Compromised Family Coping Nursing Diagnosis and Nursing Care Plan

Last updated on April 30th, 2023 at 12:01 am

Compromised Family Coping Nursing Care Plans Diagnosis and Interventions

Compromised Family Coping Nursing Care Plans Diagnosis and Interventions

Family coping is the capacity of the family to confront vital and stressful events putting into action measures to solve or improve the situation with a direct impact on the family’s health. It involves behavioral and cognitive efforts using a set of resources such as material resources, social skills, social support, beliefs, and motivations to ensure the health of family members.

Family health is an effective family functioning that promotes growth and development according to the demand of each stage of life. The member’s health and the overall family’s health are reciprocal because any unhealthy family life could make them all sick.

On the other hand, compromised family coping are situations in which the supportive primary person in the family or a close friend is giving ineffective or insufficient support, comfort, or encouragement needed by the unhealthy family member.

It can potentially weaken the family dynamics and resources usually manifested through miscommunication and decrease self-esteem among its members. Family coping strategies maintain communication and family organization, promote independence and self-esteem of its members, maintain the bonds and unity as a family, maintain and develop social support and community relations, and monitor the impacts of situations and changes in the family.

However, these family coping strategies change over time due to stressors, conflicts, demands, disturbances in the family system, and availability of resources thus, these strategies should be formed and modified over time.

Causes of Compromised Family Coping

The causes of compromised family coping may include:

  • Chronic disease. Living with and caring for a relative with chronic disease produces psychological distress among family members from feelings of helplessness and lack of control. Those with poor family relationships may find it hard to support each other emotionally resulting in compromised family coping.
  • Autism Spectrum Disorder (ASD). Parents with children diagnosed with ASD are reported to have higher levels of anxiety, depression, and mental health-related issues from adjustment difficulties resulting in crises within the family.
  • Mental illness. Psychosocial challenges may arise due to the stigma attached to mental illness, which can affect the family as a whole.
  • Addiction. Substance use disorder can be an after-effect of poor family relationships or unmet developmental stages affecting behavioral and emotional patterns. The family should be treated as a whole to support each other to change.
  • Accidents and disability. It is a traumatic event leaving the family with significant psychosocial disruption. Everyone in the family can be overwhelmed with critical roles to support their family members due to their lack of experience and preparedness.
  • Family adjustment. The problems related to this differ from their relationship with each other and problems may not easily be shared living with the burdens alone. The responsibilities rest with each member of the family can also burden them leading to an imbalance in the family dynamics.
  • Labor and financial problems. Low-income households are vulnerable to financial and health problems which greatly affect psychological well-being. Lack of support and consideration among family members can give more distress and problems.

Several factors can increase a family’s risk of compromised coping, such as:

  • Inadequate or incorrect information and unrealistic expectations interfere with the needed assistance and support.
  • The temporary preoccupation of the supportive family member, who cannot perceive the needs of others and fulfill them due to personal suffering and emotional conflicts.
  • Inadequate or incorrect understanding between family members or close friends.
  • Temporary family disorganization and changes in roles interfere with other important roles in their life.
  • Situations or crises that the supportive family member is facing
  • Family members fail to provide mutual support to the supportive family member.
  • Prolonged disease or progression of the disability of a family member can exhaust the supportive capacity of other family members.
  • Unexpressed feelings of guilt, anxiety, hostility, and despair among family members
  • Stress or nervousness with a family member receiving care results in a highly ambivalent relationship.

Nursing Management for Compromised Family Coping

The nurse can help the family by doing the following actions:

