Nursing diagnosis – DISABLED FAMILY COPING

DISABLED  FAMILY  COPING

DEFINITION

Behavior of significant person (family members or other primary per-

son) that disables his or her capabilities and the patient’s capabilities

to effectively address tasks essential to either person’s adaptation to

the health challenge

DEFINING CHARACTERISTICS

• Intolerance

• Distortion of reality regarding

• Agitation, depression, aggres-

patient

sion, hostility

• Impaired restructuring of a

• Taking on illness of patient

meaningful life

• Rejection

RELATED FACTORS

• Arbitrary handling of family’s

• Significant person with chroni-

resistance to treatment

cally unexpressed feelings (e.g.,

• Dissonant coping styles among

guilt, anxiety, hostility,

significant people

despair)

• Basic breast-feeding knowledge

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Communication

• Knowledge

• Coping

• Values and beliefs

EXPECTED OUTCOMES

To the extent possible, family members will participate in aspects of

patient’s care without evidence of increased conflict.

The patient will

• Express confidence in his or ability to make decisions despite pres-

sure from family members.

• Contact appropriate sources of support outside the family.

• Take steps to ensure that care needs are met despite family’s short-

comings.

• Express greater understanding of emotional limitations of family

members.

SUGGESTED NOC OUTCOMES

Caregiver Emotional Health; Caregiver–Patient Relationship; Care-

giving Endurance Potential; Family Coping

INTERVENTIONS AND RATIONALES

Determine: Assess effects of patient’s disease on ability of family to

cope to identify strengths and weaknesses in patient’s patterns of

coping.

Describe role relationships in the family. Evaluate changes that

occur in family relationships during the course of the patient’s hos-

pitalization. This information will be helpful in making a plan.

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Have patient identify support systems outside the family to encour-

age responsibility for knowing what support systems are helpful.

Perform: Engage family in assisting with physical aspects of patient

care. Family members should have an opportunity to overcome dys-

functional behavior.

Develop short- and long-term goals with both patient and family.
Problems associated with coping may will require long-term plan-

ning to resolve.

Inform: Teach patient strategies to discuss, to confront in a positive

way that will help cope with the present situation. Role-play coping

strategies with the patient to reinforce new adaptive behaviors.

Educate family members about resources in the community that

can assist them with the patient after hospitalization.

Teach patient decision-making skills and assist him or her to prac-

tice with simple decisions. Beginning with simple decisions will

begin helping the patient lay out options before deciding.

Attend: Maintain objectivity when dealing with family conflicts. Do

not become embroiled in the dynamics of a dysfunctional family in

order to maintain objectivity and effectiveness.

Focus on being a patient advocate. Reaffirm patient’s right to

make decisions without interference from family members. Encour-

age patient to seek help family cannot provide by participating in

support group.

Help patient select a support group that best meets personal

needs. Participation in a support group may improve the patient’s

ability to cope as well as provide meaningful relationships.

Listen attentively to patient’s expression of pain over unresolved

conflicts with family members. The patient may have to grieve over

the fact that he or she does not have an “ideal” family, capable of

meeting his emotional needs. Therapeutic listening helps patient to

understand himself and his family better and to understand how

conflicts from the past affect his behavior.

Manage: Refer patient to a home health agency, homemaker service,

meals-on-wheels, or other appropriate community services for assis-

tance and follow-up. Use of various community services may help

make up the family’s shortcomings in coping.

SUGGESTED NIC INTERVENTIONS

Anger Control Assistance; Caregiver Support; Family Involvement

Promotion; Family Mobilization; Family Support

Reference

Andershed, B. (2006, September). Relatives in end-of-life care, Part 1: A sys-

tematic review of the literature the last five years, January, 1999–February,
2004. Journal of Clinical Nursing, 15(9), 1158–1169.

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