The most appropriate nursing action for a depressed patient who does not want to join a group is to:

AIIMS Delhi NO - 2018

Mental Health Nursing

Medium

Appeared in: AIIMS Delhi NO - 2018

Explanation

This action acknowledges the patient's lack of energy and motivation (avolition), which are core symptoms of depression.
Offering direct, hands-on assistance is a supportive and non-demanding way to help the patient initiate an activity.
It fosters a therapeutic relationship by showing empathy and a willingness to partner with the patient in their recovery.
This approach gently encourages participation in the therapeutic milieu, which is crucial for combating social withdrawal.

Option A: This approach is authoritarian and focuses on rules rather than the patient's therapeutic needs. It can induce feelings of shame and is not a therapeutic way to communicate.
Option B: This is a threat and is considered a punitive, non-therapeutic response. It can increase feelings of worthlessness and damage the nurse-patient relationship.
Option D: This option is overly permissive and reinforces the patient's social withdrawal and anergia. Allowing a depressed patient to remain isolated can worsen their symptoms.

Clinical Relevance

Nursing practice connection: Use the key finding related to Therapeutic nursing interventions for a patient with depression to guide bedside assessment, documentation, and the next nursing action.
A key nursing role in mental health is to actively help patients overcome the inertia of their illness. For depression, this means providing the initial energy and support to engage in therapeutic activities.
The nurse must balance empathy for the patient's feelings with the therapeutic need for activation and social engagement.
What if the patient still refuses after the nurse offers assistance? The nurse should then sit with the patient for a few moments, acknowledge their feelings without judgment (e.g., "I understand it feels very difficult to get up right now"), and state they will be back in a short while to check on them. This maintains the therapeutic connection without a power struggle.

How to Approach the Question

First, identify the patient's diagnosis (depression) and the key symptom described (unwillingness to participate, suggesting avolition and anergia).
Next, evaluate each option based on established principles of therapeutic communication and nursing care for depression.
Eliminate options that are punitive, coercive, or authoritarian (e.g., stating rules, making threats).
Eliminate options that are overly permissive and reinforce the negative symptoms of the illness (e.g., allowing isolation).
Select the option that is supportive, empathetic, and actively helps the patient overcome a symptom of their illness in a non-confrontational way.

Concept Tested & Keywords

Concept Tested: Therapeutic nursing interventions for a patient with depression.
Stem keywords: depressed patient, nursing action, does not want to join a group
Lead-in keywords: most appropriate
Negative lead-in flag: false

Q1lQkw0XB7WC8cTJi6R6WA

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 218-220

E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 157-159