DianNers Site

Suggested NIC Interventions Compromised Family Coping

• Caregiver Support
• Coping Enhancement
• Family Involvement Promotion
• Family Mobilization
• Family Support
• Mutual Goal Setting
• Normalization Promotion
• Sibling Support

Example NIC Activities—Family Support

Appraise family’s emotional reaction to client’s condition; promote trusting relationship with family

Nursing Interventions and Rationales

• Assess the strengths and deficiencies of the family system. EBN: Assessments allow for anticipatory care and guidance to help members acquire and maintain supports and coping strategies (Thomas, 2000). EB: Chronic illness in children affects the psychological health of the parents. Active coping strategies are associated with fewer distress indices and thus if inculcated may improve the ability to bear the burden of the illness without becoming themselves affected by psychiatric illnesses (Rao, 2004).
• Assess how family members interact with each other; observe verbal and nonverbal communication and individual and group responses to stress. EBN: Understanding how families cope with stress is important. Family cohesion, presence of a partner, emotional support, and a mother’s satisfaction with her family all contributed to her better mental health in a research study focusing on mothers of low-birth-weight infants (Weiss & Chen, 2002).
• Establish rapport with families by providing accurate communication EBN: This qualitative exploratory study of families in psychiatric settings indicated that family care can be improved by focusing on building rapport and communicating problems and concerns between families and health professionals (Rose, Mallinson, & Walton-Moss, 2004).
• Consider the use of family theory as a framework to help guide interventions (e.g., family stress theory, role theory, social exchange theory). EBN: This study demonstrated that use of a family assessment tool is an effective way of appraising families and addressing suffering. Formative evaluations demonstrated improvements in team members’ perceptions of their knowledge, family centeredness, and ability to assess and intervene with families (Hogan & Logan, 2004.)
• Help family members recognize the need for help and teach them how to ask for it. EBN: Recognizing the need for help and knowing how to ask for it enables family members to maintain control (Szabo & Strang, 1999).
• Encourage expression of positive thoughts and emotions. EB: Positive emotions initiate upward spirals toward enhanced emotional well-being (Fredrickson & Joiner, 2002). EBN: This study shows that clients believe that coping is important to their well-being (Edgar, 2004).
• Encourage family members to verbalize feelings. Spend time with them, sit down and make eye contact, and offer coffee and other nourishment. EBN: The expression of feelings helps family caregivers to regain and maintain control (Szabo & Strang, 1999). Acceptance of nourishment indicates a beginning acceptance of the situation.
• Provide opportunities for families to discuss spirituality. EB: This research provided by survivors of haematological malignancies gives insight into factors impacting their need to talk about spiritual issues (McGrath & Clarke, 2003).
• Mothers may require additional support in their role of caring for chronically ill children. EBN: Mothers exhibit greater efforts than fathers in coping patterns, including strategies to acquire social support outside the family, increase self-worth, and decrease psychological tensions (Brazil & Krueger, 2002).
• Provide privacy during family visits. If possible, maintain flexible visiting hours to accommodate more frequent family visits. If possible, arrange staff assignments so the same staff members have contact with the family. Familiarize other staff members with the situation in the absence of the usual staff member. Providing privacy, maintaining flexible hours, and arranging consistent staff assignments will reduce stress, enhance communication, and facilitate the building of trust.
• Determine whether the family is suffering from additional stressors (e.g., child care issues, financial problems). EBN: One study found that in mothers of low-birth-weight infants, the presence of other life stressors and the family’s use of internally focused coping strategies contributed to worse mental health outcomes for the mother (Weiss & Chen, 2002).
• Refer the family with ill family members to appropriate resources for assistance as indicated (e.g., counseling, psychotherapy, financial or spiritual support). EBN: The findings of this study demonstrate the importance of supporting family functioning in the families of people with heart disease is an important challenge for family nursing. The most important predictors of family health were family structural factors. It was found that the better the family structure and relationships, the better the family health (stedt-Kurki et al, 2003).