Risk for relocation stress syndrome

Domain 9. Coping-stress tolerance
Class 1. Post-trauma responses
Diagnostic Code: 00149
Nanda label: Risk for relocation stress syndrome
Diagnostic focus: Relocation stress syndrome

Nursing Diagnosis: Risk for Relocation Stress Syndrome

Relocation stress syndrome (RSS) is a challenging and often difficult psychological condition that can manifest when an individual, or entire family, moves to a new location. Resources for medical professionals who must provide assistance to those at- risk for relocation stress syndrome are limited. This article provides information about the diagnosis of RSS, risk factors and populations, associated conditions and suggested alternative nursing diagnoses, as well as nursing interventions, objectives and criteria for evaluation.

Introduction to Nursing Diagnosis

In order to properly evaluate, plan for and treat a patient, it is necessary for the healthcare provider to conduct an assessment of the patient's current state in order to determine if a nursing diagnosis is necessary. A nursing diagnosis is a recognized label which captures a patient's physical, psychological and social response to illness, with the focus placed on the patient's responses rather than the illness itself. It is critical in the assessment process to recognize any risk factors in order to intervene earlier in the treatment process.

NANDA Nursing Diagnosis Definition

The NANDA-International Taxonomy of Nursing Diagnoses defines Risk for Relocation Stress Syndrome as "the state in which an individual is at risk of emotional distress due to relocation". It is a risk diagnosis which should be determined when the individual is in the process of relocating or is already settled in a new location, and is a combination of the physical and psychological responses to the relocation.

Risk Factors and At-Risk Populations

Risk Factors: There are a variety of factors which may put an individual at risk for developing relocation stress syndrome, including cultural change, economic change, premature termination of significant relationships, lack of preparedness, insufficient knowledge of the new environment, overextension of resources, loss of personal identity, low self-esteem, and history of pre-existing mental illness.

At-Risk Populations: Those at risk for relocation stress syndrome encompass all ages, from infants to the elderly. In addition to age, those who have a history of mental health issues, are involved in the military or recently immigrated to a new country are more likely to develop this syndrome.

Associated Conditions

Symptoms of relocation stress syndrome can range from mild to very serious. Commonly, individuals will display a change in sleeping habits or appetite, experience changes in mood, or become anxious, hostile, or withdrawn. Serious cases may progress to depression, PTSD, post-traumatic growth, and even psychosis.

Suggestions for Use

It is important for healthcare providers to recognize the risk factors associated with relocation stress syndrome in order to provide proper treatment and intervention. Identifying areas of need such as education, current and expected transition challenges, as well as designing individualized plans are important in providing tailored care to individuals who are at risk.

Suggested Alternative NANDA Nursing Diagnoses

• Ineffective Coping
• Risk for Compromised Family Processes
• Risk for Imbalanced Nutrition: More Than Needed
• Self-Esteem Disturbance
• Social Isolation

Usage Tips

When assessing an individual for relocation stress syndrome, assess for potential triggers or contributing factors for the syndrome. Identify related nursing diagnoses that may need to be addressed in order to prevent additional problems or complications that can result from the relocation. Consider the impact of the transition on the individual's psychological and physical wellbeing before the transition occurs, during the transition, and after the move is complete.

NOC Outcomes

• Coping: Demonstrates balanced strategies for managing everyday situations and stresses related to relocation
• Family Processes: Demonstrates appropriate family interaction related to relocation
• Integrity and Resilience: Demonstrates ability to successfully adjust to relocation and new environment
• Nutrition: Demonstrates proper dietary practices, and demonstrates healthy dietary intake related to relocation
• Self-Esteem: Demonstrates understanding of personal and cultural identity related to relocation
• Sociability and Social Participation: Demonstrates sustained relationship with family, peers, and community in the new environment

Evaluation Objectives and Criteria

The primary objective of evaluating and diagnosing relocation stress syndrome is to identify the signs and symptoms of this condition, as well as any risk factors present. The criteria which should be evaluated in order to determine the presence of RSS include psychological and physiological responses related to relocation, such as difficulty with sleeping, lack of interest in daily activities, feelings of powerlessness, isolation, decreased sense of control, and changes in appetite. Other criteria could include educational attainment, knowledge of the new environment, and economic status of the individual.

NIC Interventions

• Crisis Intervention: Provides emotional support and safety for individuals with relocation stress syndrome
• Environmental Management: Prepares the patient’s environment to induce safety and wellness related to relocation
• Family Education: Teaches family members techniques to facilitate adjustment post-relocation
• Stress Management: Provides education and techniques to mitigate stress related to relocation
• Support Systems: Connects the individual with support systems in the new location

Nursing Activities

It is essential that the nurse identify at-risk populations and intervene early to prevent long-term symptoms or co-morbidities. Nurses should assess the individual for risk factors, ask about employment, living and financial situations, as well as provide education about any available support services.

Conclusion

Relocation stress syndrome can have a significant impact on individuals, families and communities. Healthcare providers must have the knowledge and skills to properly assess and diagnose RSS in order to intervene early, provide support and reduce the sufferings associated with this commonly overlooked syndrome.

5 FAQs

• What is Relocation Stress Syndrome? Relocation Stress Syndrome is a psychological condition that develops due to the emotional distress associated with relocation.
• Who is at risk of developing Relocation Stress Syndrome? Individuals of any age, including infants to seniors, or those with a history of mental health issues, involvement in the military, or recent immigration may be at risk.
• What are possible symptoms of Relocation Stress Syndrome? Symptoms can range from mild to severe and include changes in sleep and appetite, mood swings, anxiety, hostility or withdrawal, and in rare cases, depression, PTSD, or psychosis.
• How can I identify if someone has Relocation Stress Syndrome? A healthcare provider can assess for risk factors when determining if someone has Relocation Stress Syndrome. Identifying areas of need and creating an individualized plan can help tailor care to those at risk.
• What steps can I take to help relieve symptoms of Relocation Stress Syndrome? Healthcare providers should assess for any potential triggers or contributing factors to Relocation Stress Syndrome, as well as related nursing diagnoses in order to prevent further problems. Additionally, providing education and connecting the individual with support services within their new environment can help to mitigate stress.

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