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REFLECTIVE CRITICAL ANALYSIS FOR CARING FOR A DEMENTIA PATIENT

 

Reflective Critical Analysis Instructions

The purpose of an RCA is to provide an in-depth exploration of your experience, and to demonstrate your professional growth, and ability to integrate evidence into practice.

  • Experience: Dementia/ Schizophrenia patient attended in the past (First year)
  • Relate with mental health understanding

RCA should be 4-5 pages

 

INTRODUCTION

Clear identification of the concepts, experience, or central idea(s) that will be discussed in the paper

 

BODY

Description of the Experience

  • Clear and concise explanation of the experience.

 

Analysis of the Experience

  • Outcomes, rationale, and impact upon own/others’ behaviours and reactions questioned
  • Nursing literature, community health literature, RNAO best practice guidelines, CNO standards, and/or ways of knowing are incorporated – at least three references (one of which is a research article)

Ways of Knowing

Cue: How has this experience changed my ways of knowing?

  • Empirical – scientific
  • Ethical – moral knowledge
  • Personal – self-awareness and connection through life experience
  • Aesthetics – the art of what we do
  • Emancipatory – advocacy, awareness of injustice

 

  • Each idea links back to the central concepts, idea or experience introduced in the introduction.

 

Personal Areas for Development

  • Personal areas for development explored (Knowing how to help/treat mental health clients/patients)
  • Solid understanding of new knowledge demonstrated – Knowledge about mental health
  • Questions for future exploration proposed, if appropriate

 

CONCLUSION

  • Main points discussed throughout the body of paper summarized

 

 

Note

 

STRUCTURE AND FORMAT

  • Proper use of language and grammar
  • Well-organized and logical flow of ideas
  • Clear transitions between paragraphs
  • Proper use of APA 7 format and TURNITIN utilized

 

***Required documents

RNAOComponents of a Mental Status Assessment

Appearance

  • Age (chronological age and whether person looks this age)
  • Sex, Race
  • Body build (thin, obese, athletic, medium)
  • Position (lying, sitting, standing, kneeling)
  • Posture (rigid, slumped, slouched, comfortable, threatening)
  • Eye contact (eyes closed, good contact, avoids contact, stares)
  • Dress (what individual is wearing, cleanliness, condition of clothes, neatness, appropriateness of garments)
  • Grooming (malodorous, unkempt, dirty, unshaven, overly meticulous, hairstyle, disheveled, makeup)
  • Manner (cooperative, guarded, pleasant, suspicious, glib, angry, seductive, ingratiating, evasive, friendly, hostile)
  • Attentiveness to examiner (disinterested, bored, internally preoccupied, distractible, attentive)
  • Distinguishing features (scars, tattoos, bandages, bloodstains, missing teeth, tobacco-stained fingers)
  • Prominent physical irregularity (missing limb, jaundice, profuse sweating, goiter, wheezing, coughing)
  • Emotional facial expression (crying, calm, perplexed, stressed, tense, screaming, tremulous, furrowed brow)
  • Alertness (alert, drowsy, stupor, confused)

Motor/Behaviour

  • Retardation (slowed movements)
  • Agitation (unable to sit still, wringing hands, rocking, picking at skin or clothing, pacing, excessive movement, compulsive)
  • Unusual movements (tremor, lip smacking, tongue thrust, mannerisms, grimaces, tics)
  • Gait (shuffling, broad-based, limping, stumbling, hesitation)
  • Catatonia (stupor, excitement)

Speech

  • Rate (slowed, long pauses before answering questions, hesitant, rapid, pressured)
  • Rhythm (monotonous, stuttering)
  • Volume (loud, soft, whispered)
  • Amount (monosyllabic, hyper-talkative, mute)
  • Articulation (clear, mumbled, slurred)
  • Spontaneity

Mood/Affect

  • Stability (stable, fixed, labile)
  • Range (constricted, full)
  • Appropriateness (to content of speech and circumstance)
  • Intensity (flat, blunted, exaggerated)
  • Affect (depressed, sad, happy, euphoric, irritable, anxious, neutral, fearful, angry, pleasant)
  • Mood (reported by patient/client)

Thought Content

  • Suicidal or homicidal ideations (intent, plan, access to means, time-frame)
  • Depressive cognition (guilt, worthlessness, hopelessness)
  • Obsessions (persistent, unwanted, recurring thought)
  • Ruminations
  • Phobias (strong, persistent, fear of object or situation)
  • Ideas of reference
  • Paranoid ideation
  • Magical ideation
  • Delusions (false belief kept despite no supportive evidence)
  • Overvalued ideas
  • Thought broadcasting, insertion or withdrawal
  • Other major themes discussed by patient/client

Thought Process

  • Coherence (coherent, incoherent)
  • Logic (logical, illogical)
  • Stream (goal-directed, circumstantial, tangential [diverges suddenly from a train of thought], looseness of associations, flight of ideas, rambling, word salad)
  • Perseveration (pathological repetition of a sentence or word)
  • Neologism (use of new expressions, phrases, words)
  • Blocking (sudden cessation of flow of thinking and speech related to strong emotions)
  • Attention (distractibility, concentration)

Perception

  • Hallucinations (auditory [including command, running commentary], visual, olfactory [smelling], gustatory [taste], tactile)
  • Illusions (misinterpretation of actual external stimuli)
  • Depersonalization
  • Déjà vu, Jamais vu

Cognition

  • Orientation (time, person, place)
  • Memory (short-term, long-term)
  • Intellect
  • Abstract thought
  • Capacity to read and write
  • Level of consciousness

Insight/Judgement

  • Awareness of illness (insight)
  • Ability to make a decision wisely considering pros and cons for a course of action

See the attachment for CNO best practice