology Appraisal 59. National Institute for Clinical Excellence, London
• Onalaja, D., Sultana, M., Afghan, S. and Coupe, T. (2008) Improving ECT practice with a care pathway: hits and misses. International Journal of Psychiatry in Clinical Practice 12(3) pp. 235-237
• Payne, N.A. and Prudic, J. (2009) Electroconvulsive Therapy Part I : A Perspective on the Evolution and Current Practice of ECT Journal of Psychiatric Practice 15(5) pp.346-368
• Scott, A.I. (2005) The ECT Handbook 2nd edition The Royal College of Psychiatrists, London
• Tollefson, J. (2004) Clinical Psychomotor Skills 2nd edition Thomson Social Science Press, Melbourne

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