Domain 9. Coping-stress tolerance
Class 2. Coping responses
Diagnostic Code: 00152
Nanda label: Risk for powerlessness
Diagnostic focus: Power
Nursing Diagnosis Risk for Powerlessness
Introduction
The concept of "powerlessness" has become an important aspect of nursing care. It is defined as a feeling of being in a situation where one's desired outcome is not likely to occur, even though every effort is put in to work toward that outcome. When assessing a patient for the presence of powerlessness, it is important to recognize the many factors that can contribute to this experience. This article will focus on nursing diagnosis risk for powerlessness and the associated considerations for both the patient and the nurse.
NANDA Nursing Diagnosis Definition
Nursing diagnosis risk for powerlessness is defined as an “actual or potential state in which an individual experiences fear that he or she will be unable to influence events or make decisions concerning his/her own life”. The feeling of being unable to affect change or make one’s own decisions can be emotionally draining and lead to decreased quality of life.
Risk Factors
Powerlessness can be caused by a variety of different factors, including physical limitations, socio-economic status, age, health issues or environmental factors. Other risk factors include lack of autonomy, cognitive impairment and functional disability.
For instance, age can be a significant factor in a person's experience of powerlessness. Older persons may be more likely to feel powerless due to the physical, cognitive and psychological changes associated with aging. They may also find it more difficult to make decisions, giving them less control over their own lives. Socioeconomic status can also play a role, as those in lower socioeconomic classes may have fewer tangible resources as well as fewer social and political power.
At Risk Population
At risk population groups are those most likely to experience powerlessness due to their vulnerable position in society. These groups can include the elderly, people with physical or mental disabilities, people with chronic illnesses, those in poverty or who have suffered traumatic experiences.
Associated Conditions
A diagnosis of powerlessness may be associated with any of the following conditions: depression, substance misuse, anxiety, isolation, aggression or other mental health issues. People experiencing powerlessness may also have poorer overall health outcomes due to a lack of self-care and increased stress levels.
Suggested Use
In order to address feelings of powerlessness among patients, nurses should seek to understand their clients’ perspectives and seek out interventions to help them regain a sense of control over their lives. It is important to ensure that clients feel they have access to information and can make decisions regarding their own care. One way to promote autonomy and empower clients is to provide them with support, education and resources to make informed decisions and give them the opportunity to advocate for themselves.
Suggested Alternative NANDA Nursing Diagnosis
Alternative nursing diagnoses related to powerlessness may include: impaired verbal communication, activity intolerance, decreased cardiac output and social isolation.
Usage Tips
Some tips to consider when working with clients who struggle with feelings of powerlessness include:
- Developing a trusting relationship with the client.
- Providing safety measures and empowering the client through goal setting and problem solving.
- Encouraging the client to express their feelings of powerlessness.
- Helping the client to identify their unique areas of personal strength and how they can use those strengths to take charge of their own lives.
NOC Outcomes
NOC outcomes related to powerlessness include:
- Self-care: Ability to bathe, dress, feed oneself, and perform other activities necessary for daily living.
- Coping: Ability to manage life situations in a constructive manner.
- Health perception: State of understanding about personal health.
- Autonomy: Sense of self-determination and freedom from external influence.
- Self-concept: Assessment of personal worth.
Each of these outcomes should be assessed and addressed according to the individual's situation and level of risk for powerlessness. For example, interventions that focus on helping the patient gain a sense of autonomy and boost self-confidence may be particularly beneficial for an elderly patient who feels powerless due to age-related health issues.
Evaluation Objectives and Criteria
The goal when evaluating patients for powerlessness is to assess their ability to function, interact and cope independently within their environment. To do so, nurses should be able to quantify the degree of powerlessness and its magnitude. Evaluation criteria may include assessment of physical health, mental health, self-esteem and confidence levels, autonomy, coping skills and social interaction.
NIC Interventions
NIC interventions related to powerlessness include:
- Cognitive stimulation: Use of creative activities to enhance cognitive functioning.
- Cognitive reframing: Reframing thoughts to limit negative self-dialogue and enhance confidence.
- Self-care support: Providing assistance and training to help the patient complete activities of daily living.
- Social support: Connecting the patient to supportive friends/family members or providing additional social support.
- Activity therapy: Using physical activities to restore sense of control and self-efficacy.
Nursing Activities
When working with patients regarding the risk of powerlessness, nurses should implement several strategies to address the underlying causes. These strategies may include:
- Providing emotional support and a safe environment for the patient to explore their feelings.
- Exploring all options for regaining control in difficult situations.
- Identifying and challenging negative thinking patterns.
- Teaching effective coping strategies such as goal-setting and problem solving.
- Offering guidance on how to take action and empower the client.
Conclusion
Nurses play an important role in recognizing and addressing the risk for powerlessness among their patients. Nurses should look for signs and symptoms of powerlessness and develop interventions to empower their patients and help them regain control.
Five FAQs
Q: What is nursing diagnosis risk for powerlessness?
A: Nursing diagnosis risk for powerlessness is an actual or potential state in which an individual experiences fear that he or she will be unable to influence events or make decisions concerning his/her own life.
Q: What are some risk factors for powerlessness?
A: Risk factors for powerlessness include physical limitations, socio-economic status, age, health issues and environmental factors.
Q: Who is most at risk for powerlessness?
A: At risk population groups for powerlessness include the elderly, people with physical or mental disabilities, people with chronic illnesses, those in poverty or who have suffered traumatic experiences.
Q: What are some associated conditions for powerlessness?
A: A diagnosis of powerlessness may be associated with depression, substance misuse, anxiety, isolation, aggression or other mental health issues.
Q: What are some nursing interventions that can be used to help patients experiencing powerlessness?
A: When working with patients experiencing powerlessness, nurses should seek to develop a trusting relationship, provide safety measures and empowering strategies, encourage clients to express their feelings, and help the client to identify areas of strength and make decisions.
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