This guide is about impaired social interaction, impaired social interaction diagnosis, impaired social interaction assessment, impaired social interaction interventions, and 1 impaired social interaction care plan. It can be used to create educational nursing plans for impaired social interaction.
IMPAIRED SOCIAL INTERACTION
What is impaired social interaction?
Impaired social interaction is a consistent lack of orientation to a person, place, circumstances or time for a period exceeding 3 to 6 months creating the necessity to form a protective environment. Protecting the patient is a professional judgment based on the application of clinical knowledge that determines the actual or potential experience of a patient. It also requires professional judgment to determine the response by a patient to this impairment and life processes it affects.
Impaired Social Interaction Care Plan outline the various set action carried out when managing this condition. An impaired social interaction care plan helps the nurse to follow the commonly applied interventions and choose the most applicable to a patient. Choosing the intervention from a standard Impaired Social Interaction Care Plan allows fast, efficient understanding of the patient needs, the ways to sort them out and promote patient safety.
What are the factors related to impaired social interaction?
Here are the common related factors for impaired social interaction that can be as your “related to” in your schizophrenia nursing diagnosis statement:
- Difficulty with communication
- Difficulty with concentration
- Exaggerated response to alerting stimuli
- Feeling threatened in social situations
- Impaired thought processes (delusions or hallucinations)
- Inadequate emotional responses
- Self concept disturbance (verbalization of negative feelings about self)
What are the defining characteristics of impaired social interaction?
The commonly used subjective and objective data or nursing assessment cues (signs and symptoms) that could serve as your “as evidenced by” for this nursing care plan for schizophrenia:
- Appears upset, agitated, or anxious when others come too close in contact or try to engage him/her in an activity
- Dysfunctional interaction with others/peers
- Inappropriate emotional response
- Observed use of unsuccessful social interactions behaviors
- Spends time alone by self
- Unable to make eye contact, or initiate or respond to social advances of others
- Verbalized or observed discomfort in social situations
IMPAIRED SOCIAL INTERACTION DIAGNOSIS
How do you diagnose for impaired social interaction?
A diagnosis is essential in finding out if a patient has impaired social interaction, particular need and the right course of action without going through a long narrative. After suspecting patient to have impaired social interaction, a caregiver should look if a patient has these signs and symptoms to confirm the existence.
- Persistent state of disorientation to the environment
- Extreme confusion
- Inability to follow simple instructions, concentrate or reason
- Memory decline that leads to loss of social function or occupation
- Slow response to questions
A patient with these relating factors could also be having impaired social interaction.
- Huntington’s disease
IMPAIRED SOCIAL INTERACTION CARE PLAN GOALS AND OUTCOMES
What are the goals and outcomes for nursing diagnosis of impaired social interaction?
A nurse should prepare a Impaired Social Interaction Care Plan with a goal to help the patient in achieving these outcomes that contribute to containing impaired social interaction:
- Patient will attend one structured group activity within 5-7 days.
- Patient will seek out supportive social contacts.
- Patient will improve social interaction with family, friends, and neighbors.
- Patient will use appropriate social skills in interactions.
- Patient will engage in one activity with a nurse by the end of the day.
- Patient will maintain an interaction with another client while doing an activity (e.g., simple board game, drawing).
- Patient will demonstrate interest to start coping skills training when ready for learning.
- Patient will engage in one or two activities with minimal encouragement from nurse or family members.
- Patient will state that he or she is comfortable in at least three structured activities that are goal directed.
- Patient will use appropriate skills to initiate and maintain an interact
IMPAIRED SOCIAL INTERACTION ASSESSMENT
How can a nurse access for impaired social interaction?
Nursing assessment is essential to determine the defining factors showing that a patient must be having impaired social interaction. It also helps to define the right interventions to include in the Impaired Social Interaction Care Plan and help the patient to overcome the impairments.
A nurse should make these assessments:
- Coordination and interaction with other people in the social settings
- Hearing or vision deficits
- Knowledge and communication
- Sensory perception
IMPAIRED SOCIAL INTERACTION INTERVENTIONS
What are the nursing interventions and rationales for impaired social interaction?
