Fear

Fear

Domain 9. Coping-stress tolerance
Class 2. Coping responses
Diagnostic Code: 00148
Nanda label: Fear
Diagnostic focus: Fear

Introduction to Nursing Diagnosis Fear

Fear is one of the most common emotions we experience. It is a normal part of life that can evolve from rational worries or irrational anxieties. Although the feeling of fear can often be helpful, it can also can start to interfere with our ability to live our lives to the fullest. In the healthcare setting, nurses can identify and assess a patient’s fear in order to determine the best way to approach their treatment. The formation of a valid nursing diagnosis pertaining to fear is essential for effective nursing intervention and patient care.

NANDA Nursing Diagnosis Definition

The North American Nursing Diagnosis Association, or NANDA, is an internationally recognized organization that defines, classifies, and validates nursing diagnoses. According to NANDA-I, fear is defined as “a state in which an individual perceives a threat related to a specific object or situation.” It is characterized by certain defining characteristics, including mental preoccupation, anticipation of danger, increased vigilance, and physiological arousal.

Defining Characteristics

Subjective:

  • Expresses feelings of fear
  • Verbalizes feelings of anxiety or dread
  • Reports difficulty sleeping and/or concentrating
  • Experiences an increase in heart rate or other physical signs of distress

Objective:

  • Increased heart rate
  • Pale or sweaty appearance
  • Agitated or defensive behavior
  • Decreased respiration rate

Related Factors

Fear can develop due to any number of underlying influences. These may include physical or mental health conditions, real or perceived threats, stressful events or situations, past trauma, insecurity, and various knowledge deficits.

At Risk Population

There is no single demographic that is considered to be more at risk for experiencing fear than any other. Everyone is capable of developing fear regardless of age, gender, culture, or economic background. However, certain populations may be disproportionately impacted due to unique individual circumstances. For example, patients diagnosed with mental illness, survivors of abuse or trauma, individuals vulnerable to environmental exposures, low-income populations, or those without access to medical services may be more likely to exhibit signs of fear or anxiety.

Associated Conditions

Fear can be associated with a variety of other symptoms and conditions, such as insomnia, depression, paranoia, panic attacks, aggression, hypervigilance, suicidal thoughts, and/or self-injurious behaviors.

Suggestions in Use

When fear manifest in a clinical setting, the first action a nurse should take is to assess the type and severity of the patient’s symptoms. Developing an accurate understanding of the effect the fear is having on the patient is essential for effective intervention and treatment. Nurses can also use a variety of techniques to help a patient learn to cope with their fear, such as deep breathing exercises, progressive muscle relaxation, guided imagery, and/or cognitive-behavioral therapy.

Suggested Alternative NANDA Nursing Diagnoses

In some cases, a nurse may nevertheless choose to refer to a different NANDA nursing diagnosis when treating a patient’s fear. These may include a diagnosis of Anxiety, Phobia, Powerlessness, or Coping, Ineffective.

Usage Tips

When educating patients on managing their fear, it can help to identify the root cause of the fear, focus on positive experiences and successes, cultivate supportive relationships in the patient’s life, and challenge negative thought patterns. Additionally, nurses should consider incorporating complementary therapies into their care plans, such as mindfulness, music therapy, expressive writing, or aromatherapy.

NOC Outcomes

When implementing interventions for fear, nurses should consider assessing their patient’s progress using these NOC (Nursing Outcomes Classification) measures: Physicians Clinical Impressions, Physical Comfort Level, Pain Management, Behavioral Control, Safety Status, Knowledge, Mood Equilibrium, Sleep Patterns, Readiness for Enhanced Coping, and Self Care Ability.

Evaluation Objectives and Criteria

The effectiveness of nursing interventions for a patient’s fear can usually be evaluated by measuring changes in symptoms, considering changes in emotion or behavior, and assessing progress towards meeting treatment goals.

NIC Interventions

These NIC (Nursing Interventions Classification) interventions may be useful when addressing a patient’s fear: Psychological Support, Stress Management Class, Comforting Intervention, Meditation Facilitation, Relaxation Training, Affective Education, and Reassurance.

Nursing Actions

When treating fear, nurses should take a holistic approach that is tailored to the individual needs of their patients. This may involve creating a safe environment, providing physical and emotional comfort, teaching stress management skills, giving advice on problem solving and/or assertiveness training, making use of evidence-based interventions, encouraging goal-setting and development of social networks, and/or helping the family deal with feelings of guilt, anger and/or sadness.

Conclusion

Fear is a normal emotion that can interfere with the quality of life. When it manifests in the medical setting, it is important to assess a patient’s symptoms in order to develop a valid nursing diagnosis. By doing so, nurses can then take the necessary steps to provide the best possible care and assist the patient in managing their fear.

FAQs

  • What is fear? Fear is an emotion we all experience that can range from rational worries to irrational anxieties. It is characterized by certain defining characteristics, including mental preoccupation, anticipation of danger, increased vigilance, and physiological arousal.
  • How can fear interfere with daily life? Fear can often be helpful in certain situations, but it can also become overwhelming and negatively impact our ability to live our lives to the fullest.
  • What is the NANDA definition of fear? According to NANDA-I, fear is defined as “a state in which an individual perceives a threat related to a specific object or situation.”
  • What is the role of nurses in addressing fear? Nurses play an important role in assessing a patient’s symptoms in order to form a valid nursing diagnosis and develop the most effective treatment plan. Additionally, nurses can provide psychological support, teach stress management skills, and encourage coping mechanisms that can help the patient manage their fear.
  • What methods can be used to manage fear? Various methods can be used to help a patient cope with fear, such as deep breathing exercises, progressive muscle relaxation, guided imagery, and/or cognitive-behavioral therapy. Additionally, nurses may consider incorporating complementary therapies, such as mindfulness, music therapy, expressive writing, or aromatherapy.

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