Fear, Nursing Assessment for Fear, Nursing Interventions for Fear, and 6 Nursing Care Plans for Fear

Fear, Nursing Assessment for Fear, Nursing Interventions for Fear, and 6 Nursing Care Plans for Fear

This guide is about Fear, Nursing Assessment for Fear, Nursing Interventions for Fear, and 6 Nursing Care Plans for Fear. Use it to create educational nursing care plans for fear.

Fear

Fear, Nursing Assessment for Fear, Nursing Interventions for Fear, and 6 Nursing Care Plans for Fear
Fear

What is Fear?

Fear is defined as a real or perceived threat of danger or harm, and this can be very distressing if it affects a person’s daily activities. The source of fear may vary, but mostly it is derived from an individual’s life experience. There are many related factors such as influence and culture that affect how fear is managed. The most common representation of fear in the healthcare setting is seen in patients who have doubts and worries about undergoing diagnostic procedures and hospitalizations.

It is crucial to identify the fear of a patient in order to address and provide care for them. Determining the level of fear and its alarming levels would help manage the conditions and help patients take back control over their life. Referral to a reliable support system and programs increase the chances of successfully managing, treating, and overcoming phobias and other fears.

What are The Types and Causes of Fear?

There are many possible causes of fear. Its complexity cannot simply be limited to a person’s past trauma, phobia, etc., but mostly fear emanates from a person’s actual life experience. Some of the common causes of fear are the following:

  • Innate fear. Fear and Anxiety go hand in hand since both produce a similar stress reaction. They are often linked to one another. An existing disorder can trigger fear in a person. In that case, the presence of anxiety disorders can lead to such. Fear can manifest as fear about the condition, loss of control, loss of innervation, and loss of a functional role.
  • Learned fear.  This type of fear is usually a result of environmental triggers. It can also be a form of response to a specific situation, object, and person. The person may imagine a potential threat in a situation as a response to an external stimulus.

What are The Factors Related to Fear?

  • Culture
  • Age
  • Gender
  • Influence
  • Religion
  • Environmental triggers

What are The Signs and Symptoms of Fear?

  • Panic
  • Anorexia
  • Exhaustion
  • Nauseous vomiting
  • Paleness
  • Tensing of muscles
  • Increased BP, respiration, pulse rate
  • Frightened behavior
  • Crying, protesting
  • Expression of fear such as:
    • Fear of death
    • Fear of pain
    • Fear of injury
    • Fear of a diagnostic test
    • Fear of invasive procedures

Nursing Assessment for Fear

How do you Assess a Patient with Fear?

Assessment is needed in order to identify possible problems that may have lead to Fear.

Assessment Rationales
Determine the type of the patient’s fear by thorough, rational questioning and active listening. The external cause of fear can be known. Patients who find it unacceptable to expose fear may find it convenient to know that someone is willing to listen if they choose to share their feelings at some time in the future.
Assess the behavioral and verbal expression of fear. This information provides a foundation for planning interventions to support the patient’s coping strategies.
Evaluate the measures the patient practices to cope with that fear. This information helps determine the effectiveness of coping strategies used by the patient.
Learn to what extent the patient’s fears may be influencing his or her ability to function. Anti-anxiety medications or referral to specially designed treatment programs is necessary for persistent, immobilizing fears. Patient safety must always be a priority.

Nursing Interventions for Fear

Fear, Nursing Assessment for Fear, Nursing Interventions for Fear, and 6 Nursing Care Plans for Fear
Nursing Interventions for Fear

What are Some Nursing Interventions for Fear?

