A program for water-intoxicated patients at a state hospital

Area of Science:

• Psychiatric Nursing
• Internal Medicine
• Clinical Psychology

Background:

• Water balance is crucial for health; imbalances can lead to severe conditions like self-induced water intoxication and psychosis.
• Untreated water intoxication can cause serious complications, including renal failure, heart failure, seizures, coma, and death.
• Managing water intoxication poses a significant challenge for psychiatric nurses.

Purpose of the Study:

• To evaluate a specialized program for chronically ill patients suffering from water intoxication.
• To assess the effectiveness of a control, monitoring, and psychoeducational group approach in managing this condition.

Main Methods:

• A cohort of nine chronically ill patients participated in a 3-month program.
• The program incorporated controlled fluid intake, monitoring, and a psychoeducational group approach within a closed psychiatric unit.
• Data collected included serum electrolytes, serum osmolality, urine specific gravity, anxiety symptoms, psychotic behavior, and restraint usage.

Main Results:

• After 3 months, patients showed normalized serum electrolytes, serum osmolality, and urine specific gravity.
• Significant reductions in anxiety symptoms (restlessness, pacing, demanding behavior) and stabilization of psychotic behavior were observed.
• The use of physical restraints decreased dramatically, from 1303 hours in the preceding 3 months to 20 hours and 55 minutes for the nine patients.

Conclusions:

• The implemented psychoeducational group program is effective in managing self-induced water intoxication in chronically ill patients.
• The program successfully improved physiological parameters, reduced psychological distress, and decreased the need for physical restraints.
• This approach offers a viable nursing intervention for addressing water intoxication in psychiatric settings.