INEFFECTIVE HEALTH MAINTENANCE
Inability to identify, manage, and/or seek out help to maintain health
· Demonstrated lack of adaptive behaviors (internal or external
· Demonstrated lack of knowledge regarding basic health practices
· History of lack of health-seeking behaviors
· Reported or observed impairment of personal support systems
· Reported or observed inability to take responsibility for meeting
basic health practices in any or all functional pattern areas.
· Reported or observed lack of equipment or ﬁnancial and other
· Cognitive impairment
· Diminished gross motor skills
· Complicated grieving
· Inability to make appropriate
· Deﬁcient communication skills
· Diminished ﬁne motor skills
· Ineffective family coping
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
· Risk management
· Healthcare system
· Values and beliefs
The patient will
· Maintain current health status.
· Sustain no harm or injury.
· Verbalize feelings and concerns.
· Explain health maintenance program.
· Identify available health resources.
SUGGESTED NOC OUTCOMES
Coping; Decision Making; Health Beliefs: Perceived Resources;
Health-Promoting Behavior; Social Support; Spiritual Health
INTERVENTIONS AND RATIONALES
Determine: Assess current health status; personal habits such as use
of tobacco, drugs, and alcohol; level of knowledge about disease
process; level of family and community assistance; coping
mechanisms and communication skills (verbal and written); and
degree of motivation to maintain health. Assessment factors will
assist the nurse in establishing interventions for this diagnosis.
Perform: Provide assistance with self-care, as needed. Encourage
increasing levels of independence. The patient should be as
independent in ADLs as possible.
Administer medications as prescribed to ensure continuation of
Adapt environment to that which is best suited to the particular
patient. Reorient the patient as needed. In the disoriented patient,
reorientation should take place frequently to keep the person as
close to knowing person, place, and time as possible.
Provide a consistent caretaker whenever possible to promote sta-
bility for the patient.
Plan a health maintenance program for patient and family members
addressing current disabilities. Provide patient and family with a writ-
ten copy. Giving instructions in writing will reinforce the various
aspects of the program and increase the possibility of compliance.
Inform: Fully describe all aspects of the patient’s care to the family
to elicit cooperation from them in continuing a plan.
Instruct family members how to carry out health maintenance
practices. Demonstrate skills such as bathing, feeding, and reality
orientation; then, have family members return demonstration under
supervision. Involving family members allows them the opportunity
to perform skills and solve problems with support and supervision.
Provide speciﬁc instructions on how to maintain a safe
environment for the patient to avoid falls and other types of
Teach relaxation techniques (e.g., guided imagery, progressive mus-
cle relaxation, and meditation) that can be done by the patient and
the family to enhance coping ability and restore psychological and
physical equilibrium by decreasing autonomic response to anxiety.
Attend: Encourage patient and family to verbalize feelings and con-
cerns related to health maintenance. This promotes better
understanding and greater ease in managing challenging situations.
Demonstrate willingness to repeat instruction and demonstrate
skills needed to care for the patients until they feel comfortable.
Manage: Refer to social and community resources, such a stroke sup-
port group, and Alzheimer’s family support group. This helps the family
gain support and receive factual information. It provides opportunity to
express feeling in a group where others are experiencing similar issues.
Making referrals is appropriate to mental health professional to
assist with prevention of burnout for the family.
SUGGESTED NIC INTERVENTIONS
Anticipatory Guidance; Coping Enhancement; Counseling; Discharge
Planning; Health Education; Health System Guidance; Physician
Support; Referral; Support System Enhancement
Cole, C. S., et al. (2006, April). Assessment and discharge planning for the
older hospitalized adults with delirium. Medsurg Nursing, 15(2), 71–76.