精神科看護英語：必須語彙とフレーズ

"mental state examination"

A structured clinical assessment of a patient's current psychological functioning covering appearance, behaviour, speech, mood, affect, thought, perception, cognition, and insight

"The admitting nurse completed a mental state examination and documented that the patient appeared dishevelled, was speaking rapidly, and expressed grandiose beliefs."

"presenting complaint"

The primary problem or set of symptoms that has prompted the patient to seek or be referred for psychiatric care, recorded in the patient's own words where possible

"The presenting complaint was low mood and inability to leave the house for the past three weeks, which the patient described as feeling completely numb."

"psychiatric history"

A comprehensive account of a patient's previous mental health episodes, diagnoses, treatments, hospitalisations, and responses to past interventions

"Taking a thorough psychiatric history revealed two previous depressive episodes requiring inpatient admission and a prior trial of antidepressant medication."

"risk assessment"

A systematic evaluation of the likelihood and nature of harm a patient may cause to themselves or others, informing the level of observation and care required

"Following disclosure of suicidal ideation, the nurse completed a formal risk assessment and escalated findings to the on-call psychiatrist for an urgent review."

"insight"

A patient's awareness and understanding of their own mental illness, including recognition that they have a condition and that their symptoms require treatment

"The nurse documented limited insight after the patient denied having any mental health problems and refused to acknowledge that their beliefs might be delusional."

"collateral history"

Information gathered from sources other than the patient, such as family members, carers, or previous medical records, used to supplement or verify the patient's account

"Collateral history from the patient's partner confirmed that the mood change had developed over six weeks and was preceded by a significant reduction in sleep."

"affect"

The observable external expression of a patient's emotional state as seen by the clinician, which may be described as flat, blunted, labile, anxious, or congruent with mood

"The nurse described affect as flat and incongruent with the patient's reported mood, noting the absence of facial expression throughout the assessment interview."

"thought disorder"

A disturbance in the form or process of thinking, characterised by disorganised, incoherent, or illogical speech patterns such as loose associations or flight of ideas

"Marked thought disorder was evident during the interview, with the patient moving rapidly between unrelated topics and being unable to answer direct questions coherently."

"hallucination"

A perception experienced without an external stimulus, occurring in any sensory modality; auditory hallucinations such as hearing voices are the most common in psychosis

"The patient reported auditory hallucinations in the form of two voices discussing her in the third person, which she heard as clearly as real speech."

"delusion"

A fixed, false belief that is firmly held despite clear evidence to the contrary and is not consistent with the person's cultural or religious background

"A persecutory delusion was documented after the patient expressed an unshakeable belief that neighbours were installing cameras throughout his home to monitor him."

"positive symptoms"

Features of psychosis that represent an addition to normal mental functioning, including hallucinations, delusions, and disorganised thinking and behaviour

"Antipsychotic medication was commenced after the patient presented with positive symptoms including command hallucinations and paranoid delusions that had persisted for four weeks."

"negative symptoms"

Features of schizophrenia representing a reduction or absence of normal functions, including flat affect, poverty of speech, avolition, and social withdrawal

"Despite resolution of acute positive symptoms, the patient's quality of life remained poor due to prominent negative symptoms including marked avolition and social withdrawal."

"first-episode psychosis"

The first documented presentation of psychotic symptoms in an individual, representing a critical window for early intervention to improve long-term outcomes

"The early intervention team was contacted following confirmation of first-episode psychosis, and the patient was offered a package of care including CBT and family psychoeducation."

"antipsychotic medication"

A class of psychiatric drugs used to treat psychosis by primarily blocking dopamine receptors; divided into first-generation (typical) and second-generation (atypical) agents

"The psychiatrist prescribed atypical antipsychotic medication and asked the nurse to monitor the patient's weight and metabolic parameters at regular intervals."

"depot injection"

A slow-release intramuscular formulation of antipsychotic medication administered every one to four weeks, used to improve medication adherence in patients with psychosis

"After several relapses attributed to non-adherence to oral medication, the patient agreed to trial a depot injection every two weeks administered by the community mental health nurse."

"command hallucinations"

Auditory hallucinations in which the patient hears voices that instruct them to carry out specific actions, which may include self-harm or harm to others

"The nursing risk assessment identified command hallucinations telling the patient to harm themselves, prompting an immediate increase to one-to-one observation."

"suicidal ideation"

Thoughts about ending one's own life, ranging from passive wishes to die to active plans with intent; the nature, frequency, and intensity must be carefully assessed

"The patient disclosed suicidal ideation with a specific plan and had already researched methods, which prompted immediate transfer to a place of safety and psychiatric review."

