Nursing diagnosis – READINESS FOR ENHANCED COMMUNITY COPING

READINESS  FOR  ENHANCED

COMMUNITY  COPING

DEFINITION

Pattern of community activities for adaptation and problem solving

that is satisfactory for meeting the demands or needs of the commu-

nity but can be improved for management of current and future

problems/stressors

DEFINING CHARACTERISTICS

• Active planning to handle predicted stressors

• Active problem solving when faced with stressors

• Agreement that community carries responsibility for stress manage-

ment

• Positive communication among community members and between

community members and larger organizations

RELATED FACTORS

One or more characteristics that indicate effective coping:

• Acknowledges power

• Defines stressors as manageable

• Aware of possible environmen-

• Seeks knowledge of new

tal changes

strategies

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Communication

• Populations

• Coping

• Risk management

EXPECTED OUTCOMES

Community members will

• Express understanding of problems associated with failure to

immunize population and will recognize the needs to reduce the
number of adults and children who are not immunized.

• Initiate a plan to increase the number of immunizations in popula-

tion and provide adequate protection from communicable diseases.

• Work to reduce spread of communicable diseases and increase the

number of immunizations.

• Evaluate established plans for ensuring that all children become

immunized, and will make changes to plans as needed.

SUGGESTED NOC OUTCOMES

Community Competence; Community Health Status: Immunity;

Community Risk Control: Communicable Disease

INTERVENTIONS AND RATIONALES

Determine: Assess community member’s level of understanding of the

importance of immunization. If level of compliance is low, survey

community needs to determine why. Determine ease of access in the

community for members to comply with immunization

requirements/needs. Identify new members of the community, such

as immigrants or refugees. This assessment will assist in identifying

appropriate intervention.

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Perform: Collect statistical data from community health sources,

such as the health department and schools to continue to identify

children who have not been immunized. Recruit local agencies with

an adequate number of professionals able to deliver the immuniza-

tion services.

Contact parents personally or by handwritten note about children

who have not been immunized. Make it clear to the parents that

your purpose is to protect the children.

Inform: Provide extensive educational opportunities in the

community about communicable diseases and the importance of

immunization. Educate persons in the community in their first lan-

guage to ensure adequate understanding.

Attend: Encourage community members to implement a program to

disseminate information about problems associated with inadequate

immunization to educate residents and promote the community’s

established immunization program.

Encourage health departments, clinics, and practitioners’ offices to

provide information on the recommended childhood immunization

schedule to the public to foster understanding about the importance

of educating the public.

Conduct a follow-up survey on immunization rates to measure the

effectiveness of educational initiatives.

Manage: Supply a list of referrals for the parents of children who

are not immunized. Include information on low-cost health

insurance, city health centers, and well-baby clinics to encourage

compliance. Helping the parents by giving referrals will empower

them to meet their child’s health care needs.

SUGGESTED NIC INTERVENTIONS

Communicable Disease Management; Community Health Develop-

ment; Health Education; Health Policy Monitoring; Immunization/

Vaccination Management

Reference

Pender, N. J., Murdaugh, C., et al. (2006). Health promotion in nursing prac-

tice (5th ed.). Upper Saddle River, NJ: Prentice Hall.

Nursing diagnosis – INEFFECTIVE COMMUNITY COPING

INEFFECTIVE  COMMUNITY  COPING

DEFINITION

Pattern of community activities for adaptation and problem-solving

that is unsatisfactory for meeting the demands or needs of the com-

munity

DEFINING CHARACTERISTICS

• Deficits in participation

• Excessive conflicts

• Expressed powerlessness and vulnerability

• Failure of community to meet its own expectations

• High illness rate

• Increased social problems (abuse, divorce, and unemployment)

• Perception of stressors as excessive

RELATED FACTORS

• Deficits in community social

• Natural disasters

support services

• Man-made disasters

• Deficits in community social

• Inadequate resources for prob-

resources

lem solving

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Communication

• Risk management

• Coping

• Values and beliefs

• Healthcare system

EXPECTED OUTCOMES

Community members will

• Express awareness of seriousness of high school adolescent preg-

nancy rate in their community.

• Express need for plan to reduce prevalence of teen pregnancy.

• Develop and implement plan to reduce teen pregnancy.

• Evaluate success of plan in meeting goals and objectives and will

continue to revise it, as necessary.

• Report reduction in rate of teen pregnancy.

SUGGESTED NOC OUTCOMES

Community Competence; Community Health Status

INTERVENTIONS AND RATIONALES

Determine: Assess the following: community demographics; number of

teen pregnancies in the community in the past 2 years; attitudes toward

teen mothers and their infants; availability of programs in the schools

that help teen mothers continue their education; teens’ knowledge about

sex and sexuality; religious attitudes in the community toward sex

and sexuality; influence of religious groups on educators. Assessment

information will be useful in establishing appropriate interventions.

Perform: Collect statistical data from schools to analyze teen

pregnancy rates as a basis for evaluating a pregnancy prevention

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program. Plan a teen pregnancy program that can be used in

schools. Include information on risks, problems, and complications

of teen pregnancy. Contact local corporations for financial assistance

in supporting educational programs.

Establish clubs for adolescent girls in the community. These can

be used as a method for educating as well as helping girls establish

healthy relationships.

Establish therapeutic relationships with pregnant adolescents to

build support during this difficult period.

Inform: Provide education on birth-control measures (including absti-

nence from sex) and have this information available at school.

Encourage an information campaign to educate adolescents, parents,

and community members about problems related to teen pregnancy.

Teach parent to observe behavioral cues from child. For example,

the child may become fussy when he is ready for a nap or may pull

his ear if he has an earache to indicate that he has pain. Explain the

range of options for responding to these cues in positive ways. Par-

ents may be unfamiliar with cues from child behavior.

Teach parents to give physical care when the need exists. The

parents may need instruction on the importance and proper way of

providing care. Teach relaxation techniques that can be done by the

parents such as guided imagery, progressive muscle relaxation, and

meditation. These measures restore psychological and physical equi-

librium by decreasing autonomic response to anxiety.

Encourage local youth groups and religious and social

organizations to feature guest speakers on pregnancy prevention at

their meetings. Speakers with expertise in the area of teen pregnancy

are better able to provide information that may help teens make

better choices in sexual behavior.

Attend: Encourage community members to establish school-based

clinics that allow teens access to reproductive-system models, preg-

nancy tests, and nonprescription birth-control measures to support

teens who choose to protect themselves from unwanted pregnancy.

Manage: Develop a referral list for teens that includes resources such as

hospitals with human sexuality courses, charities that provide prenatal

care and childbirth services, women’s clinics, and Planned Parenthood

to compensate for restricted access to information in the schools.

SUGGESTED NIC INTERVENTIONS

Community Health Development; Health Education; Health Screen-

ing; Program Development

Reference

Brindis, C. D. (2006). A public health success: Understanding policy changes

related to teen sexual activity and pregnancy. Annual Review of Public
Health, 27, 277–295.