  • Assess the level of anxiety and stressors. They may be preoccupied with the situation and become overwhelmed by a sudden approach from the nurse. Take note of nonverbal signs, and avoid distractions and stimuli that can be threatening to them.
  • Establish rapport using therapeutic communication. Convey feelings of acceptance to establish trust and open communication, and explore barriers to their ability to cope. Use empathic words and be supportive to have an honest conversation, reducing anxiety and isolation.
  • Gather basic information and family history. The family’s familial and cultural background may affect their understanding and response to the current situation. These provide baseline data for effective planning of care and interventions.
  • Assess the individual level of functioning and perception of the situation. Facing difficult situations can make them overly dramatic and unrealistic, it is important to understand the magnitude of the situation to guide the family in coping.
  • Assess for suicidal tendencies. Note for signs of self-harm or harm to others due to the inability to solve problems. The home setting may not be a suitable environment for them and must need immediate intervention.
  • Identify causative factors. Gathering information can help the nurse prepare a treatment plan and understand the situation of each family member. Circumstances may have a significant effect on the body that may contribute to the inability of the family member to provide needed support.
  • Identify behaviors and coping methods used. Everyone has coping strategies to use to deal with their problems and family members with maladaptive coping may need additional teachings on how to use coping strategies in different situations.
  • Identify support systems and available resources. A family member may not have adequate support in the home setting. Identify roles and responsibilities changes and provide options for additional assistance or support.
  • Provide information about the effects of their behaviors. Fostering awareness can lead to the realization of their progress or changes toward effective coping. An outside perspective can assist them in recognizing barriers and ineffective coping behaviors.
  • Encourage everyone to be objective and sensitive. Evaluating everyone’s situation and accomplishments may help them to become skilled in recognizing individuals’ needs and strengths to manage the situation effectively.
  • Educate about coping strategies. Constructive problem-solving can promote a sense of autonomy and independence. Role-playing or activities to foster feelings of accomplishment can boost confidence. Use distraction techniques to block the attention to fearful stimuli and direct the attention towards pleasurable experiences.
  • Educate the family about relaxation techniques and diversional activities. Cognitive behavioral therapy like music therapy, guided imagery, and desensitization, can help the patient relieve anxiety. Consider mental and physical activities such as exercise, sports, or games.
  • Promote wellness and health teachings. Adequate rest and sleep support the physiologic effects of stress in the body. Aerobic exercise and meditation can relieve stress and anxiety by decreasing cortisol and increasing endorphins. Establish routines at home and focus on active interest and family activities. Eat a well-balanced diet to combat the physiologic effects of stress.
  • Involve the family in the treatment plan, modifications, and long-term plan. Participation and offering choices can increase self-esteem and feelings of being in control of their situation. Discuss changes in the treatment plan with the family members and professionals involved in the care to promote continuity. Teach and demonstrate individual care needs for continuity of care.
  • Provide emotional support. Anxiety needs to be dealt with before treatment can begin. Acknowledge the difficulty of the situation to reduce feelings of helplessness and uselessness.
  • Educate about support groups and professional therapy. Family members with special needs and interventions can receive additional help from support groups with the same situations and community groups for empathy.
  • Referral plans. Counseling can help the family work with a system and use their resources efficiently.

Family Coping Strategies

Families are using positive and negative coping mechanisms depending on the causative factors, such as:

  • Chronic disease. Positive coping strategies focus on the emotion and problem that usually develops during the diagnostic process of chronic disease to carry out new roles. These include searching for information, distraction, value restructuring, family integration, and social, spiritual, and family support. Negative coping strategies include evasion or avoidance, starvation, and bargaining.
  • Autism Spectrum Disorder (ASD). Positive coping strategies focus on the problem to promote acceptance, cooperation, family integration, positive reinterpretation, and planning. These include searching for information, adopting new forms of interaction and communication, social and spiritual support, and improving self-esteem and emotional strength. Negative coping strategies include increased protection, suppression of activities, and social isolation.
  • Mental illness. Positive coping strategies focus on the emotion and problem to promote acceptance, family support, and solutions to problems. These include positive interaction, good humor, and searching for social, emotional, and organizational support systems. Negative coping strategies focus on emotions such as behavioral disconnection, isolation, blaming, anger, avoiding the problem, stigmatizing conditions, and overloading.
  • Addiction. Positive coping strategies focus on recovery and adaptation through distraction, restriction of access, and social, spiritual, and family support. Negative coping strategies include avoidance, minimization, and normalization of the problem.
  • Accidents and disability. Positive coping strategies focus on recovery and rehabilitation through searching for information. Negative coping strategies include self-blame, avoidance, minimization, and negation.
  • Family readjustment. Positive coping strategies include family support and readjustment, spirituality, and resiliency.
  • Job and financial problems. Positive coping strategies include retrenchment or fundraising.

Compromised Family Coping Nursing Diagnosis

Nursing Care Plan for Compromised Family Coping 1

Cleft Palate

Nursing Diagnosis: Compromised Family Coping related to unrealistic post-surgery expectations secondary to the cleft palate as evidenced by anxiety concerning the child’s normal growth and development.