In this section are the nursing actions or interventions and their rationale or scientific explanation for impaired social interaction (nursing diagnosis for schizophrenia):
|Assess if the medication has reached therapeutic levels.||Many of the positive symptoms of schizophrenia (hallucinations, delusions, racing thoughts) will subside with medications, which will facilitate interactions.|
|Identify with client symptoms he experiences when he or she begins to feel anxious around others.||Increased anxiety can intensify agitation, aggressiveness, and suspiciousness.|
|Keep client in an environment as free of stimuli (loud noises, crowding) as possible.||Client might respond to noises and crowding with agitation, anxiety, and increased inability to concentrate on outside events.|
|Avoid touching the client.||Touch by an unknown person can be misinterpreted as a sexual or threatening gesture. This particularly true for a paranoid client.|
|Ensure that the goals set are realistic; whether in the hospital or community.||Avoids pressure on the client and sense of failure on part of nurse/family. This sense of failure can lead to mutual withdrawal|
|Structure activities that work at the client’s pace and activity.||Client can lose interest in activities that are too ambitious, which can increase a sense of failure.|
|Structure times each day to include planned times for brief interactions and activities with the client on one-on-one basis||Helps client to develop a sense of safety in a non-threatening environment.|
|If client is unable to respond verbally or in a coherent manner, spend frequent, short period with clients.||An interested presence can provide a sense of being worthwhile.|
|If client is found to be very paranoid, solitary or one-on-one activities that require concentration are appropriate.||Client is free to choose his level of interaction; however, the concentration can help minimize distressing paranoid thoughts or voice.|
|If client is delusional/hallucinating or is having trouble concentrating at this time, provide very simple concrete activities with client (e.g., looking at a picture or do a painting).||Even simple activities help draw client away from delusional thinking into reality in the environment.|
|If client is very withdrawn, one-on-one activities with a “safe” person initially should be planned.||Learn to feel safe with one person, then gradually might participate in a structured group activity.|
|Try to incorporate the strengths and interests the client had when not as impaired into the activities planned.||Increase likelihood of client’s participation and enjoyment.|
|Teach client to remove himself briefly when feeling agitated and work on some anxiety relief exercise (e.g., meditations, rhytmic exercise, deep breathing exercise).||Teach client skills in dealing with anxiety and increasing a sense of control.|
|Useful coping skills that client will need include conversational and assertiveness skills.||These are fundamental skills for dealing with the world, which everyone uses daily with more or less skill.|
|Remember to give acknowledgment and recognition for positive steps client takes in increasing social skills and appropriate interactions with others.||Recognition and appreciation go a long way to sustaining and increasing a specific behavior.|
|Provide opportunities for the client to learn adaptive social skills in a non-threatening environment. Initial social skills training could include basic social behaviors (e.g., appropriate distance, maintain good eye contact, calm manner/behavior, moderate voice tone).||Social skills training helps the client adapt and function at a higher level in society, and increases the client’s quality of life.|
|As the client progresses, provide the client with graded activities according to the level of tolerance e.g., (1) simple games with one “safe” person; (2) slowly add a third person into “safe”.||Gradually the client learns to feel safe and competent with increased social demands.|
|As the client progresses, Coping Skills Training should be available to him/her (nurse, staff or others). Basically the process:
||Increases client’s ability to derive social support and decrease loneliness. Clients will not give up the substance of abuse unless they have alternative means to facilitate socialization they belong.|
|Eventually engage other clients and significant others in social interactions and activities with the client (card games, ping pong, sing-a-songs, group sharing activities) at the client’s level.||Client continues to feel safe and competent in a graduated hierarchy of interactions.|
1 IMPAIRED SOCIAL INTERACTION NURSING CARE PLAN
r/t Severe Anxiety
Use of unsuccessful social interaction behaviors
Dysfunctional interaction with others
Impaired social interaction r/t severe anxiety
After 2 hours of nursing intervention the client will be able to:
Identify feelings that lead to poor social interaction.
Verbalize awareness of factors causing or promoting impaired social interaction
Verbalize how to use effective coping skills.
1. Encourage the patient to verbalize feeling of discomfort about social situation.
2. Encourage the client to verbalize perception of problem and causes.
3. Determine client’s use of coping skills and defense mechanism.
4. Observe and describe social and interpersonal behaviors in objective terms.
5. Established therapeutic communication using positive regard in client.
6. Encourage the client to keep a daily journal.
1. to assess the other contributing factors that may affect client’s impaired social interaction.
2. to assess degree of impairment.
3. this may affect ability to be involved in social situation.
4. This will help the kinds of extent of problem client exhibiting.
5. to assess the client recognized or make a positive-changes in impaired social interactions.
6. helps client to identify responsibility for own behaviors and learn new skill that can be used to enhance social interaction