Domain 7. Role relationship
Class 2. Family relationships
Diagnostic Code: 00060
Nanda label: Interrupted family processes
Diagnostic focus: Family processes
Nursing diagnosis is an important step in the nursing process and is used to assess the health status of patients. The nurse first assesses the patient’s needs and then designs a care plan based on her findings. Nursing diagnosis can include physical, mental, and emotional issues that impede the patient’s health. Nursing diagnosis includes identifying the causes of disturbed family processes. One example of this type of diagnosis is interrupted family processes.
NANDA Nursing Diagnosis Definition
Interrupted family processes is defined by the North American Nursing Diagnosis Association (NANDA) as a disruption in dyadic or interpersonal relationships between family members, affecting communication, decision-making, problem-solving, expectations, and behaviors. This definition encompasses any disruption of a family system to the extent that functioning within the family is less than optimal and as a result, one or more family members suffer distress.
The defining characteristics of family processes that are disrupted include:
- Altered communication patterns
- Ineffective decision making
- Unsuccessful problem-solving attempts
- Unrealistic expectations
- Inappropriate behaviors
- Lack of trust, intimacy, and/or closeness within family members
- Grief, anger, pain, confusion, guilt, fear, and worry expressed by family members
- Stressful circumstances in the family environment
There are several factors that can contribute to interrupted family processes. These include, but are not limited to, illness or disability of a family member, death of a family member, family member being incarcerated, financial pressures, substance abuse, cultural differences, geographical distance, relational conflict, and trauma experienced by one or more family members.
At Risk Population
Those most at risk of experiencing interrupted family processes are individuals who come from socioeconomically disadvantaged backgrounds. This includes individuals who live in poverty, those who lack access to basic resources, and those who have little or no access to healthcare. Other vulnerable populations are families with young children, those in which there are high levels of stress, violence, or conflict, and families with members with chronic illnesses or disabilities.
The associated conditions of interrupted family processes are varied and depend on the individual family’s dynamics. However, some common conditions include depression, anxiety, decreased role satisfaction, psychological distress, physical illness, marital conflict, and child/adolescent behavioral issues.
Suggestions of Use
Nurses must be familiar with the concepts and definitions of interrupted family processes to effectively identify and respond to them. Nurses must be able to accurately assess the family system to identify any disruptions and evaluate the family dynamic. All family members must be included in the assessment so that their perspectives can be considered. Nurses must also be skilled in creating interventions to improve family functioning.
Suggested Alternative NANDA Nursing Diagnosis
The following are suggested alternative NANDA nursing diagnoses for dealing with disrupted family processes:
- Family Processes, Alteration in
- Family Caregiver Role Strain
- Family Role Confusion
- Family Dysfunction
- Risk for Family Violence
When using these nursing diagnoses, it is important to tailor the interventions to meet the individual family’s needs. The nurse should ensure that all family members are involved in the treatment plan and should involve other stakeholders in the community such as religious groups and local agencies, if necessary.
The following are possible NOC outcomes for interrupted family processes:
- Family Functioning – the degree of family integration, including the level of harmony and communication, decision making efficacy, and cooperation.
- Family Strength-based Problem Solving – the family’s ability to identify and utilize strengths to resolve problems and changes.
- Family Support – the amount of assistance and encouragement provided by family members.
- Caregiver Relationship Quality – the quality of the relationship between family members and caregivers.
- Caregiver Role Competence – the ability of family members to meet the needs of the patient(s).
- Family Comfort and Ease of Interaction – the family’s comfort level with interacting with each other.
- Family Coping – the family’s ability to manage stress and changes in an adaptive manner.
Evaluation Objectives and Criteria
The evaluation objectives and criteria for measuring the effectiveness of interventions for interrupted family processes include increased family functioning, increased family strength-based problem solving, increased family support, improved caregiver relationship quality, improved caregiver role competence, increased family comfort and ease of interaction, and increased family coping.
The following are possible NIC interventions for interrupted family processes:
- Family counseling and education – to address the family’s dysfunctional patterns of interaction and to provide information, support, and skills training.
- Family advocacy – to help the family and individual members obtain needed resources.
- Family support services – to ensure that the family has adequate resources to meet their needs.
- Advocacy on behalf of the patient – to ensure that the patient has appropriate care.
- Assessment of family relationships –to identify areas of discord and conflict.
- Conflict resolution and mediation – to help family members resolve conflicts and restore peace within the family.
- Rule setting – to establish expectations for family dynamics, communication, and behavior.
- Stress management – to assist the family in managing stress more effectively.
The nurse should focus on creating a nurturing environment where family members can feel safe to express their emotions and concerns. The nurse should assess family dynamics, identify broken communication patterns, facilitate mutually beneficial dialogue, set agreed-upon rules and roles, provide problem-solving strategies, build healthy boundaries, and create respectful and meaningful rituals.
Nurses have an important role in helping families cope with the disruption of family processes. Nurses must be knowledgeable about the concept of interrupted family processes and be able to accurately assess the family’s dynamics to identify any disruption. Nurses must also be skilled in creating interventions to restore and improve family functioning.
- What is interrupted family processes? Interrupted family processes is defined by the North American Nursing Diagnosis Association (NANDA) as a disruption in dyadic or interpersonal relationships between family members, affecting communication, decision-making, problem-solving, expectations, and behaviors.
- What are the defining characteristics of interrupted family processes? The defining characteristics of family processes that are disrupted include altered communication patterns, ineffective decision making, unsuccessful problem-solving attempts, unrealistic expectations, inappropriate behaviors, lack of trust, intimacy, and/or closeness within family members, grief, anger, pain, confusion, guilt, fear, and worry expressed by family members, and stressful circumstances in the family environment.
- What population is most at risk for experiencing interrupted family processes? Individuals who come from socioeconomically disadvantaged backgrounds, specifically those living in poverty, lacking access to basic resources, and having little or no access to healthcare, are most at risk for experiencing interrupted family processes. Other vulnerable populations are families with young children, those in which there are high levels of stress, violence, or conflict, and families with members with chronic illnesses or disabilities.
- Which NANDA nursing diagnoses can be used to address disrupted family processes? The suggested alternative NANDA nursing diagnoses for dealing with disrupted family processes are Family Processes, Alteration in; Family Caregiver Role Strain; Family Role Confusion; Family Dysfunction; and Risk for Family Violence.
- What NOC outcomes can be used to evaluate interventions for disrupted family processes? The possible NOC outcomes for interrupted family processes are Family Functioning, Family Strength-Based Problem Solving, Family Support, Caregiver Relationship Quality, Caregiver Role Competence, Family Comfort and Ease of Interaction, and Family Coping.