Nursing diagnosis – INEFFECTIVE COPING

INEFFECTIVE  COPING

DEFINITION

Inability to form a valid appraisal of the stressors, inadequate

choices of practiced responses, and/or inability to use available

resources

DEFINING CHARACTERISTICS

• Change in communication patterns

• Decreased use of social support

• Destructive behavior toward self or others

• Difficulty asking for help

• Fatigue

• High illness rate

• Inability to meet basic needs and role expectations

• Statements indicating inability to cope

RELATED FACTORS

• High degree of threat

• Inability to conserve adaptive energies

• Inadequate resources available

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Behavior

• Communication

• Coping

EXPECTED OUTCOMES

The patient will

• Verbalize increased ability to cope.

• Expand support network to meet social and emotional needs.

• Locate and use appropriate resources for help in problem solving.

• Report increased ability to meet demands of daily living.

• Make changes to environment to ensure enhanced coping or move

into long-term care facility, as needed.

SUGGESTED NOC OUTCOMES

Coping; Decision Making; Impulse Self-Control; Information

Processing; Social Interaction Skills

INTERVENTIONS AND RATIONALES

Determine: Monitor physiological responses to increased activity

level, including respirations, heart rate and rhythm, and blood pres-

sure. Vital signs are likely to change as the patient deals with the

frustration from poor coping strategies. Assess understanding of the

current health problem and desire to participate in treatment.

Perform: Listen to the patient. Respond in a matter-of-fact, nonjudg-

mental manner. Judgmental responses will impede the development

of a trusting relationship. Practice guided imagery and deep breath-

ing with the patient to help the patient relax.

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Inform: Provide patient with information about relaxation

techniques. These techniques take practice. Information will help the

patient understand the benefit.

Teach patient about her disease process and explain treatments to

allay fear and allow the patient to regain sense of control.

Teach positive coping strategies and have patient role-play them

and give praise for successful modeling. This will help to reinforce

coping behaviors.

Attend: Assist patient to develop short- and long-term goals to

encourage better coping and a roadmap to measure progress.

Provide emotional support and encouragement to help improve

patient’s negative self-concept and motivate the patient to perform

ADLs. Involve patient in planning and decision making. Having the

ability to participate will encourage greater compliance with

treatment plan. Encourage patient to engage in social activities with

people of all age groups. Participation once a week will help relieve

the patient’s sense of isolation.

Manage: Refer patient for professional psychological counseling. For-

mal counseling helps ease the nurse’s frustration, increases objectiv-

ity, and fosters collaborative approach to patient’s care.

Before discharge, refer patient to case manager who can help

patient become involved in informal community programs, such as

volunteer, foster grandparents, or religious groups, to provide peer

and social contact and decrease the patient’s loneliness and isolation.

Refer patient to a support group. In the context of a group, the

patient may develop a more positive view in the present situation.

SUGGESTED NIC INTERVENTIONS

Coping Enhancement; Decision-Making Support; Emotional Support;

Environmental Management; Impulse Control Training; Support Sys-

tem Enhancement

Reference

Popejoy, L. (2005, September). Health-related decision-making by older adults

and their families: How clinicians can help. Journal of Gerontological Nurs-
ing, 31(9), 12–18.

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