ACT directly and intensively provides nearly all treatment, rehabilitation, and support services, while case management offers a limited array of direct services delivered with less intensity than ACT programs. Nursing implications One of the first concerns for the nurse working with community-based chronically ill schizophrenic patients is to encourage compliance with medical regimens. 15 Health teaching is a critical component of the treatment plan. Schizophrenic patients tend to comply with their treatment programs best when they know enough about their medication. Active psychosis is likely for noncompliant patients, who may then neglect nutritional needs, exercise, sleep, rest, and other health promoting behaviors.
Patients often exhibit a self-care deficit.
To help patients care for themselves, remember that patient safety and comfort are nursing priorities. Also, encourage the patient to perform activities as independently as possible. Provide positive reinforcement for increments of independent accomplishments, and continually educate the patient about his or her medications. The final step of the nursing process is to evaluate the objective goals. It's essential to continually assess schizophrenic symptoms as well as suicidality and substance abuse, both of which are common in people with schizophrenia.