Nursing diagnosis – HOPELESSNESS

HOPELESSNESS

DEFINITION

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

DEFINING CHARACTERISTICS

• 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

RELATED FACTORS

• Abandonment

• Lost belief in spiritual power

• Deteriorating physical

• Lost belief in transcendent

condition

power

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Behavior

• Roles/responsibilities

• Coping

• Values/beliefs

EXPECTED OUTCOMES

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

relaxation.

173

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

of crisis.

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

Reference

Kronenwetter, C., et al. (2005, March–April). A qualitative analysis of inter-

views of men with early stage prostate cancer. Cancer Nursing, 28(2),
99–107.

Leave a Reply