Subjective state in which an individual sees few or no available alter-
natives or personal choices available and is unable to mobilize energy
on own behalf
• Decreased appetite, affect, response to stimuli, verbalization
• Increased or decreased sleep
• Lack of involvement in self-care
• Nonverbal cues, such as closing eyes, shrugging in response to
question, and turning away from speaker
• Passivity and lack of initiative
• Lost belief in spiritual power
• Deteriorating physical
• Lost belief in transcendent
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
The patient will
• Identify feelings of hopelessness regarding present situation.
• Demonstrate more effective communication skills.
• Resume appropriate rest and activity pattern.
• Participate in self-care activities and decisions regarding care planning.
• Use diversional activities.
SUGGESTED NOC OUTCOMES
Acceptance: Health Status; Adaptation to Physical Disability;
Depression Control; Hope; Quality of Life
INTERVENTIONS AND RATIONALES
Determine: Assess the following: nature of current medical diagnosis;
patient’s knowledge about medical diagnosis; actual or perceived
self-care deﬁcits; mental status; communication patterns and support
systems; nutritional status and appetite; and sleep patterns. Also
monitor heart rate and blood pressure; respiratory rate, quality and
depth of respirations, and breath sounds. Assessment factors will
help identify appropriate interventions.
Perform: Follow medical regimen to manage the patient’s physiologic
condition. Build non–care-related time into the daily schedule to
allow time to develop a trusting relationship with the patient.
Provide comfort measures: adjust lighting and sound to minimize
irritating stimuli; offer back rubs and space procedures to promote
Inform: Keep patient informed about what to expect and when to
expect it. Accurate information reduces anxiety.
Teach self-healing techniques to both the patient and the family,
such as meditation, guided imagery, yoga, and prayer, to enhance
coping strategies. Teach patient how to incorporate the use of self-
healing techniques in carrying out usual daily activities.
Attend: Encourage patient to talk about personal assets and accom-
plishments and about improvements in his or her condition, no mat-
ter how small they may seem. Give positive feedback. Conversation
assists evaluation of patient’s self-concept and adaptive abilities.
Direct the patient’s focus beyond the present state. For example,
“Your nasogastric tube will come out tomorrow and you will feel
more comfortable.” This helps instill hope.
Encourage patient to talk about appropriate diversions and to
participate in them. Pleasurable activity decreases potential hazard
Manage: Refer patient and family to other professional caregivers,
for example, dietitian, social worker, clergy, mental health
professional, and support groups such as Ostomy Club, I Can Cope,
and Reach for Recovery. Assist patient to utilize appropriate
resources by contacting family and scheduling follow-up
appointments. These measures help give the patient a sense of direc-
tion and control over his or her future care.
SUGGESTED NIC INTERVENTIONS
Coping Enhancement; Decision-Making Support; Energy
Management; Mutual Goal Setting; Sleep Enhancement; Spiritual
Growth Facilitation; Support Group
Kronenwetter, C., et al. (2005, March–April). A qualitative analysis of inter-
views of men with early stage prostate cancer. Cancer Nursing, 28(2),