Desired Outcomes:

  • The family’s coping skills with the infant’s well-being and healthcare demands will improve.
  • The parents will express their belief that the infant will have a positive outcome after the surgery.
  • The parents will display coping behaviors by holding and assisting with infant care.
Compromised Family Coping Nursing InterventionRationale
Evaluate family coping strategies that are being implemented and their efficiency.  This gives more information about coping strategies and the requirement for learning new coping abilities. Family views have a direct impact on a child’s sense of self-worth, and a special needs child can enhance or disrupt family bonds.
Determine the parent’s existing knowledge and perspective of the situation.  Limited knowledge or unreasonable expectations can interrupt family members and the client’s reaction to the problem and the scenario.
Promote family members to communicate their concerns and work together to find solutions.This lessens anxiety, improves comprehension, and allows for recognizing issues and coming up with solutions. Assist them to understand that any unpleasant emotions they experience—such as grief or rage—about the newborn or themselves are normal. Although this reassurance does not immediately help them feel better over what has happened but realizing the emotions they are having are normal may help them start to deal with these issues.
Provide the family with valuable feedback and acknowledge their efforts to improve coping and problem-solving skills for the child’s care.Honoring the family’s contributions to long-term care motivates them to continue. Pay close attention to the parents and show them compassion, respect, honesty, support, and understanding. These are crucial to address the parents’ demands for compassion and caring as well as to prepare them for any problems they may encounter.

Nursing Care Plan for Compromised Family Coping 2

Prenatal Substance Abuse

Nursing Diagnosis: Compromised Family Coping related to situational crises of drug abuse and pregnancy secondary to prenatal substance abuse as evidenced by denial of the notion that drug usage is the source of all problems.

Desired Outcomes:

  • The patient will express their comprehension of codependence interactions and take part in both individual and family sessions.
  • The customer will present or arrange the required lifestyle adjustments.
  • The client will work to improve self-destructive habits and/or adjust behavior that correlates to dependence.
Compromised Family Coping Nursing InterventionRationale
Examine the family history, the responsibilities of the family members, the conditions surrounding drug use, as well as their strengths and growth potential. Observe attitudes and beliefs towards conception and parenting.This establishes the areas of attention and the possibility of change. Numerous research and reports have shown the negative influences on the stability of family, marriage, finances, emotional well-being, parenting competency, how the family interacts both within and outside of the home, and on each family member’s physical and mental health.
Evaluate environmental and social factors.Evaluation of social and environmental factors is recommended for all pregnancies; however, women with drug abuse disorders may be more vulnerable to these issues. Screening for concerns such as domestic violence, homelessness, and food shortages should be done consistently at the time of initial presentation, regularly throughout prenatal care, and if social circumstances change.
Give the client and family accurate information on the effects of addictive behaviors on the family as well as what to expect from drug withdrawal and the progress of the pregnancy.Many people are unaware of how addiction works, how it affects families, and how it affects fetuses and pregnant women. The patient and family members may think that consuming drugs purchased legitimately does not amount to abuse. Families gain knowledge about SUDs (symptoms, causes, and consequences), therapies, recovery problems for SUD-diagnosed family members, relapse, mutual support programs, the effects of SUDs on families and members, and professional resources and mutual support programs that are accessible to families.  
Encourage the members of the family to be attentive to their own emotions and to approach the situation rationally and with perspective.Family members that are codependent may decide to change when they realize how their behaviors contribute to the user’s difficulties. If they change, the patient will have to address the consequences of her own choices and may choose to recover. Families can assist themselves by talking about their experiences with the SUD-affected family member, reflecting on and altering their behaviors and emotional responses, and considering how to transform the family structure as a whole.

Nursing Care Plan for Compromised Family Coping 3

Spina Bifida

Nursing Diagnosis: Compromised Family Coping related to the situational crisis of a child’s long-term situation secondary to Spina Bifida as evidenced by the family’s unable to cope with or adjust to the child’s chronic illness and disability positively, family members admit to feeling guilty, irritability and irritation on the part of family members in responding to the child, and insufficient assistance from family and friends.

Desired Outcomes:

  • The family will adjust to their child’s disabilities and start going forward.
  • Family members will discuss helpful coping mechanisms and resources to avoid using unsuccessful ones.
  • Family members will mention they are comfortable managing their stress and knowing when to ask for help.
Compromised Family Coping Nursing InterventionRationale
Evaluate the degree of anxiety in the family and the child, how the crisis is perceived, the efficiency of coping and problem-solving techniques, and the approaches used.Determines the necessity of learning new coping mechanisms, realistic goal-setting, and interventional actions to help the family and the child deal with the crisis.  
Evaluate the family’s capacity to adapt to the kid, and the family’s developmental level, the impact of stress on family connections, the response of siblings, understanding of health practices, family role behavior toward long-term care, financial stress, capabilities to care for long-term conditions and the grief process, indicators of depression, feelings of helplessness, and discouragement, and the grieving method.Contains information regarding family values and coping abilities that directly influence the child’s health and sense of well-being; a chronic condition affecting a child in a family may enhance or damage relationships, and members may establish emotional difficulties when the family is distressed.
Allow family members to express their emotions and reactions about the baby’s or child’s appearance and well-being.Provides a sense of relief and acceptance for their reactions.
Demonstrate empathy for the patient and his or her family.Helps people cope with their sickness and make healthy adjustments.  
Give proactive advice for handling crises.Helps the family find a new coping strategy and adjust to the situation.  
Educate parents that the congenital defect did not develop because of their fault by outlining the condition’s causes, treatments, and prognosis.Provides relevant information about the condition and alleviates guilt.  
​​Assist the family in determining the circumstances of the disability and recommending contacts with community organizations, clergy, social services, and physical and occupational rehabilitation.Gives assistance, information, and support.  