The following are the therapeutic nursing interventions for Fear nursing care plan and diagnosis:

Interventions Rationales
Open up about your awareness of the patient’s fear. This approach validates the feelings the patient is holding and demonstrates recognition of those feelings.
Discuss the situation with the patient and help differentiate between real and imagined threats to well-being. This approach helps the patient deal with fear.
Tell patient that fear is a normal and appropriate response to circumstances in which pain, danger, or loss of control is anticipated or felt. This reassurance places fear within the field of normal human experiences.
Be with the patient to promote safety especially during frightening procedures or treatment. The physical connection with a trusted person helps the patient feel secure and safe during a period of fear.
Maintain a relaxed and accepting demeanor while communicating with the patient. The patient’s feeling of stability increases in a peaceful and non-threatening environment.
Familiarize the patient with the surrounding as necessary. Familiarity with the setting promotes comfort and a decrease in fear.
Provide accurate information if irrational fears based on incorrect information are present. Replacing inaccurate beliefs into accurate information reduces anxiety.
If patient’s fear is a reasonable response, empathize with him or her. Avoid false reassurances and be truthful. Reassure patients that asking for help is both a sign of strength and a step toward resolution of the problem.
Use simple language and easy to understand statements regarding diagnostic procedures. The patient may find it hard to understand any given explanations during excessive fear. Simple, clear, and brief instructions are necessary.
Maintain a quiet environment whether at home or in a hospital setting. Drop any unnecessary stuff around the patient. Patient’s fear is not reduced and resolved if the environment is unsafe.
Provide safety measures within the home when indicated (e.g., alarm system, safety devices in showers or bathtubs). Patient’s fear will not be reduced or resolved if the home environment is unsafe.
Support the patient in recognizing strategies used in the past to deal with fearful situations. This method allows the patient to think that fear is a natural part of life and can be dealt with successfully.
As the fear subsides, encourage the patient to involve himself or herself to specific events preceding the onset of the fear. Recognition and explanation of factors leading to fear are vital in developing alternative responses.
Allow the patient to have rest periods. Relaxation improves ability to cope. The nurse needs to pace activities, especially to older adults to conserve the patient’s energy.
Suggest the patient to bring comforting objects when away from home. This method can enhance feelings of security in a new environment.
Access community resources to meet the fearful needs of the patient and family (e.g., spiritual counselor, social worker). Appropriate resources render organized and regulated patient care that indicates supportive healthcare service.
Initiate alternative treatments. Provide verbal and nonverbal (touch and hug with permission) reassurances of safety if safety is within control. Meditation, prayer, music, Therapeutic Touch, and healing touch techniques help lighten fear.
Refer to cognitive behavioral group therapy. A reward that comes from participating in a group is the opportunity to meet others with the same problem. Even if not everyone will have the same triggers or severity of symptoms, it is helpful to know that the patient realizes that he or she is not alone.

6 Nursing Care Plans for Fear

Fear, Nursing Assessment for Fear, Nursing Interventions for Fear, and 6 Nursing Care Plans for Fear
Nursing Care Plans for Fear

What Care Plans are Available for a Patient Suffering from Fear?

Nursing Care Plan 1

Sexual Dysfunction

Nursing Diagnosis: Fear related to erectile dysfunction and decreased estrogen in postmenopusal women, secondary to sexual dysfunction, as evidenced by feelings of fear, disgust, and nervousness to sexual contact, lack of sexual eagerness, lack of sexual fantasies, reduced sexual activity, decreased desire.

Desired Outcome: The patient will resume sexual activity and express satisfaction to his/herself and partner.

Intervention Rationale
Assess the patient’s level of stress by employing open ended-questions that are adaptable and inclusive. To determine the patient’s stressors and triggers. It is essential to employ open-ended questions since they adapt to the patient’s perspective and current condition.
Assess the patient’s mental and emotional status by encouraging verbalization of his/her concerns, problems and current situation in life. Encouraging the patient to discuss his/her disease progress openly would provide knowledge about the contributing factors to sexual dysfunction.
Establish nurse and patient relationship. Encourage open discussion of the patient’s sexual dysfunction and disease progress. Encouraging the patient to openly discuss his/her disease progress would provide knowledge about the contributing factors to sexual dysfunction.
Educate the patient about alternative means of attaining sexual pleasure. Suggest to the patient to consider sexual counseling with his/her partner. Educating the patient about existing alternative methods would provide slight relief. This would also build a rapport of trust and reassurance that his/her difficulties and struggles would not be overlooked.

Nursing Care Plan 2

Anxiety Disorders

Nursing Diagnosis: Fear related to phobia stimulation, physiological and mental conduct suggestive of panic, secondary to anxiety disorder, as evidenced by verbalization of unwarranted fear, altered behavior, and activity.

