Nursing diagnosis – PARENTAL ROLE CONFLICT



Parent experience of role confusion and conflict in response to crisis


• Disruption in care-taking routines

• Expressed concern about changes in parental role and family func-

tioning, communication, and health

• Expressions of inadequacy to provide for child’s needs

• Expressed loss of control over decisions relating to child

• Expressed or demonstrated feelings of guilt, anger, fear, anxiety,

and frustration about the effect of the child’s illness on family

• Reluctance to participate in usual caregiving activities, even with



• Change in marital status

• Intimidations with invasive

• Home care of a child with


special needs

• Intimidation with restrictive

• Interruptions of family life due


to home care regimen

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Behavior

• Roles/relationships

• Communication

• Self-perception

• Coping


The parents will

• Communicate feelings about present situation.

• Participate in their child’s daily care.

• Express feelings of greater control and ability to contribute more

to the child’s well-being.

• Express knowledge of child’s developmental needs.

• Hold, touch, and convey warmth and affection to child.

• Use available support systems or agencies to assist with coping.


Caregiver Adaptation to Patient Institutionalization; Caregiver Care

Readiness; Coping: Family


Determine: Assess the child’s special needs; age and maturity of par-

ents; roles within the family; available support systems for parents;

parent–child relationship; and presence of conflict between family’s

lifestyle and child’s needs. Assessment information will be useful in

establishing appropriate interventions.


Perform: Make changes in the environment with child-friendly

pictures, and so forth, to foster enhanced communication between

parents and child.

Provide family-centered care by involving the parents in the child’s

care. Parents are responsible for decisions about the child’s care.

Inform: Provide information on informed consent because parents

will be making decisions for child’s care.

Teach parents about normal growth and development and advocate

that they provide as much normalcy for the child with special needs as

possible. Treating them differently will retard progress in socialization.

Teach patient and caregiver the skills necessary to manage care

adequately. Teaching will encourage compliance and adjustment to

optimum wellness.

Teach parents how to find areas in ADLs in which it is possible to

maintain control in order to avoid feelings of powerless.

Teach parents to assist child with self-care activities in a way

that maximizes the child’s potential. This enables caregivers to

participate in child’s care while supporting child’s independence.

Attend: Encourage visit by friends to promote socialization.

Encourage parents to pay attention to needs of siblings at home,

and to discuss with siblings their feelings about having a sister or

brother with special needs. The goal is to have siblings be support-

ive but feel important in their own rites.

Provide respite care to promote emotional well-being of parents.

Encourage patents to spend time away from child to enhance their

marital relationship.

Manage: Act as a liaison between family and multidisciplinary health-

care team to provide support to the patients as they reach out for


Refer parents to home care agencies and ensure that an appropri-

ate assessment is done to encourage long-term support.

Refer parents to a mental health specialist to enable support for the

family members as they continue coping with the child’s special needs.

Arrange for parents to meet with parents who are coping

positively with the same kinds of issues. Peer support will help par-

ents cope with their child’s issues.


Family Process Maintenance; Limit Setting; Mutual Goal-Setting;

Parenting Promotion; Role Enhancement


Secco, M. Loretta, et al. (2006). Factors affecting parenting stress among bio-

logically vulnerable toddlers. Issues in Comprehensive Pediatric Nursing,
29(3), 131–156.