"manic episode"

A distinct period of abnormally elevated, expansive, or irritable mood lasting at least one week, accompanied by increased energy, reduced sleep, and impulsive behaviour

"The patient was admitted during a manic episode after going three days without sleep, spending large amounts of money, and sending hundreds of messages to strangers online."

"depressive episode"

A period of persistent low mood, loss of interest or pleasure, and associated physical and psychological symptoms lasting at least two weeks and causing significant impairment

"The severity of the depressive episode was established using the PHQ-9 questionnaire, which indicated a score consistent with severe depression requiring inpatient care."

"mood stabiliser"

A medication used to prevent and treat the extreme mood swings of bipolar disorder; common agents include lithium, valproate, and lamotrigine

"Lithium was commenced as a mood stabiliser, and the nurse educated the patient about the importance of maintaining adequate fluid intake and attending regular blood level monitoring."

"anhedonia"

The inability to feel pleasure or interest in activities that were previously enjoyable, a core symptom of depressive episodes and a key marker of treatment response

"The patient reported complete anhedonia, stating that hobbies she had previously loved, including painting and gardening, now held no appeal whatsoever."

"psychomotor retardation"

A slowing of physical movement, speech, and thought processes observable during a depressive episode, reflecting the neurobiological impact of severe depression

"Psychomotor retardation was evident during the nursing assessment, with the patient speaking slowly, taking long pauses before answering, and moving with visible effort."

"electroconvulsive therapy"

A medical procedure in which electrical stimulation of the brain under general anaesthesia is used to treat severe, treatment-resistant depression and other mental health conditions

"After two antidepressant trials had failed, the multidisciplinary team recommended a course of electroconvulsive therapy, and the nurse was involved in obtaining informed consent and providing pre-procedure education."

"euthymia"

A stable, normal mood state that is neither depressed nor elevated, representing the goal of treatment for patients with bipolar disorder

"The patient had maintained euthymia for eight months on the current medication regimen and was beginning a graduated return to work programme supported by the occupational therapist."

"level of observation"

The frequency and closeness with which a patient is monitored by nursing staff, ranging from general ward observation to continuous one-to-one engagement

"Following the disclosure of a specific suicide plan, the nurse escalated the patient's level of observation to continuous one-to-one and documented the rationale in the care notes."

"self-harm"

Deliberate injury to one's own body, often used as a coping mechanism for emotional distress rather than a direct attempt to end life, though it increases suicide risk

"The patient disclosed a history of self-harm by cutting and was offered a safety plan, wound care, and a referral to the dialectical behaviour therapy programme."

"risk formulation"

A clinical summary that analyses the factors increasing and decreasing a patient's risk, providing a holistic framework to guide risk management decisions rather than relying on scoring alone

"The multidisciplinary team reviewed the risk formulation at the ward round and agreed that protective factors including family support and help-seeking behaviour reduced the immediate risk level."

"safety plan"

A collaboratively developed written document outlining warning signs, coping strategies, support contacts, and means restriction steps that a patient can use to manage a crisis

"The community psychiatric nurse worked with the patient to develop a detailed safety plan before discharge, including emergency contact numbers and a plan to remove means of self-harm from the home."

"detained patient"

A patient held in a psychiatric facility under the authority of mental health legislation and who cannot be discharged or leave the ward without authorisation

"As a detained patient under section 3 of the Mental Health Act, the ward manager explained the patient's rights, including the right to appeal to the Mental Health Tribunal."

"de-escalation"

A set of verbal and non-verbal communication techniques used by nursing staff to calm an agitated or potentially violent patient and reduce the risk of harm without physical intervention

"The nurse used de-escalation techniques, including a calm tone, open body language, and active listening, to help the patient express their distress and agree to take their prescribed medication."

"ligature risk"

The potential for a patient to use an anchor point and a length of material to attempt hanging or strangulation; a key environmental risk factor in inpatient mental health settings

"The environmental risk assessment identified several ligature risks in the bathroom and the nurse manager requested urgent maintenance review and interim enhanced observation."

"capacity assessment"

A clinical evaluation of whether a patient has the cognitive ability to understand, retain, weigh up, and communicate information required to make a specific decision about their treatment

"The nurse raised concerns about the patient's ability to consent to discharge and requested a formal capacity assessment, which concluded that capacity was lacking due to active psychosis."

"emotionally unstable personality disorder"

A personality disorder characterised by intense emotional instability, impulsivity, unstable relationships, and a fear of abandonment; also known as borderline personality disorder

"The nursing care plan for the patient with emotionally unstable personality disorder incorporated DBT skills coaching and a structured approach to managing interpersonal crises on the ward."

