This guide is about hopelessness, hopelessness nursing diagnosis, and hopelessness nursing care plan. It can be used to create nursing care plans for educational purposes.
What is hopelessness in nursing?
Hopelessness is a nursing diagnosis defined as a state in which the individual perceives a lack of personal control over certain situations or events and a sense that his/her actions will have no significant influence on an outcome.
What is the learned hopelessness theory?
The theory that individuals acquire passivity and a sense of being unable to act and to control their lives. This happens through unpleasant experiences and traumas against which client’s efforts to correct or avoid were ineffective; according to Seligman, this brings on depression.
There are instances when a person feels like his or her life is worthless and will never get better. This is a common example of hopelessness and can often occur when individuals seem to be feeling discouraged, depressed, or anxious about a sudden event. In the case of a patient suffering from spinal cord injury, he or she may feel hopeless in response to having permanent paralysis.
Hopelessness can result when someone is going through difficult times or unpleasant experiences. A person may feel overwhelmed, trapped, or insecure, or may have a lot of self-doubts due to multiple stresses and losses. He or she might think that challenges are unconquerable or that there are no solutions to the problems and may not be able to mobilize the energy needed to act on his or her own behalf.
Patient living in social isolation, who lacks social support system and resources, may also experience hopelessness. Other factors include poverty, being homeless, those with limited access to health care, and loss of belief in God’s care or loss of trust in prior spiritual beliefs.
Factors Related to hopelessness
What are the factors related to hopelessness?
- Dysfunctional Environment
- Complex treatment regimen
- Insufficient Interpersonal Interactions
Defining Characteristics of hopelessness
What does hopelessness look like?
- Feelings of alienation
- Frustration on inability to perform previous activities
- Doubt about role performance
- Insufficient sense of control
- Inadequate participation in care
Hopelessness Nursing Diagnosis
How is hopelessness diagnosed?
Assessment is needed in order to recognize possible difficulties and events that may have lead to Hopelessness.
|Assess physical appearances such as the grooming, posture, and hygiene.||Patients who are experiencing hopelessness may not have the urge to participate in self-care activities.|
|Ascertain the role that illness presents in the patient’s hopelessness.||Patient’s current situation may affect his or her physical functioning. Cancer often makes patients’ perception to extremes.|
|Assess the patient’s understanding of the situation, belief in self, and his or her own abilities.||Patients may consider the peril is greater than their resources to manage it.|
|Assess the patient for and point out reasons for living.||Interventions that build the awareness of reasons for living may lower feelings of hopelessness and reduce suicidal thoughts.|
|Assess patient’s willingness to eat, sleeping patterns, and daily activities.||Alterations from these regular patterns are apparent during hopelessness. Patients may have decreased appetite and poor activity level. Patients may sleep more or experience insomnia.|
|Learn whether the patient perceives unachieved outcomes as failures or emphasizes failures instead of accomplishments.||Feelings of hopelessness might develop when the patient sees failure as the end result of every effort he or she makes.|
|Evaluate the patient’s ability to establish goals, make decisions, and solve problems.||Patients who are hopeless often think he or she is unable to meet established goals and incompetent to make any decisions and solve problems.|
|Identify previous coping strategies and their effectiveness.||Successful coping is determined by past experiences.|
|Take time to listen to verbalization of hopelessness, suicidal thoughts, and lack of self-worth.||Suicidal ideation and behaviors are usually present in patients experiencing hopelessness.|
|Determine the patient’s social support system and possible source of hope.||Patients in social isolation find it hard to improve their condition. Assessment and evaluation of support group may render the assistance the patient needs at this time.|
|Ascertain the patient’s expectations for the future.||Dependence on others for help and treatments and uncertainty about events can add to a feeling of hopelessness.|
Hopelessness Nursing Care Plan
What are the nursing interventions for hopelessness?
The following are the therapeutic nursing interventions for Hopelessness:
|Encourage a positive mental perspective, discourage negative thoughts, and brace patient for negative results.||Accurate information is generally favored by families; surprise information concerning a shift in status may cause the family to worry that information is being withheld from them.|
|Provide openings for the patient to verbalize feelings of hopelessness.||The nurse promites a supportive environment by taking time to listen to the patient in a nonjudgemental way.|
|Manage to have consistency in staff appointed to care for the patient.||This approach establishes trust, reduces the patient’s feeling of isolation, and may promote coping and restore hope.|
|Assist patient with looking at options and establishing goals that are relevant to him or her.||Mutual goal setting guarantees that goals are achievable and helps to restore a cognitive-temporal sense of hope.|
|Encourage the patient to recognize his or her own strengths and abilities.||Promoting awareness can facilitate the use of these strengths.|
|Work with the patient to set small, attainable goals.||Mutual goal setting guarantees that goals are achievable and helps to restore a cognitive-temporal sense of hope.|
|Render physical care that the patient is unable to achieve and respect patient’s abilities.||This approach overcomes weakness, guilt, and other negative perceptions.|
|Stay and spend time with the patient. Use empathy; try to understand what the patient is saying, and communicate this understanding to the patient.||These approaches can inspire hope. Experiencing warmth, empathy, genuineness, and unconditional positive regard can greatly reduce feelings of hopelessness.|
|Assist the patient in establishing realistic goals by recognizing short-term goals and revising them as needed.||Supervising the patient little by little makes the problem more manageable. Setting realistic goals is important so as not to be frustrated with the chance of not to accomplish them.|
|Help the patient in developing a realistic appraisal of the situation.||Patients may not be aware of all the available resources and support groups that can help them move through this stressful life situation.|
