Domain 7. Role relationship
Class 1. Caregiving roles
Diagnostic Code: 00056
Nanda label: Impaired parenting
Diagnostic focus: Parenting
Nursing diagnosis is a process used by healthcare professionals to identify and address the patient’s health-related conditions. When a nurse evaluates a patient, one particular diagnosis could be “impaired parenting”. This diagnosis is based on the patient’s environment, behavior and experiences that are related to parenting. It involves evaluating how the patient lives-in, develops and interacts with their children.
NANDA Nursing Diagnosis Definition
NANDA (North American Nursing Diagnosis Association) defines impaired parenting as “a parental behavior characterized by an inability to adequately or effectively perform the parenting role.” Parents may be deficient in physical, psychological or spiritual well being, lack basic knowledge of child rearing and development, or lack financial resources which make it difficult to provide for the needs of their children.
Subjectives: feelings of guilt, remorse, anxiety, depression, hopelessness and helplessness regarding parenting. Parents may have a sad demeanor and an inability to engage in age and situation appropriate parenting activities.
Objectives: neglectful behaviors, physical abuse, substance abuse, developmental and cognitive delays in children, failure to use age-appropriate discipline, poor communication, inadequate supervision of children leading to unsafe behaviors and risky play, lack of affection towards children, disruptive/erratic parenting behaviors.
There are many factors that contribute to Impaired Parenting, including mental illness, substance abuse, poverty, illiteracy, domestic abuse, physical illness, lack of case management services, poor academic and job performance, social isolation and dysfunctional family relationships.
At Risk Population
Members of at-risk populations who have suffered some trauma tend to have a higher likelihood of having difficulties with parenting since they may have had no positive role models or inadequate instruction on parenting when they were growing up. Children of these at-risk populations are more likely to have behavior issues like drug and alcohol use, suicidal ideation, criminal behavior, and running away from home.
Various conditions are associated with Impaired Parenting, such as depression, bipolar disorder, ADHD, addiction, post-traumatic stress disorder (PTSD), autism spectrum disorder, and other psychiatric disorders. In addition, parents who are immigrants or refugees often experience higher levels of stress due to cultural differences and displacement.
Suggestions of Use
Healthcare professionals can help families by providing education on parenting skills and strategies, referring the family to support services and community resources that are tailored to meet the individual needs of the family, and conducting stress assessments in order to evaluate the level of distress among family members.
Alternate NANDA Nursing Diagnosis Suggestions
- Knowledge Deficit: Parenting
- Family Processes, Interrupted
When formulating a nursing plan of care, nurses should consider the specific needs of the family. It is important to assess the family dynamics and provide education on parenting strategies such as positive reinforcement, appropriate discipline and communication skills.
Nursing Outcome Classification (NOC) outcomes that can be used to improve parenting include:
- Parenting Knowledge: A family’s understanding of parenting, development, infant and child health knowledge is improved. (This outcome measures the quality of the mother’s knowledge about appropriate care for her children.)
- Engagement with Health Care Professionals: The family participates in consultations with healthcare professionals to improve their parenting skills and gain information about the health of the child. (This outcome indicates the family’s ability to follow through with medical recommendations and access necessary resources.)
- Parental Coping: The family demonstrates adequate coping and problem-solving skills when confronted with new or challenging parenting situations. (This outcome measures the family’s ability to address parenting issues in an appropriate manner.)
- Environmental Support: The family’s access to community resources (e.g. day care, play groups, parenting classes) improves, providing supportive environment for the family. (This outcome reflects the family’s ability to access necessary services and resources needed to become successful parents.)
Evaluation Objectives and Criteria
When evaluating this nursing diagnosis, nurses need to consider the following objectives and criteria:
- Objective 1: Evaluate the family’s knowledge of parenting techniques and strategies.
Criteria 1: Demonstrate an ability to provide quality care for the child.
- Objective 2: Evaluate the family’s ability to access community resources and follow treatment plans.
Criteria 2: Demonstrate adequate understanding of appropriate treatment plans.
- Objective 3: Evaluate the family’s ability to cope with parenting challenges.
Criteria 3: Demonstrate an ability to problem solve with acceptable parenting methods.
Nursing Interventions Classification (NIC) interventions that can be used to improve parenting include:
- Caregiver Coaching and Guidance: Guide and encourage the family to learn and practice effective parenting principles. (This intervention includes helping the family to appraise parenting skills and develop appropriate responses to child behaviors.)
- Safety Facilitation: Foster an environment that is safe for children through safety planning, setting boundaries and effective discipline. (This intervention focuses on helping the family maintain an appropriate level of safety for their children.)
- Family Education: Provide information to the family about parenting and child health to promote well-being. (This intervention involves educating the family on the importance of health promotion, nutrition, exercise and immunization.)
- Case Management: Facilitate access to community resources and services that are needed by the family. (This intervention focuses on helping the family to find and access appropriate community resources.)
Nurses can be involved in the following activities to improve parenting:
- Conduct safety assessments to screen for dangers in the environment that may increase the risk for injury or illness.
- Complete an initial assessment of family dynamics and coping skills.
- Provide education on parenting role, development and nutrition.
- Provide emotional support and referrals to social services, when needed.
- Refer family to appropriate community resources to support parenting.
- Teach problem-solving strategies and protective behaviors for children.
- Monitor development of the child and provide anticipatory guidance.
Although there are many factors that contribute to impaired parenting, healthcare professionals can make a difference in the lives of these families by providing support, education and direction. Through the use of various NANDA and NIC interventions, nurses can help families create a safe and nurturing environment for their children.
- What is involved in an impaired parenting diagnosis?
An impaired parenting diagnosis involves evaluating how the patient acts, behaves, and interacts with their children. This diagnosis is based on the patient’s environment, behavior and experiences that are related to parenting. It can involve assessing the patient’s physical, psychological or spiritual well being, evaluation of basic knowledge about child rearing and development, and assessing the patient’s financial resources to provide for the needs of their children.
- What are some related factors to impaired parenting?
There are many factors that can relate to impaired parenting such as mental illness, substance abuse, poverty, illiteracy, domestic abuse, physical illness, lack of case management services, poor academic and job performance, social isolation and dysfunctional family relationships.
- What interventions can help to improve impaired parenting?
Nurses can help families by providing education on parenting skills and strategies, referring the family to support services and community resources that are tailored to meet the individual needs of the family, and conducting stress assessments in order to evaluate the level of distress among family members.
- What types of evaluations should be considered when diagnosing impaired parenting?
When evaluating this nursing diagnosis, nurses need to consider objectives and criteria such as evaluating the family’s knowledge of parenting techniques and strategies, assessing the family’s ability to access community resources, and measuring the family’s ability to cope with parenting challenges.
- What types of activities can nurses do to improve parenting?
Nurses can be involved in assessing the environment for potential dangers, completing an assessment of family dynamics and coping skills, providing education on parenting role, development and nutrition, providing emotional support and referrals to social services, referring the family to appropriate community resources, teaching problem-solving strategies, and monitoring the development of the child and providing anticipatory guidance.