Nursing diagnosis – INTERRUPTED FAMILY PROCESSES

INTERRUPTED  FAMILY  PROCESSES

DEFINITION

Change in family relationship or functioning

DEFINING CHARACTERISTICS

Changes in:

• Assigned tasks

• Availability for affective responses and/or emotional support

• Communication patterns

• Effectiveness in completing assigned tasks

• Expressions of conflict within family and/or community resources

• Expressions of isolation from community resources

• Intimacy

• Participation in problem solving and/or decision making

• Stress-reduction behaviors

RELATED FACTORS

• Developmental crises

• Modification in family finances

• Developmental transition

• Modification in family social

• Family role shift

status

• Interaction with community

• Situational transition

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Communication

• Emotional

• Coping

• Roles/relationship

EXPECTED OUTCOMES

Family members will

• Not experience physical, verbal, emotional, or sexual abuse.

• Communicate clearly, honestly, consistently, and directly.

• Establish clearly defined roles and equitable responsibilities.

• Express understanding of rules and expectations.

• Report the methods of problem solving and resolving conflicts

have improved.

• Report a decrease in the number and intensity of family crises.

• Seek ongoing treatment.

SUGGESTED NOC OUTCOMES

Family Coping; Family Functioning; Family Normalization; Social

Interaction Skills; Substance Addiction Consequences

INTERVENTION AND RATIONALES

Determine: Assess family’s developmental stage, roles, rules, socioeco-

nomic status, health history, history of substance abuse; history of sex-

ual abuse of spouse or children, problem-solving and decision-making

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skills, and patterns of communication. Assessment information will

provide development of appropriate interventions.

Perform: Meet with family members to establish levels of authority

and responsibility in the family. Understanding the family dynamics

provides information about the kinds of support the family needs to

work with the patient’s issues.

Create an environment in which family members can express

themselves openly and honestly to build trust and self-esteem.

Establish rules for communication during meetings with the family

to assist family members to take responsibility for their own behavior.

Inform: Teach family members basic communication skills to enable

them to discuss issues in a positive way. Have them role-play with

one another numerous times to demonstrate what has been learned.

Involve the family in exercises to reduce stress and deal with

anger.

Attend: Hold adults accountable for their alcohol or substance abuse

and have them sign a “Use contract” to decrease denial, increase

trust, and promote positive change.

Involve patient in planning and decision making. Having the abil-

ity to participate will encourage greater compliance with the plan.

Assist family to set limits on abusive behaviors and have them

sign “Abuse contracts” to foster feelings of safety and trust.

Manage: Refer to case manager/social worker to ensure that a home

assessment is done.

Refer to support groups that deal with substance abuse, domestic

violence, or sexual abuse depending on the needs of the patient

and/or family to enhance interpersonal skills and strengthen the fam-

ily unit.

Provide all appropriate phone numbers so that the family

members can initiate whatever follow-up is needed.

SUGGESTED NIC INTERVENTIONS

Coping Enhancement; Family Integrity Promotion; Family Process

Maintenance; Family Support; Normalization Promotion; Substance

Use Prevention; Substance Use Treatment

Reference

Yonaka, L., et al. (2007, January–February). Barriers to screening for domestic

violence in the emergency department. Journal of Continuing Education for
Nursing, 38(1), 37–45.

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