Desired Outcomes:

  • The patient will resume daily activities.
  • The patient will express understanding and recognition of fears.
  • The patient will use coping techniques to manage fear.
Intervention Rationale
Before initial assessment, ensure that the patient’s environment is accommodating, peaceful and non-threatening. It is important that the patient feels safe in his/her environment. This helps avert feelings of anxiety and fear to thrive. Being provided care by a calm and understanding nurse eases these negative feelings. In some cases, extreme panic levels can make the patient fear for his/her own life.
Assess the patient’s perceived harm to physical integrity or threat to self-image. To better understand the patient’s perceived fear of a situation, a person, a thing. To help reduce the patient’s adverse reaction to a stimulus.
Recommend that the patient replace negative thoughts with positive ones instead. Thoughts heavily influence the emotional aspect of a person. Changing a negative mindset to a positive one reinforces coping with criticism. It allows the patient to see the problem in a different light. Simultaneously, positive thinking reduces the level of anxiety.
When formulating a treatment regimen, the nurse should allow active participation of the patient in the decision-making process. Active participation of the patient and allowing him/her to make decisions, reinforces control and self-integrity to one’s treatment. Also, the patient’s ritualistic behavior can easily be assimilated with the coping strategies as evaluated.
In the event of fear in a situation, encourage the patient not to panic and instead take a brief moment to stop and wait. Encourage the patient to carry out relaxation techniques such as deep breathing exercises or guided muscle relaxation. When fear takes over, it can cloud the patient’s thought process and control of the situation. This real or perceived threat can lead to a lack or absence of response on the patient’s part. On the contrary, by closely recognizing the onset of anxiety, the patient can reduce its levels and outcome by using relaxation techniques.

Nursing Care Plan 3

Somatoform Disorders

Nursing Diagnosis: Fear related to unremarkable family dynamics, and environmental triggers, secondary to somatoform disorders, as evidenced by painful urination, chest, back, joints pain, gastrointestinal symptoms, impaired menstrual bleeding, sexual indifference, erectile dysfunction, vomiting during pregnancy and impaired coordination.

Desired Outcome: The patient will employ effective coping strategies to manage stress, anxiety, and fear.

Intervention Rationale
Determine the patient’s medical history, detailing prior physical problems, undertaken medical tests, and previous surgical procedures. Thorough reporting of the patient’s medical history would provide insight into the patient’s condition.
Employing open-ended questions, ask the patient to express his/her emotions about the condition—accounts of physical symptoms and prior struggle in a specific situation. Open-ended questions are effective and adaptable to the patient’s needs since it does not limit the patient to express his/her feelings. Allowing the patient to verbally communicate his/her experience and symptoms reinforces the patient’s integrity and builds trust in the nurse-patient relationship.
Observe the patient for any unusual behavior and general demeanor. The patient suffering from somatoform disorders usually exhibits altered motor behavior. It can either result in decreased movement with an antalgic gait or a painful expression or discomfort evident in his/her appearance.
Educate the patient on the disease process. Assist the patient in understanding the change in routine to improve wellness and health behaviors. To help the patient understand his/her illness. Being aware of the condition lessens the fear of receiving treatment and undergoing several medical diagnostic tests.
Educate the patient with effective coping techniques such as: Deep breathing exercises, Muscle relaxation exercises, Listening to music, Role-playing communication, Guided imagery To help the patient progressively reach a state of relaxation.

Nursing Care Plan 4

Heart Failure

Nursing Diagnosis: Fear related to invasive surgical procedures and extended hospitalization, secondary to heart failure, as evidenced by surgical procedures, treatment, pain expectation, the anticipation of an imagined threat or danger, and the possibility of death.

Desired Outcome: The patient will express fears and demonstrate effective coping to improve psychological and physical comfort.