Nursing Care Plan for Compromised Family Coping 4

Congenital Heart Diseases

Nursing Diagnosis:

Compromised Family Coping related to crises in the family and child’s environment and development secondary to congenital heart disease as evidenced by displaying concern and worry over the infant/child’s sickness and condition, protective behavior that is out of proportion to the need to develop and grow, and chronic anxiety, potential hospitalization, and surgical procedures.

Desired Outcomes:

  • The patient will recognize their inappropriate behavior and how those actions prevent them from managing their stress well.
  • The patient will speak about useful coping mechanisms and resources to avoid inefficient coping.
  • The patient will be confident in their ability to deal with stressors and know when to seek assistance.
Compromised Family Coping Nursing InterventionRationale
Monitor family members for unusual behavior (anger, tension, disarray), and the impression of the crisis.Information influencing the family’s capacity to adapt to the infant/ child’s heart condition.
Encourage the expression of emotions and offer reliable information about the infant/child.Decreases anxiety and improves family members’ comprehension of the disease.  
Evaluate the efficiency of common family coping mechanisms.Identifies the necessity of learning new coping techniques if tried-and-true techniques fail to change demonstrated behavior.  
Determine the information and assistance needed.Gives information about the need for treatments to alleviate anxiety and worry.  
Provide clarification for any misunderstandings and provide information on the disease process.Minimizes unneeded stress brought on by incorrect facts or misconceptions.  
Assist in the identification and application of methods to deal with and solve issues and take charge of the circumstance.Enables the management of the issue and supports problem-solving.  
Advise parents to engage their sick newborn or child in family events instead of having the family revolve around the concerns of the infant or child.Encourages healthy family development and normal growth for children and infants.  
Teach parents about their children’s nutritional and physical activity needs, as well as any restrictions or strategies that may help them create a routine that works.Helps a baby or child with a heart abnormality deal with the effects and special needs.

Nursing Care Plan for Compromised Family Coping 5

Bronchopulmonary Dysplasia

Nursing Diagnosis: Compromised Family Coping related to a chronic condition that decreases the ability of family members to provide support secondary to bronchopulmonary dysplasia as evidenced by repeated and prolonged hospital stays, family members’ obsession with anxiety, guilt, and panic regardless of infant or kid condition, and demonstration of protective behaviors by family members that are inappropriate to the needs of the infant/child.

Desired Outcomes:

  • The family members will discuss the significant stressors related to the infant’s illness.
  • The family will list three support structures and coping methods they can use.
Compromised Family Coping Nursing InterventionRationale
Evaluate the level of anxiety, dread, abnormal behavior, and crisis perception among family members.Gives information influencing the family’s ability to cope with the long-term illness of a newborn or child.  
Promote an open, accepting, and nonjudgmental expression of thoughts and inquiries from the family members.It reduces anxiety and enhances family members’ comprehension of the infant’s condition.  
Allow family members to discuss past coping strategies and improve them as necessary.Acknowledges the effective coping mechanism while considering the need to develop new coping methods.
Promote family participation in hospital care both during and after the stay.Reduces anxiety and fear associated with the use of medical equipment in care management  
Recognizing the efforts of the family develop coping mechanisms, find solutions to problems, and care for the child.Inspires parents and family members to participate in the care and obtain some influence over the situation.  
Inform parents about the infant’s health and development, the necessity to address oxygen dependence, and the justification for care and medicine.Reduces anxiety in parents and families by anticipating the need for disease and care information.
Reiterate the importance of maintaining family members’ health and parents’ emotional stability.The health and caregiving abilities of the family will be hindered by chronic anxiety and exhaustion.  

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.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

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


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Anna Curran. RN, BSN, PHN

Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.

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