Pattern of family's cognitive and/or behavioral efforts to manage a stressful or unpleasant situation, which can be strengthened

• Family process, including normal pattern of interaction among family members, family's understanding and knowledge of patient's present condition, support systems available (financial, social, and spiritual), family's past response to crises (coping patterns), and communication patterns used to express anger, affection, and confrontation
• Patient's illness, including progression and severity of illness, patient's perception of health problem, and problem-solving techniques used by patient to cope with life problems

• Desires to acknowledge growth impact of crisis
• Desires to choose experiences that optimize wellness
• Desires to enhance connection with others who have experienced a similar situation
• Desires to enhance enrichment of lifestyle
• Desires to enhance health promotion

• Family members will discuss impact of patient's illness and feelings about it.
• Family members will participate in treatment plan.
• Family members will establish a visiting routine beneficial to patient and themselves.
• Family members will demonstrate care needed to maintain patient's health status.
• Family members will identify and use available support systems.

Suggested NOC Outcomes

• Allow time for family members to discuss impact of patient's illness and their feelings. Encourage expression of feelings to allow family members to realistically adjust to the patient's problems.
• Encourage family conferences; help family members identify key issues and select support services, if needed, to develop sense of shared responsibility and feelings of safety, adequacy, and comfort.
• Help patient and family establish a visiting routine that won't tax patient's or family's resources. Use patient's daily routine to aid in planning—for example, no visiting during treatments or during periods of uninterrupted sleep. Involving family members reassures patient of their care and reduces family's fear and anxiety.
• Reinforce family members' efforts to care for the patient to let them know they're doing their best and to ease adaptation and grieving process.
• Demonstrate care procedures and encourage participation in treatment and planning decisions (such as selecting times for pulmonary toilet for the patient with cystic fibrosis). Meeting others' needs promotes self-esteem.
• Provide family members with clear, concise information about patient's condition. Be aware of what they have been told, and help them interpret information. This information will help alleviate their concerns.
• Ensure privacy for patient and family during visits to foster open communication.
• Help family support the patient's independence. Encourage attendance at therapy sessions and allow the patient to demonstrate new skills and abilities. Independence helps patient reach maximum functional level.
• Provide emotional support to family by being available to answer questions. Attentive listening conveys empathy, recognition, and respect for a person.
• Inform family of community resources and support groups available to assist in managing the patient's illness and providing emotional or financial support to caretakers, such as Easterseals Association, Visiting Nurse Association, and Meals on Wheels. Community resources may help the patient develop potential, independence, and self-reliance.

Suggested NIC Interventions

• Family members acknowledge their feelings about patient's illness.
• Family members spend adequate time with patient and seek to participate in care.
• Family members establish a visiting routine beneficial to patient and themselves.
• Family members display competence in caring for patient through return demonstration and provide adequate level of care to maintain patient's health.
• Family members make contact with support resources available in their community.

• Family's response to patient's illness
• Family's current understanding of patient's illness
• Observations about family's interaction with patient and acceptance of current situation
• Evaluations for expected outcomes

• Ahmad, S., Ishtiaq, S. M., & Mustafa, M. (2017). The role of socio-economic status in adoption of coping strategies among adolescents against domestic violence. Journal of Interpersonal Violence, 32(18), 2862-2881.
• Azman, A., Jamir Singh, P. S., & Sulaiman, J. (2017). Caregiver coping with the mentally ill: A qualitative study. Journal of Mental Health, 26(2), 98-103.
• Machado, B. M., Ferreira Dahdah, D., & Martins Kebbe, L. (2018). Caregivers of family members with chronic diseases: Coping strategies used in everyday life. Brazilian Journal of Occupational Therapy, 26(2), 219-313.
• McCann, T. V., & Lubman, D. I. (2018). Adaptive coping strategies of affected family members of a relative with substance misuse: A qualitative study. Journal of Advanced Nursing, 74(1), 100-109.