|Acknowledge acceptance of expression of feelings.||Active listening may help patients express themselves.|
|Promote an attitude of realistic hope.||Stressing the patient’s intrinsic worth and seeing the immediate problem as manageable in time may provide support. Giving unrealistic hopes will not help the patient and might worsen the situation.|
|Send feelings of acceptance and understanding. Avoid false reassurances.||An honest relationship facilitates problem-solving. False reassurances are never helpful to patients.|
|Provide time for patient to initiate interactions.||Patients who have feelings of hopelessness require special moment to initiate relationships and sometimes are not able to.|
|Strengthen patient’s relationship with significant others; allow them to take part in patient’s care.||Enhancing a sense of connectedness fosters hope. Concern from others may help change the patient’s focus from self.|
|Encourage family and significant others to display care, hope, and love for patient.||Encouraging the family to present patient support, to understand patient’s feelings, and to be physically present and involved in care are approaches that allow the family to change patient’s hope state.|
|Practice touch, if appropriate and with authority, to show care, and encourage the family to do the same.||This approach provides comfort and is necessary for the development of hope.|
|Present opportunities for the patient to manage care setting.||When a hopeless patient is given opportunities to make choices, his or her perception of hopelessness may be reduced.|
|Promote the use of spiritual resources as desired.||Religious practices may provide strength and inspiration.|
|Provide plant or pet therapy if possible.||Taking care of pets or plants promotes redefining patient’s identity and makes him or her feel needed and loved.|
|Refer patient to self-help groups such as I Can Cope and Make Today Count.||These groups enable the patient to acknowledge the love and care of others, and they foster sense of belonging.|
Hopelessness Nursing Diagnosis and Nursing Care Plan Examples
Nursing Care Plan 1
Nursing Diagnosis: Powerlessness/Hopelessness related to expression of an actual or perceived threatening situation secondary to anxiety disorder as evidenced by extraneous movement, fidgeting, hypervigilance, insomnia, poor eye contact, and restlessness secondary to anxiety
Desired Outcome: The patient will be able to identify, verbalize, and demonstrate techniques to control anxiety and demonstrate return of basic problem-solving skills
|Assess the patient’s level of anxiety and physical reactions to anxiety like tachycardia, tachypnea, and nonverbal expressions of anxiety. Symptoms evaluated include the mood, fear, insomnia, tension, worry, depressed mood, concentration, somatic complaints, cardiovascular, gastrointestinal, respiratory, autonomic, genitourinary, and behavioral symptoms. Use the Hamilton Anxiety Scale, which evaluates 14 symptoms.||Assessment of the anxiety levels and the patient’s physical reactions to anxiety should be done first to determine the interventions that should be performed on the patient. Generalized anxiety disorder is the most common anxiety with a 12-month prevalence.|
|Rule out alcohol, sedative, and smoking withdrawal as the cause of anxiety.||Those who withdraw from alcohol, sedatives, or smoking demonstrate higher levels of anxiety and nervousness.|
|Use empathy for the encouragement of the patient to interpret symptoms of anxiety as normal.||The nurses’ interaction with the patient influences the patient’s quality of life. Provision of psychological and social support can reduce the symptoms and problems that are associated with anxiety. Patients exhibit more trust and respond with more success to nurses who provide empathetic and compassionate responses and suggestions.|
|If irrational fears or thoughts are present, offer the patient accurate information and encourage the patient to talk about the significance of the events that are contributing to the anxiety.||Providing the patients with accurate information about their condition, prognosis, and outcomes significantly reduced their anxiety levels and increased patient empowerment.|
|Encourage the patient to use positive self-talk.||Reduction in negative self-talk and increasing positive self-talk is beneficial for all types of anxiety. Self-talk strengthens both actual behavior performance and potential behavioral intentions.|
|Intervene and remove sources of anxiety whenever possible.||Removal or the reduction of sources of stress and anxiety among patients has been shown to decrease comorbid conditions and hypertension.|
Nursing Care Plan 2
Nursing Diagnosis: Powerlessness/Hopelessness related to insufficient information secondary to diabetes diagnosis
Desired Outcome: The patient will be able to explain the disease state, appreciate the need for medications, and comprehend treatments. The patient will also be able to incorporate health regimen into lifestyle and demonstrate how to perform health-related procedures satisfactorily
|Consider the literacy of the patient with regards to health and his/her readiness to learn.||Health literacy can vary depending on the situation and complexities of a chronic condition. Readiness to learn can also affect interventions done to improve the patient’s knowledge.|
|Focus on the tone of spoken and written communication when teaching patients who have literacy needs.||Provide an overview of tools for effective communication for teaching including providing feedback, actively seeking questions, using a teach-back method, and providing age-appropriate patient education materials that are written in simple language.|
|Things to be in consideration are the context, timing, and order of how the information is presented.||Presenting the most important information first and grouping information presented in short sessions are effective.|
|Use patient-centered approaches that interact and engage with patients.||Using teaching methods adapted to the patient’s learning style and priority concerns are effective for patient outcomes.|
|Reinforcement of learning through frequent repetition and follow-up sessions.||Frequent and regular education sessions will improve medication and self-care management outcomes for people who have chronic conditions.|
|Use of a variety of technological and multimedia methods of relaying information as appropriate.||Use of multimedia education as an adjunct with current education programs are shown to be effective.|
|Encourage patients and caregivers to maintain and/or expand social networks for support as self-care learning resources when appropriate.||Patients with long-term chronic health conditions who have sustained or expanded community networks are more likely to sustain self-care management, maintain treatment regimens and behavioral change, and access voluntary caregiving over formal caregiving.|