Diminished ability to recover from perceived adverse or changing situations

• Disrupted family rituals
• Disrupted family roles
• Hopelessness
• Impaired family processes
• Inadequate health resources
• Inadequate social support
• Inconsistent parenting behaviors
• Ineffective family adaptation
• Ineffective impulse control
• Perceived vulnerability
• Powerlessness
• Substance misuse
• Unaddressed community violence

• Infertility treatment regimen
• Intellectual disability
• Psychological disorder

• Patient's perception of problem, coping mechanisms, problem-solving ability, decision-making competencies, relationships, family system
• Health history, history of chronic illness
• Activity status, nutritional status, sleep patterns
• Cultural status, including affiliation with racial, ethnic, or religious groups

• Decreased interest in academic activities
• Decreased interest in vocational activities
• Decreased social interaction
• Depressive symptoms
• Exacerbation of disease signs
• Exacerbation of disease symptoms
• Excessive guilt
• Frequent illness
• Inadequate self-esteem
• Inadequate sense of control
• Ineffective use of coping strategies
• Repetitive excessive stress
• Shame

• Patient will adapt to new or changing situation.
• Patient will have interest in academic activities.
• Patient will identify personal strengths.
• Patient will integrate into new environment.
• Patient will engage in activities that promote health.
• Patient will identify strategies that have been successful in previous times of stress.

Suggested NOC Outcomes

• Explore with patient what maladaptive behaviors patient is exhibiting due to impaired individual resilience. Patient must take ownership of behaviors before change can take place.
• Assist patient in making a list of strengths and resources with contact information and the parameters for contacting those resources. Planning for needs decreases anxiety and increases self-care.
• Instruct patient to engage in positive health behaviors. Adequate sleep, nutritional intake, and activity improve decision-making.
• Encourage patient to wait to make life-changing decisions until the current crisis is over. Decision-making is impaired during times of crisis.
• Refer patients to mental health resources in the event of maladaptive coping or safety risk. Individuals with impaired individual resilience face an increased risk of physical and mental illness.

Suggested NIC Interventions

• Patient expresses adjustment to new or changing situation.
• Patient engages in academic activities.
• Patient identifies at least three personal strengths that lead to increased resilience.
• Patient shares strategies that were successful during other stressful periods.
• Patient states activities that will promote health.

• Patient's expressions of feelings regarding current crisis
• Patient's planned health promotion behaviors
• Patient's understanding of available resources if needed
• Evaluations for expected outcomes

• Ayed, N., Toner, S., & Priebe, S. (2018). Conceptualizing resilience in adult mental health literature: A systematic review and narrative synthesis. Psychology and Psychotherapy: Theory, Research and Practice. doi:10.1111/papt.12185
• Greup, S. R., Kaal, S. E. J., Jansen, R., Manten-Horst, E., Thong, M. S. Y., van, d. G., … Husson, O. (2018). Post-traumatic growth and resilience in adolescent and young adult cancer patients: An overview. Journal of Adolescent and Young Adult Oncology, 7(1), 1-14. doi:10.1089/jayao.2017.0040
• Rook, C., Smith, L., Johnstone, J., Rossato, C., López Sánchez, G. F., Suárez, A. D., & Roberts, J. (2018). Reconceptualising workplace resilience—A cross-disciplinary perspective. Anales De Psicología, 34(2), 332-339. doi:10.6018/analesps.34.2.299371