Unsatisfactory handling of symptoms, treatment regimen, and lifestyle changes associated with living with a chronic condition
Discuss health maintenance needs with patient while carrying out routine activities to reinforce their importance.
Involve patient in decision-making by allowing choices in determining where, when, and how activities are to be carried out. Ask, for example, Would you like a bath or shower in the morning or evening? Participation in decision-making increases feelings of independence.
Monitor patient's self-efficacy and use of problem-solving skills as patient manages own health. These concepts reflect a new paradigm in health management that acknowledges that patients need many skills and confidence to carry out plan of care.
Help patient perform health maintenance activities, such as daily skin inspection and weekly catheterization for residual urine. Encouraging skill development in patient promotes continued use of those skills after discharge.
Instruct patient in specific skills needed in monitoring health status to prompt participation in self-care. Allow patient to perform skills to encourage independence.
Assist patient in setting goals and making informed choices. This patient-nurse collaborative relationship helps patient and nurse identify barriers to optimal health management and overcome them.
Teach patient about disease states and regimens but, more importantly, teach problem-solving skills to ensure active participation in self-health management despite any possible setbacks.
Provide encouragement to help motivate patient to maximize healthy behaviors. This highlights that behavior is best changed by internal motivation rather than by external motivation.
Consult with social services or other health care team members to identify health care resources (e.g., Meals on Wheels or homemaker services) and help patient contact and arrange for follow-up. These resources can help patient maintain independence after discharge.
Encourage patient and family members to verbalize feelings and concerns related to health maintenance to help them develop greater understanding and better manage their health.
Help family members develop coping skills necessary to deal with patient. If patient's illness is prolonged, family members could develop maladaptive coping strategies.
Make referrals, as appropriate, to psychiatric liaison nurse and social services to help prevent burnout among family members.
Coordinate care with social services and colleagues in other disciplines to ensure that family, economic, and social barriers to optimal self-health management have been addressed.
Suggested NIC Interventions
Anticipatory Guidance; Behavior Modification; Complex Relationship Building; Decision-Making Support; Health Education; Health System Guidance; Learning Facilitation; Mutual Goal Setting; Referral; Support System Enhancement; Self-Awareness Enhancement; Teaching: Disease Process |