Intervention Rationale
Ensure that the patient is comfortable and at ease during initial assessment. To help alleviate the patient’s negative feelings and emotions.
Ensure that the patient’s environment is non-threatening, safe, peaceful and quiet. To help the patient become more relaxed.
Employing open-ended questions, have the patient express his/her fears and feelings about the condition. The use of open-ended questions will help the patient freely express his/her feelings and experience regarding the condition. This will also help the patient recognize his/her fears with the condition. It enables room for communication, thereby reducing fear in a patient.
Determine the patient’s coping strategies, both past, and present. Document the patient’s coping measures Documenting the patient’s past and present ritualistic coping strategies helps identify the appropriate therapeutic measures to employ. This information will aid in the formulation of coping strategies that the patient can easily adapt to.
While communicating, the nurse should express openness in behavior. This helps build the nurse-patient relationship. It also promotes the patient’s feelings of stability in the environment.
Using layman’s terms, educate the patient about the disease’s pathophysiology, diagnostic procedures, and management. Teaching the patient using simple language or easy-to-understand explanations will be more effective since the patient will have an easier time following instruction. Simple statements will also help the patient understand the disease process.
Instigate a support system for the patient by allowing participation from family, friends, and loved ones. To better reduce the patient’s level of fear. Participation or support from his/her family and other loved ones enhances the patient’s self-esteem. Often, their support is more likely to bring a positive change and outcome to the patient.

Nursing Care Plan 5

Surgery/ Perioperative Client

Nursing Diagnosis: Fear related to unfamiliarity with a new environment, secondary to surgery, as evidenced by fear of consequences, increased tension, restlessness, decreased self-assurance.

Desired Outcome: The patient will demonstrate effective coping strategies to address fears and anxiety.

Intervention Rationale
Educate the patient prior to operation, including taking an appointment with an OR personnel, if possible, prior to surgery. Disclose information on areas of concern and what to expect, such as bright lights, IV fluid, cuff, BP, autoclave machine, suction noises in the background, and use of masks Educating the patient prior to diagnostic and therapeutic engagement will help reduce fear and anxiety. It reassures the patient since the provided information is likely to answer some of his/her doubts and worries. Subjecting the patient in an unfamiliar and new situation is guaranteed to arouse fear; therefore, assurance and providing the needed information help reduce negative feelings.
Inform the patient of the handling nurse’s responsibilities and role in the intraoperative process. This helps build the nurse-patient relationship. It establishes the patient’s trust and improves control over a new environment.
Determine the patient’s fear levels prior to a surgical procedure. A high fear level may lead to a delay, rescheduling or postponement of surgical procedure. Intense fears may lead to extreme stress response, which can increase the risk of surgery and development of a reaction to anesthetics.
During transfer to the OR, safeguard the patient from possible body exposure. The patient may be wary about his/her dignity. Preventing any form of exposure would reduce loss of composure and integrity.
If increasing levels of fear are observed, confer postponement or discontinuation of the surgery to the handling physician, anesthesiologist, the patient, family members, and guardians To reduce the risk of further complications.

Nursing Care Plan 6

Brain Cancer

Nursing Diagnosis: Fear related to change in wellness and threat to self-image, secondary to brain cancer, as evidenced by increased concern about diagnosis, uneasiness, fear and worry of pre and postoperative procedures, social separation, and insomnia.

Desired Outcome:

  • The patient will report on reduced fear and anxiety.
  • The patient will appear relaxed.
Intervention Rationale
Using open-ended questions, evaluate the anxiety level of the patient, the possible triggers, and obtain any information to potentiate relief after surgery. To establish a baseline review on the patient’s anxiety degree. Using open-ended questions will help the patient recognize fear and worries about the several surgical procedures and treatment plans.
Ensure to communicate in a calm and approachable demeanor. Ensure that the environment is non-threatening by providing sufficient light, ventilation, and reduced background noise. To help the patient become more relaxed.
Encourage the patient to express his/her feelings and thoughts about the condition, its complications, and prognosis. This helps the patient alleviate his/her negative feelings, thereby decreasing anxiety and fear. Allowing the patient to release his/her emotions also provides healthcare providers the opportunity to identify therapeutic measures to apply.
Provide a support system to the patient by discussing the available treatment regimen with family and significant loved ones. To promote feelings of care and concern. This also encourages the patient’s integrity and motivation. Discussing psychotherapy options with a licensed therapist will help the patient and other/s understand the effective management of the symptoms or condition.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier.

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.

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