Spend 10 minutes with patient twice per shift. Convey a willingness to listen. Offer understanding and empathy; for example, “I know you're frightened. I'll stay with you.” Specific amount of uninterrupted, non-care-related time spent with anxious patient builds trust and reduces tension. Active listening helps patient ventilate feelings.- Give patient clear, concise explanations of anything that's about to occur. Avoid information overload; an anxious patient can't assimilate many details. Anxiety may impair patient's cognitive abilities.
- Listen attentively; allow patient to express feelings verbally. This may allow patient to identify anxious behaviors and discover the source of anxiety.
- Make no demands on patient. An anxious patient may respond to excessive demands with hostility and abuse.
- Attend to patient's comfort needs to increase trust and reduce anxiety.
- Identify and reduce as many environmental stressors (including people) as possible. Anxiety commonly results from lack of trust in the environment.
- Have patient state what kinds of activities promote feelings of comfort and encourage patient to perform them. This gives patient a sense of control.
- Remain with patient during severe anxiety. Anxiety is usually related to fear of being left alone.
- Include patient in decisions related to care, when feasible. Anxious patient may mistrust own abilities; involvement in decision-making may reduce anxious behaviors.
- Support family members in coping with patient's anxious behavior. Involving family members in the process of reassurance and explanation allays patient's anxiety as well as their own.
- Identify your feelings toward the patient to keep your feelings from interfering with treatment.
- Accept patient as is. Forcing patient to change before patient is ready causes panic.
Explore factors that precipitate phobic reactions and anxiety. This is important for understanding patient's behavioral dynamics.
Reassure patient about being safe. Patient may perceive being at risk, which may increase patient's level of anxiety.- Support patient with desensitization techniques to help overcome patient's problem.
- Give patient a chance to ventilate own feelings. This reduces patient's tendency to suppress or repress bottled-up feelings, which may continue to affect behavior even though patient may be unaware of them.
- Allow extra visiting periods with family if this seems to allay patient's anxiety. This allows anxious patient and family to support each other according to their abilities and at their own pace.
- Help patient set limits and compromises on behavior when ready and allow patient to be afraid. Fear is a feeling, neither right nor wrong.
- Teach patient relaxation techniques to be performed at least every 4 hours, such as guided imagery, progressive muscle relaxation, and meditation. These measures restore psychological and physical equilibrium by decreasing autonomic response to anxiety.
- Give patient facts about fear and anxiety and their consequences to reduce anxiety and encourage patient to help manage problem.
- Encourage patient not to run away when afraid to help patient learn that fear can be faced and managed.
- Help patient develop own techniques for dealing with fears to establish alternatives to escape or avoidance behaviors.
- Offer relaxing types of music to patient for quiet listening periods. Listening to relaxing music may provide distraction and have a calming effect on patient.
Refer patient to community or professional mental health resources to provide ongoing mental health assistance. Encouraging the use of community resources reinforces the notion that anxiety reduction is a long-term process.
Suggested NIC Interventions
Active Listening; Anger Control Assistance; Anticipatory Guidance; Anxiety Reduction; Behavior Modification: Social Skills; Calming Technique; Coping Enhancement; Meditation Facilitation; Impulse Control Training; Presence; Progressive Muscle Relaxation; Simple Guided Imagery; Simple Relaxation Therapy; Spiritual Support; Support Group |