This article was reviewed and fact-checked by our Editorial Team.
- Community
-
Programs
- Schools
-
Careers
- RN Specialties
- Best RN Jobs and Salaries
- Aesthetic Nurse
- Nursing Informatics
- Nurse Case Manager
- NICU Nurse
- Forensic Nurse
- Labor and Delivery Nurse
- Psychiatric Nurse
- Pediatric Nurse
- Travel Nurse
- Telemetry Nurse
- Dermatology Nurse
- Nurse Practitioner
- Best NP Jobs and Salaries
- Family NP (FNP)
- Pediatric NP
- Neonatal NP
- Oncology NP
- Acute Care NP
- Aesthetic NP
- Women's Health NP
- Adult-Gerontology NP
- Orthopedic NP
- Emergency NP
- Psychiatric-Mental Health NP (PMHNP)
- APRN
- Nurse Educator
- Nurse Administrator
- Certified Nurse Midwife (CNM)
- Clinical Nurse Specialist (CNS)
- Certified Registered Nurse Anesthetist (CRNA)
- Resources
- Education
The psychosocial nursing diagnosis focuses on how a patient's mental health and social environment might affect their overall wellness. Instead of strictly physical issues, like other medical diagnoses, this type of evaluation looks at emotional and mental attributes—such as anxiety, depression, or low self-esteem—that can manifest into serious physical conditions.
An estimated 20% of Americans(1) are affected by mental illness and substance abuse disorders, which lead to significant morbidity and mortality.
Table of Contents
Psychosocial nursing diagnoses are often used for patients with conditions such as:
It helps nurses to recognize psychological factors such as stressors, coping and relationships that may be contributing to the physical or psychological state of the patient. By taking a holistic approach to the patient, psychosocial nursing diagnoses can provide essential background information and insight which help create a detailed plan of care that accounts for the patient's emotional and social—as well as physical—needs.
Psychosocial diagnoses are invaluable in creating patient-centered clinical plans, which can lead to better care outcomes. Ideally, the resulting evaluation gives insight into how best to help patients attain optimal physical health and improved quality of life.
NANDA-I List of Psychosocial Nursing DiagnosisExamples of psychosocial nursing diagnoses are (not exhaustive):
Psychosocial Care PlansThe following are potential evidence-based nursing care plans that could be used in conjunction with a psychosocial nursing diagnosis.
Ineffective Coping Care Plan
Nursing diagnosis of ineffective coping is a label given to those individuals who find it difficult to deal with stressful situations effectively. The inability to cope with different stressors interferes with daily life and an individual's overall health and well-being.
This diagnosis can be seen through a person's behavior or as appearing in an individual's reaction to various life events. Treating this diagnosis depends on the source of distress and often includes long-term counseling or therapy, lifestyle changes, and supportive care management.
With proper support, individuals can process their emotions better, manage stress, and acquire new tools for effectively dealing with future challenges.
Ineffective Coping Related Diagnoses
Ineffective Coping As Evidenced By:
Ineffective Coping Nursing Assessment
Nursing Interventions and Rationale For Ineffective Coping
Expected Outcomes
Situational Low Self-Esteem Care Plan
The nursing diagnosis of Situational Low Self-Esteem is a formal recognition of an individual's lack of confidence in their abilities and value to the world. It happens when someone experiences feelings of inadequacy or helplessness in their current situation, usually caused by a traumatic event or difficult circumstances such as abuse or poverty.
This issue can greatly impact someone's life, as they may withdraw from social interaction, struggle with decision-making, avoid making long-term commitments, and possibly even experience depression and anxiety.
Fortunately, by speaking to a trained nurse or therapist who understands this diagnosis and its associated problems, sufferers can fight back against sensations of low self-esteem and learn how to thrive in difficult situations.
Currently, no test or technique is widely accepted to detect low self-esteem. Nevertheless, the Rosenberg Self-Esteem Scale (RSE) has been in use extensively to assess low self-esteem since it was developed in 1965(3).
