Somatic Symptom Disorder (SSD), previously known as somatoform disorder, is a mental illness that causes unexplained physical symptoms such as pain that are distressing or disrupt the client’s normal functioning. When no physical cause for their symptoms can be found,clients often become upset and experience even more symptoms, or the symptoms may change. While there may be no explanation for the symptoms, the distress that the client feels is very real. These are the conditions that make up SSD:
The diagnosis is made based on the amount of distress the client experiences.
Client’s pain will be managed;client will have optimal control of recognizing and managing symptoms related to psychological factors;client will have improved independence and functioning of daily activities
Perform complete nursing assessment with vital signs
Get baseline information and determine if there is a physical or explained cause of symptoms.
Perform neurological assessment daily or per facility protocol
Determine if client is having other neurological symptoms that may help determine treatment options.
Assess if client is having suicidal or homicidal ideations or potential substance abuse
Maintain client’s safety and the safety of others
Assess pain per appropriate scale
Pain is subjective and must be managed according to what the client feels and reports.
Provide accommodation for client and make them more comfortable (ie., pillows, temperature, positioning, etc.)
This can help client feel accepted and develop rapport and trust. This can allow the client to feel more comfortable and express their feelings and emotions more readily to the healthcare team.
Encourage behavior modification such as praising client and offering more attention when symptoms improve
Change the focus from what’s wrong to what’s right. Helps client feel accomplished and more positive about improvements in health condition instead of focusing on the symptoms.
Provide teaching and demonstrations of relaxation techniques including progressive muscle relaxation and deep breathing exercises
This can help relieve acute pain and distress that the client may feel, but also helps them learn to control many symptoms through focus and calming the mind.
Provide education about feared or actual medical condition
Helps client understand the condition in a more realistic light and helps alleviate fear and anxiety about a particular health concern.
Administer medications and decrease dosage as appropriate
Perceived pain and symptoms are to be treated appropriately, but as circumstance allows, decrease medication and continue offering praise for improvement of symptoms to encourage continuing positivity.
Discuss symptoms with client and when they began, what makes them better or worse and how they have been managing these symptoms
This helps make a more definitive diagnosis and help determine how to best treat client. Helping the client determine the etiology of symptoms helps them to recognize and avoid situations that make symptoms worse.
Encourage client to keep a journal of symptoms and the events or factors that lead up to the development of symptoms and their resolution
This is a technique of cognitive behavior therapy that helps the client understand what factors (usually stress) that prompt the onset of symptoms. It can also help the client determine a pattern of emotions surrounding the symptoms.
Encourage client to involve family members in their care.
Discuss signs and symptoms and what triggers those symptoms
Help the family to be aware and understand the reality of the client’s condition. This can be helpful in long-term management if client’s family is willing to provide realistic feedback and support.
For more information, visit www.nrsng.com/cornell
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