PARENTAL ROLE CONFLICT
Parent experience of role confusion and conﬂict in response to crisis
• Disruption in care-taking routines
• Expressed concern about changes in parental role and family func-
tioning, communication, and health
• Expressions of inadequacy to provide for child’s needs
• Expressed loss of control over decisions relating to child
• Expressed or demonstrated feelings of guilt, anger, fear, anxiety,
and frustration about the effect of the child’s illness on family
• Reluctance to participate in usual caregiving activities, even with
• Change in marital status
• Intimidations with invasive
• Home care of a child with
• Intimidation with restrictive
• Interruptions of family life due
to home care regimen
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
The parents will
• Communicate feelings about present situation.
• Participate in their child’s daily care.
• Express feelings of greater control and ability to contribute more
to the child’s well-being.
• Express knowledge of child’s developmental needs.
• Hold, touch, and convey warmth and affection to child.
• Use available support systems or agencies to assist with coping.
SUGGESTED NOC OUTCOMES
Caregiver Adaptation to Patient Institutionalization; Caregiver Care
Readiness; Coping: Family
INTERVENTIONS AND RATIONALES
Determine: Assess the child’s special needs; age and maturity of par-
ents; roles within the family; available support systems for parents;
parent–child relationship; and presence of conﬂict between family’s
lifestyle and child’s needs. Assessment information will be useful in
establishing appropriate interventions.
Perform: Make changes in the environment with child-friendly
pictures, and so forth, to foster enhanced communication between
parents and child.
Provide family-centered care by involving the parents in the child’s
care. Parents are responsible for decisions about the child’s care.
Inform: Provide information on informed consent because parents
will be making decisions for child’s care.
Teach parents about normal growth and development and advocate
that they provide as much normalcy for the child with special needs as
possible. Treating them differently will retard progress in socialization.
Teach patient and caregiver the skills necessary to manage care
adequately. Teaching will encourage compliance and adjustment to
Teach parents how to ﬁnd areas in ADLs in which it is possible to
maintain control in order to avoid feelings of powerless.
Teach parents to assist child with self-care activities in a way
that maximizes the child’s potential. This enables caregivers to
participate in child’s care while supporting child’s independence.
Attend: Encourage visit by friends to promote socialization.
Encourage parents to pay attention to needs of siblings at home,
and to discuss with siblings their feelings about having a sister or
brother with special needs. The goal is to have siblings be support-
ive but feel important in their own rites.
Provide respite care to promote emotional well-being of parents.
Encourage patents to spend time away from child to enhance their
Manage: Act as a liaison between family and multidisciplinary health-
care team to provide support to the patients as they reach out for
Refer parents to home care agencies and ensure that an appropri-
ate assessment is done to encourage long-term support.
Refer parents to a mental health specialist to enable support for the
family members as they continue coping with the child’s special needs.
Arrange for parents to meet with parents who are coping
positively with the same kinds of issues. Peer support will help par-
ents cope with their child’s issues.
SUGGESTED NIC INTERVENTIONS
Family Process Maintenance; Limit Setting; Mutual Goal-Setting;
Parenting Promotion; Role Enhancement
Secco, M. Loretta, et al. (2006). Factors affecting parenting stress among bio-
logically vulnerable toddlers. Issues in Comprehensive Pediatric Nursing,