Situational Low Self-Esteem Related Nursing Diagnosis
Situational Low Self-Esteem As Evidenced By:
Situational Low Self-Esteem Nursing Assessment
Nursing Interventions and Rationale for Situational Low Self-Esteem
Expected Outcomes
Grieving Care Plan
Grief is a normal, albeit oftentimes painful, emotion expressed by individuals as they cope with loss. As such, nursing diagnoses are keen on addressing the needs of mourning individuals in a variety of ways.
Nurses can assess, diagnose and create an individualized plan of care that supports their patient's grieving process through active listening, providing information about realistic expectations, suggesting problem-solving strategies or connecting patients to additional sources of support.
Through an attentive approach, nurses can safely assure their patient's healing journey remains at the forefront of care and that their grief is addressed thoroughly and compassionately.
Grieving Related Nursing Diagnosis(4)
Grieving As Evidenced By:
Grieving Nursing Assessment
Nursing Interventions and Rationale for Grieving
Expected Outcomes
Psychosocial Nursing Diagnosis Case Study ExamplesRisk for Suicide Case Study Example
Scenario
A 35-year-old homeless male presents to the emergency department via EMS for a suicide attempt after the suicide of his brother. The patient is on an involuntarily psychiatric hold and has a 1:1 sitter.
The patient's spouse found the patient with bloody wounds to his neck and wrists and a broken mirror nearby. The patient has a history of schizophrenia, major depressive disorder, alcohol abuse disorder with a history of complicated withdrawal secondary to withdrawal seizure, intravenous drug user, and one previous suicide attempt in the past by exsanguination requiring 2 liters of packed red blood cells secondary to hypovolemic shock.
Currently, the patient is having a psychotic episode but denies homicidal ideations. The patient is expressing euphoria and being grandiose with rapid speech. In addition to refusing to give blood for lab work, the patient also refuses to take medications. As a result of this failed attempt, he believes that he will succeed the next time as he knows what he did wrong as he was unsuccessful the first time. Vital signs: T 98.4, BP 175/102, P 127, R 22, SpO2 95% on room air.
Nursing Diagnosis
Risk for Self Harm related to feelings of loneliness, grief, homelessness, hopelessness, or hopelessness secondary to the psychiatric disorder schizophrenia as evidenced by suicidal ideations and self-inflicted wounds.
Subjective Data
The patient states that he understands how to change his suicide plan the next time based on this failed suicide attempt.
Objective Data
Vital signs: T 98.4, BP 175/102, P 127, R 22, SpO2 95% on room air.
The patient has multiple neck wounds requiring wound care, hypertension, tachycardia, and tachypnea. The patient is also showing psychotic behavior, as evidenced by fast, at times, grandiose, incoherent speech and euphoria. Based on the patient's history of a seizure related to alcohol withdrawal, it is necessary to observe the patient for signs of alcohol withdrawal. Also, the patient is refusing to submit for lab testing and refusing medications.
Desired Outcomes
Nursing Interventions
Psychosocial NCLEX QuestionsApproximately 9 percent of the questions on the NCLEX relate to Psychosocial Integrity(5). The following questions are hypothetical questions created to help you better understand the material.
Question: A client with borderline personality disorder is exhibiting self-harming behavior. What is the nurse's priority intervention in this situation?
Answer: The nurse's priority intervention in this situation is to ensure the client's safety and prevent further harm. This may include physically intervening to stop the self-harming behavior, providing a safe and supportive environment, and engaging in crisis management. The nurse should also assess the client's mental and emotional state, provide therapeutic communication, and collaborate with the healthcare team to develop an individualized care plan for the client.
Question: A 60-year-old male patient leaves their room and begins walking to the cafeteria. You recall that his privileges do not include visiting the cafeteria, and kindly ask the man to return to their room and you can place a food order. The patient becomes verbally abusive. What is the most appropriate approach?
Answer: Firmly escort the patient back to his room and request additional assistance if needed.
STAFF NOTE: Original Community Post
This article was created in response to a community post. The comments and responses have been left intact as they may be helpful. Here's the original post:
References
About Lemetria Whitehurst, RN
My clinical experience includes medical/surgical, psychiatric, long-term care, and orthopedic nursing.
Share this post
Share on other sites