Domain 9. Coping-stress tolerance
Class 2. Coping responses
Diagnostic Code: 00074
Nanda label: Compromised family coping
Diagnostic focus: Coping
Family coping is a process that allows members of a family to face, understand and deal with stresses, strains, and changes in their lives. It is through this process that individuals are able to mobilize resources and emotional support, to heal and recover from difficult or traumatic situations. A nursing diagnosis of “compromised family coping” occurs when the family is not able to recover from a challenging experience, either due to lack of skills or resources.
NANDA Nursing Diagnosis Definition
The NANDA-I nursing diagnosis of compromised family coping is defined as “the family is unable to use the necessary processes to identify and evaluate options, make decisions and manage stress in order to restore homeostasis.” At its core, this diagnosis acknowledges the inability of a family to cope with stress when it needs to.
- Expressions of fear, helplessness, anger, resentment, worry, or guilt
- Inability to handle stressful events or to see outcomes of decisions
- Conflict between family members
- Inability to make decisions
- Inability to communicate feelings
- Extended periods of silence in the family
- Increase in physical symptoms related to stress
- Increased arguments between family members
- Unresolved disputes between family members
- Decreased respect between family members
- Lack of decision making skills in the family
- The inability to appropriately manage stressors caused by illness, relational conflicts, and life transitions
- Lack of adequate problem solving skills
- Unrealistic expectations from family members
- A lack of social or financial resources
At Risk Population
Families who are at an increased risk for compromised family coping include:
- Families with parents or guardians facing a long-term illness or disability
- Families that have experienced a recent death or loss within the family
- Single-parent families
- Immigrant families
- Families with members suffering from mental illness
Suggestions of Use
Nurses can use this diagnosis to develop nursing interventions that support families as they attempt to cope with rapid or sudden changes. This diagnosis can also assist nurses in identifying families who require additional help and support during an especially difficult time.
Suggested Alternative NANDA Nursing Diagnoses
Alternative diagnoses to consider when a family shows signs of compromised family coping include:
- Disabled Family Coping
- Ineffective Problem Solving
- Violence: Family/Intimate Partner
- Ineffective Family Coping
- Parental Role Conflict
When diagnosing compromised family coping, it is important to remember that it is caused by a lack of skills and resources, rather than a lack of effort or will. As such, nurses need to recognize the potential power imbalance between families and health care professionals, so as to ensure the families are given enough support to eventually cope with the stressors they are facing.
The NOC outcomes associated with compromised family coping include:
- Family Coping – The ability of a family to access social, religious, economic, and other resources for managing family stress.
- Family Resilience – The capacity of a family to maintain or reestablish health and functioning after exposure to family stress.
- Family Social Support – The availability and accessibility of an extended social network that can provide emotional, instrumental, and informational support.
- Family Stress Management – The ability of the family to utilize strategies to minimize the impact of stress on family members.
Evaluation Objectives and Criteria
The nurse should observe families over a period of time to evaluate if their ability to cope has been improved. When evaluating a family’s coping ability, these objectives and criteria should be utilized:
- The family is able to effectively communicate feelings and concerns.
- The family is able to make decisions, formulate solutions, and negotiate reasonable compromises.
- The family is able to anticipate, recognize and respond to changes in the environment or relationships.
- The family is able to recognize and utilize available social, economic, and spiritual supports.
- The family is able to take responsibility for problem resolution within the unit.
Interventions most commonly used to help families cope include:
- Counseling family members and providing support as they recover from a challenging experience.
- Encouraging positive communication between family members.
- Facilitating decision making and problem solving in the family.
- Creating a plan to manage the stressors affecting the family.
- Assisting the family with identifying and utilizing social, financial, and spiritual resources.
Common nursing activities for families displaying compromised family coping include:
- Assessing family dynamics and understanding the perspectives of various family members.
- Encouraging family members to express honest feelings.
- Offering listening, validation, and empathy when appropriate.
- Actively teaching problem solving and communication skills.
- Coordinating referrals to resources, such as counseling centers, legal aid, and social services.
It is important for nurses to recognize and respond to families displaying compromised family coping. Recognizing and addressing this diagnosis can help families move toward coping and improved wellbeing. It is the nurse’s responsibility to assess a family’s coping abilities, offer resources and support, and actively teach problem solving and communication skills.
- Q. What is Compromised Family Coping?
A. Compromised family coping is a nursing diagnosis referring to a family’s inability to use the necessary processes to identify and evaluate options, make decisions, and manage stress in order to restore homeostasis.
- Q. Who is At Risk of Compromised Family Coping?
A. Families who are at an increased risk for compromised family coping include those with parents or guardians facing a long-term illness or disability, families that have experienced a recent death or loss within the family, single-parent families, immigrant families, and families with members suffering from mental illness.
- Q. What are some Suggested Interventions to Assist Compromised Family Coping?
A. Some suggested interventions to assist compromised family coping include counseling family members, encouraging positive communication, facilitating decision making and problem solving, creating a plan to manage stress, and identifying and utilizing social, financial, and spiritual resources.
- Q. How can Nurses Evaluate Compromised Family Coping?
A. Nurses should observe families over a period of time to evaluate if their ability to cope has been improved. The nurse should observe if the family is able to effectively communicate feelings and concerns, anticipate and respond to changes in the environment or relationships, recognize and utilize available social, economic and spiritual supports, and take responsibility for problem resolution.
- Q. What are some Commonly Used NOC Outcomes to Help Families Cope?
A. Commonly used NOC outcomes to help families cope include family coping, family resilience, family social support, and family stress management.