PIECESS Psychiatric Home Care Model
The PIECESS program has seven components, says Verna Carson, PhD, RN, CSP, national director of behavioral health for Staff Builders in Lake Success, NY. They are:
P = Physical. Patients receive comprehensive assessments to identify psychiatric as well as other medical conditions.
I = Interpersonal. Many patients experience significant interpersonal difficulties. They may exhibit behaviors that are distressing to others and alienate them from interpersonal contacts.
E = Emotional. Psychiatric patients frequently experience difficulty in identifying and dealing with feelings. Many psychiatric patients have experienced rejection by society and feel unworthy and unloved. The psychiatric nurse focuses on appropriate expression of feelings as well as improving self-esteem.
C = Communication. Impaired communication is a symptom of many major psychiatric illnesses. Not only is person-to-person communication impaired but also internal communication. The experience of hallucinations is one example of disordered internal communication that greatly impacts the functioning of psychiatric patients.
E = Education. Patients and their families frequently lack essential information about such issues as medications and management of illness. Nurses use standardized teaching tools to provide patients and families with knowledge to take charge of their own health.
S = Social. Patients are socially isolated because of the many misconceptions that permeate American society regarding psychiatric illness. Patients have limited access to social supports that most Americans take for granted. Psychiatric home care providers help patients build or rebuild a social support system.
S = Spiritual. Psychiatric disorders can lead to complete fragmentation and disorganization. Patients frequently draw support from spiritual and religious beliefs. Psychiatric home care providers support a healthy spirituality, and when it is absent, encourage its development.
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