Domain 7. Role relationship
Class 2. Family relationships
Diagnostic Code: 00058
Nanda label: Risk for impaired attachment
Diagnostic focus: Attachment
Nursing diagnosis is an important part of patient-oriented care, as it enables nurses to effectively assess the health status of an individual patient. It is a tool used by nurses to help identify problems that require intervention and focus on health problems that are most likely to lead to better patient outcomes. A nursing diagnosis involves the collection and analysis of data to formulate diagnoses and establish a plan of care to address identified risks or actual health problems. One such nursing diagnosis is risk for impaired attachment, meaning that the patient is at risk of forming an unhealthy emotional connection with another person or object.
NANDA Nursing Diagnosis Definition
The NANDA International (NANDA-I) defines risk for impaired attachment as “the state in which an individual is at risk of forming an unhealthy emotional connection with another person, object, or situation.” The definition further states that this connection may result from difficulty forming healthy relationships, preoccupation with someone or something, or difficulty establishing or maintaining boundaries. Other related nursing diagnoses include risk for dysfunctional relationship and risk for disorganized infant behavior.
Risk Factors
There are several common risk factors for impaired attachment. Social isolation and lack of contact with others can lead to a diminished sense of belonging and connection to others. In addition, if the environment is unstable, inconsistent, overbearing, or unsupportive, the individual may have difficulty forming secure attachments with other people. Certain mental health and substance use disorders, such as depression, anxiety, post-traumatic stress disorder, and addiction, can also negatively influence attachment.
At Risk Population
Anyone can be at risk for developing impaired attachment, however some populations experience this risk more often than others. Neonates, infants, and young children are particularly vulnerable as they often don’t receive adequate nurturing or their physical needs are not met. This can cause attachment issues later in life. Older adults can be at risk if they suffer from chronic illnesses or disability and have difficulty reconnecting with family and the community. People who have suffered abuse, neglect, or abandonment may also be at risk for impaired attachment.
Suggestions for Use
This particular nursing diagnosis can be useful in many settings. It can be applied when assessing patients in a hospital, clinic, or even in their home. This can also be applied in geriatric, psychiatric, pediatric, and even neonatal settings. The goal should always be to identify any risk factors for impaired attachment and create a plan to minimize these risks.
Suggested Alternative NANDA Nursing Diagnoses
The following alternative NANDA nursing diagnoses may also be appropriate when assessing individuals at risk for impaired attachment:
- Risk for dysfunctional relationship;
- Impaired verbal communication;
- Delayed growth and development;
- Impaired social interaction;
- Readiness for enhanced self-care.
Usage Tips
When using this nursing diagnosis, keep the following tips in mind:
- Check for any signs and symptoms that may indicate impaired attachment;
- Explore any underlying risk factors with the patient;
- Assess the patient’s ability to form meaningful relationships;
- Conduct a detailed psychosocial assessment;
- Be aware of any potential internal or external cues that may trigger feelings of vulnerability;
- Include the patient’s family members and/or significant others in case discussions and interventions.
NOC Outcomes
Nursing outcome classification (NOC) outcomes related to risk of impaired attachment include:
- Interpersonal Relationships: The patient’s ability to form and sustain meaningful relationships with others;
- Social Interaction: The patient’s interactions with family, friends, and other people in the community;
- Coping: The patient’s ability to handle stress, uncertainty, and daily demands;
- Family Processes: The patient’s ability to foster cooperation and mutual respect in the family;
- Family Coping: The family’s ability to manage problems and develop effective coping strategies.
Evaluation Objectives and Criteria
To effectively evaluate this nursing diagnosis, the following objectives and criteria should be considered:
- Objective 1: Determine the patient’s risk for impaired attachment;
- Criteria: Evaluate the patient’s social support network, interpersonal relationships, and family dynamics;
- Objective 2: Develop a plan to manage any identified risk factors;
- Criteria: Engage the patient and family members in the process to ensure mutual understanding and collaboration;
- Objective 3: Evaluate the patient’s ability to form and sustain meaningful relationships;
- Criteria: Monitor the patient’s response to interventions and provide additional support when necessary.
NIC Interventions
The following list of NANDA-I nursing interventions are appropriate when addressing risk for impaired attachment:
- Provide Psychotherapy: Provide individual and family therapy sessions to assist the patient with examining and managing emotions, unhealthy attachment styles, and stressors;
- Facilitate Communication: Facilitate open and honest communication between the patient and family members to build trust and foster positive relationships;
- Provide Supportive Care: Show respect, empathy, and positive reinforcement to promote positive behavior and enhance the patient’s self-esteem;
- Encourage Activity: Encourage the patient to participate in activities and social events to improve social interaction and strengthen relationships with others;
- Refer for Additional Resources: Refer the patient to appropriate resources such as counseling services and support groups.
Nursing Activities
The nursing activities to be performed when caring for a patient with risk for impaired attachment will depend on the patient’s specific needs and the identified risk factors. Essential activities include taking a detailed patient history, obtaining collateral information from family members, performing a physical assessment, reviewing laboratory test results, completing a psychosocial assessment, formulating a nursing diagnosis, writing a plan of care, implementing the intervention, and evaluating the results.
Conclusion
Risk for impaired attachment is an important nursing diagnosis to keep in mind when caring for patients. It is essential for nurses to assess for risk factors and intervene to appropriately address any issues. By utilizing the NANDA-I nursing diagnosis and related interventions, nurses can help to ensure that patients receive the best possible care in order to improve their health outcomes.
FAQs
- What is a nursing diagnosis? – A nursing diagnosis is a tool used by nurses to help identify problems that require intervention and focus on health problems that are most likely to lead to better patient outcomes.
- What is risk for impaired attachment? – Risk for impaired attachment is a nursing diagnosis that refers to the state in which an individual is at risk of forming an unhealthy emotional connection with another person, object, or situation.
- Who is at risk for impaired attachment? – Anyone can be at risk for developing impaired attachment, however some populations experience this risk more often than others, such as neonates, infants, and young children.
- What nursing interventions can be used to address risk for impaired attachment? – Interventions that can be used to address risk for impaired attachment include providing psychotherapy, facilitating communication, providing supportive care, encouraging activity, and referring for additional resources.
- How do nurses evaluate risk for impaired attachment? – Nurses should determine the patient’s risk for impaired attachment by evaluating the patient’s social support network, interpersonal relationships, and family dynamics. They should then develop a plan to manage any identified risk factors and monitor the patient’s response to interventions.