Domain 6. Self-perception
Class 1. Self-concept
Diagnostic Code: 00124
Nanda label: Hopelessness
Diagnostic focus: Hope
Hopelessness is a feeling of despair and pessimism, where one perceives that the outcome of any situation is painfully dismal. It could mean actively believing that any effort will be in vain and having no interest in acquiring help or support. People often feel hopeless when they go through a period of extreme grief, depression, or anxiety, and can feel as if they are being crushed by the weight of their thoughts and frustratingly unmet expectations. Unfortunately, this mindset can be catalyzed into a spiral of helplessness that has dire effects on an individual’s state of mental and physical well-being.
NANDA Nursing Diagnosis Definition
The NANDA International (NANDA-I) 2015–2017—Most Recent Edition of NANDA International’s Taxonomy of Diagnoses defines Hopelessness as “a vague, pessimistic feeling about the future and a decreased expectation of attainment of goals”. This diagnosis is relevant for people who actively lack hope and have resigned to the belief that there is no way out of a certain situation and no solution to the problem.
Defining Characteristics of Hopelessness
Subjective defining characteristics of hopelessness that clients may verbalize include, but are not limited to, apathy, extreme sadness and depression, despondency, suicidal ideation, self-accusations, low self-esteem, helplessness, self-destructive behaviors, and irritability.
Using objective methods, nurses can detect general signs of mental distress such as difficulty achieving expected cognitive performance levels like memory, learning, focusing, disturbed behavior, ill-judged actions, anxiety, and restlessness.
- Historical, traumatic events or continuing circumstances, particularly in childhood abuse or alienation
- Long-term experienced, unresolved grief
- Uncontrolled chronic pain
- Mental health, neurological, and endocrine disorders that alter emotional state
- Adverse environmental situations, especially those that threaten life purpose, autonomy, involvement, self-esteem and security.
At Risk Population
At Risk populations for hopelessness include, but are not limited to, those who are:
- Have a history of chronic medical conditions
- Chronically unemployed
- Have lost a family member
- Have a mental illness
- Victims of abuse or neglect
- NEWBORNS WITH LOW BIRTH WEIGHT
Associated conditions with hopelessness include, but are not limited to, lethargy, agitation, difficulty concentrating, insomnia, appetite changes, perpetuated depression, physical pain, social withdrawal, and suicidal thoughts or behavior.
Suggestion of Use
Recognizing the cognitive or physical warning signs of hopelessness is a crucial part of successful treatment. It is essential to monitor closely any changes in responses to treatment plans and immediate referrals should be made for individuals at risk. Having a sense of hope is important for an individual’s overall health and well-being, just as recognizing and responding to hopelessness is an essential part of nursing practice.
Suggested Alternative NANDA Nursing Diagnosis
- Infection Susceptibility related to immunosuppression
- Coping: Ineffective related to situational stress
- Anxiety related to uncertain environment
- Risk for Suicide related to feeling of hopelessness
- Risk for Injury related to impaired thinking
- Disturbed Sleep Pattern related to nervousness
Identifying the needs and understanding behaviors of individuals experiencing hopelessness is essential in providing care and establishing effective therapeutic relationships. It is important to focus on helping the client establish hope. The nurse may do this by providing self-care textbooks or readings with personal success stories relating to the client’s interests; helping the client develop an achievable plan; exploring active coping strategies; highlighting the importance of self-care; and ensuring the client knows about available resources that can help provide comfort.
- Self Care Ability
- Self Esteem
- Mood Regulation
- Health seeking Behaviors
- Sleep Pattern
- Safety Planning
- Stress Tolerance
Evaluation Objectives and Criteria
- According to NOC outcomes, the patient should demonstrate an improved outlook on life and be able to care for themselves in various ways.
- The patient should be better able to cope with stress and manage emotions.
- The patient should demonstrate a decrease in any symptoms associated with hopelessness, such as intensified depression, agitation, and reduced self-esteems.
- The patient should be able to identify and prioritize effective health-seeking behaviors.
- Psychotherapy, Cognitive Behavioral Therapy, or Talk Therapy: Focusing on providing a supportive relationship that allows for exploration of the underlying issues causing the feeling of hopelessness, along with developing healthier thought patterns for more constructive and proactive living.
- Medication: Medications such as antidepressants and mood stabilizers, may be prescribed by primary care and mental health physicians to help regulate mood and provide general psychological balance.
- Counselling & Education: Provide educational information to patients and families related to the disorder and its treatment, including behaviours, lifestyle modifications, therapy and resources.
- Facilitation of Contemplation: Encouraging constructive communication and discussion focused on individual’s mental health state and future prospects, providing opportunities for patients to express and receive support to think through factors leading to feelings of helplessness.
- Relaxation Therapy: Learning relaxation techniques to reduce tension and offer coping strategies and increased sense of control.
- Provide an empathetic and non-judgemental atmosphere to foster motivation of the patient to cooperate in treatment.
- Create opportunities for the patient to express emotions and access resources as needed.
- Encourage validation of the patient’s feeling, then focusing on problem-solving.
- Monitor and Assess the patient’s emotional state regularly.
- Teach the patient to recognize the benefits of positive thinking and the potency of hope.
- Develop future oriented goals with the patient and design an achievable plan.
- Assess suicidal tendencies and refer to psychiatrist and/or social worker if necessary.
Hopelessness is a mental state that can lead to disabling and devastating effects. By providing a supportive atmosphere and teaching constructive thought patterns, nurses and healthcare professionals can equip individuals suffering from feelings of hopelessness with effective coping methods and help them get back on the path to feeling hopeful again.
- Q: What is Hopelessness?
A: Hopelessness is a feeling of despair and pessimism, where one perceives that the outcome of any situation is painfully dismal. It could mean actively believing that any effort will be in vain and having no interest in acquiring help or support.
- Q: What Defines Hopelessness?
A: The NANDA International (NANDA-I) 2015–2017 defines Hopelessness as “a vague, pessimistic feeling about the future and a decreased expectation of attainment of goals”.
- Q: Who Is At-Risk for Developing Feelings of Hopelessness?
A: At Risk populations for hopelessness include, but are not limited to, those who are: Elderly, chronically unemployed, have mental illnesses, have lost a family member, have a history of chronic medical conditions, victims of abuse or neglect, or newborns with low birth weight.
- Q: What are Effective Methods for Treating Hopelessness?
A: Recognizing the triggers and warning signs of hopelessness is the first step in treating it. Effective methods for managing hopelessness include psychotherapy, cognitive behavioral therapy, talk therapy, medication, counselling & education, relaxation therapy, and facilitating contemplation.
- Q: What types of Goals are Appropriate for People Experiencing Hopelessness?
A: Goals for individuals dealing with hopelessness should focus on rebuilding hope, restoring self-esteem, improving sleep patterns, being safer, and developing better coping mechanisms.