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ANP in mental health care
Patricia Lok
12 oktober 2017
in collaboration with obstetrichealth care
Accompanied by Nicole Snaphaan and Carlijn Beerepoot
Contains:
• Carrier and current job
• Rural context
• Regional context
• Our method
• Kind of health issues
• Role of nurse practitioner
Carrier and current job
The main road till now
Positions/ roles
• Nurse
• Mother
• Teacher
• Nurse practitioner
• Grandma
Educations (In dutch)• HBOV
• Docentenopleiding verpleegkunde
• PABO
• MANP
• CGT
Rural context
From question to answer
LKPZ – Answer to a need
Goals:
• Sharing knowledge
• Sharing expiriences
• Producing guidelines
• Same advices to clients
• Inform clients
www.lkpz.nl
Regional context
Various problems so various pathways
Nicole Snaphaan – Midwife and PA
Screening all pregnant women
• Questionaire: Mind2 care
• Used by…
• Kind of questions…
• Ment to: prevent a lackof care, selection, explane, guiding
Several pathways/ specialy POP
• Choise for a pathway(s) depends on kind of problem(s)
• If necessary in consultation / makingchoices
Our method
Collaboration and shared care
Two frontdoors
Verloskunde Psychiatrie
And a big in-between-door
For communication
• Consultation
• Collaboration
• Suggestions
• And so on
Kind of health issues
All psychiatric illnesses
in a special stage of live
and special circumstances
• Mood diseases: depression/ bipolar
• Anxiety diseases like panickdisease/ PTSD/ OCD)
• Psychotic diseases
• ADHD / autism
• Personality diseases
• Addiction
Already existed orsuddenly ocurring
Offer from obstetrics in POP care
• More time per cliënt
• More knowhow aboutpsychiatry
• Excellent skills in communication
• Possibility to offer case-management
• More continuity
• Knowing networkpartners
Offer from psychiatry
• Preconceptional advise
• Treatment and guidingduring pregnancy
• Treatment and guidingpostpartum
Treatment and guiding
Treatment:
Education
Support
Cognitive BehaviourTherapy
Mindfulness
Medication
Guiding:
Organize rest and help as well fromfamily as well professsional agencies
Promote rithm and structure
Balance activities and rest
Drawing partner/family into range
Preparing childbirth and postpartum / preventing overload
Eventually step in also other kinds of help to complete good care
Common themes
• Feelings of guild and failure• Thoughts as being a “bad
mother”• (Non-) acceptance of disease• Sleep disturbances• Own childhood• Preparing being a parent• Preparing pregnancy and
delivery• Preparing postpartum period• Breastfeeding• Perfection and adjustment• Worries about adhesion
Nurse practitioner psychiatryOverview
Centipede with knowledge, resolution and foresighted look
Building bridges
Between nursing and medicine
&
Between psychiatry and gynecology / obstetrics
&
Between in hospital and outdoor
Building bridges (1)
Between nursing and medicine
• From consultation to independence
• Wide view
• Upgrade and update your knowledge
• Common sense
• Dare to decide
• Growing trust
• Settle down old patterns in hierarchy
• Complement each other
Growing in a new role
Building bridges (2)
Between psychiatry and obstetrics
• Knowing the issues: literature and internship
• What do this woman need?
• How can we organize?
• Advocate needs to management
• How can we organize?
• Planning and implementation
• Sharing experiences/ consultation
• Evaluate and improve
Building bridges (3)
Between in hospital and outdoor
Collaboration:• Discuss• Referring (back)• Shared dissision making• Deviding tasks• Formulate observation goals• Organize good care• Home visit
Researches• Overzichtsartikel Tijdschrift voor Psychiatrie 57
(2015) 6, 415 - 423
• Angststoornissen tijdens de zwangerschap en post-partumperiode
• M. van der Veldt, P. Lok, M. Pop-Purceleanu, I. Tendolkar, P. van Eijndhoven
• Article in the Journal of Clinical Psychiatry 2017 Jul18. pii: 16r11083
• Infant-related harming intrusions in the postpartum period: a critical review
• Elke C Brok,* MD2, Patricia Lok, MSc1, Desiree B Oosterbaan, MD, PhD1, Aart H Schene, MD, PhD1,3, Indira Tendolkar, MD, PhD1,3, Philip F van Eijndhoven, MD, PhD1,3
Thanks for your attention
• Any questions?
• Also for my colleagues
Nicole Snaphaan
Carlijn Beerepoot