"dialectical behaviour therapy"

A structured psychological treatment developed for borderline personality disorder that combines cognitive-behavioural techniques with acceptance strategies and mindfulness skills

"The nurse co-facilitated the weekly dialectical behaviour therapy skills group, focusing that session on distress tolerance techniques for managing crisis urges without self-harm."

"splitting"

A psychological defence mechanism common in personality disorders in which a person perceives others as entirely good or entirely bad, often causing conflict within the nursing team

"The ward team recognised splitting behaviour when the patient praised some staff as wonderfully caring while describing others as cruel and incompetent, and a consistent staff approach was agreed."

"therapeutic boundaries"

The professional limits that define the appropriate nurse-patient relationship and protect both parties from exploitation, dependency, or role confusion

"The clinical supervisor addressed a concern that the nurse was disclosing personal information during sessions, emphasising the importance of maintaining clear therapeutic boundaries at all times."

"anorexia nervosa"

An eating disorder characterised by severe restriction of food intake, intense fear of weight gain, and a distorted body image, leading to significant medical complications

"The patient with anorexia nervosa was admitted with a BMI of 13.2 and required nasogastric feeding after refusing oral nutrition; the nurse monitored for refeeding syndrome throughout."

"refeeding syndrome"

A potentially fatal shift in fluids and electrolytes, particularly phosphate, that can occur when nutrition is reintroduced too rapidly in severely malnourished patients

"Serum phosphate levels were monitored twice daily during the refeeding phase, and the dietitian was alerted immediately when levels fell below 0.5 mmol/L."

"body image distortion"

A perceptual disturbance in which a person perceives their body size or shape as significantly different from their actual appearance, a central feature of anorexia nervosa

"Despite reaching a healthy weight, the patient continued to describe herself as overweight; the nurse acknowledged body image distortion as a therapeutic target requiring psychological treatment."

"trauma-informed care"

An approach to nursing that recognises the widespread impact of trauma, integrates knowledge of trauma into practice, and avoids re-traumatisation through respectful, empowering interactions

"The unit adopted trauma-informed care principles following a review, training staff to ask routinely about trauma history and to minimise coercive practices that can replicate abusive experiences."

"therapeutic relationship"

A purposeful, professional connection between nurse and patient built on trust, empathy, and respect, which forms the foundation of effective mental health nursing care

"The named nurse spent time each shift building the therapeutic relationship, which eventually enabled the patient to disclose the traumatic events that had triggered the current admission."

"active listening"

A communication skill involving full attention, non-verbal engagement, reflection, and clarification to demonstrate understanding and encourage the patient to share their experience

"By using active listening during the one-to-one session, the nurse helped the patient feel genuinely heard and supported, leading to a reduction in the patient's reported distress."

"recovery-oriented care"

An approach to mental health nursing that prioritises the patient's own goals, strengths, and self-defined wellbeing rather than focusing solely on symptom elimination

"The care plan was revised using a recovery-oriented care framework, incorporating the patient's own goals of returning to volunteering and rebuilding friendships as central outcomes."

"psychoeducation"

Structured information provided to patients and their families about a mental health condition, its treatment options, and self-management strategies to support understanding and adherence

"The nurse delivered psychoeducation about bipolar disorder in a group format, explaining the importance of sleep hygiene, recognising early warning signs, and maintaining regular medication."

"motivational interviewing"

A collaborative, person-centred counselling approach designed to strengthen a patient's own motivation and commitment to change by exploring and resolving ambivalence

"Using motivational interviewing, the nurse explored the patient's mixed feelings about stopping alcohol use without advising or confronting, which led to the patient deciding to attempt a supervised detoxification."

"care programme approach"

A framework used in mental health services to coordinate the assessment, care planning, and review of people with complex mental health needs across different agencies

"The patient's care programme approach review brought together the community psychiatric nurse, social worker, and psychiatrist to update the care plan and discuss the patient's housing situation."

"clinical supervision"

A regular, structured professional relationship in which a more experienced practitioner supports a nurse in reflecting on practice, managing emotional demands, and maintaining clinical standards

"The newly qualified nurse discussed her distress following a patient's suicide attempt in clinical supervision, which helped her process the experience and identify areas for further professional development."

"handover"

The structured verbal and written communication between nursing teams at shift change, conveying essential information about each patient's condition, behaviour, and care needs

"During handover the departing nurse highlighted that three patients required enhanced monitoring overnight and summarised changes in medication, risk levels, and planned interventions for the incoming team."