Impaired social interaction is a nursing diagnosis defined as an insufficient or excessive quantity or ineffective quality of social exchange.
This condition can significantly impact a patient’s overall well-being and quality of life, making it a crucial focus for nursing care.
Causes (Related to)
Impaired social interaction can result from various physical, psychological, or environmental factors. Common causes include:
- Communication barriers (language differences, speech disorders)
- Cognitive impairments (dementia, intellectual disabilities)
- Mental health disorders (depression, anxiety, schizophrenia)
- Physical disabilities or limitations
- Sensory deficits (hearing or visual impairments)
- Cultural differences or social isolation
- Low self-esteem or poor self-concept
- Substance abuse or addiction
- Trauma or abuse history
- Environmental factors (unfamiliar settings, lack of privacy)
Signs and Symptoms (As evidenced by)
Patients with impaired social interaction may present with various signs and symptoms:
Subjective: (Patient reports)
- Feelings of loneliness or isolation
- Difficulty initiating or maintaining conversations
- Anxiety in social situations
- Lack of interest in social activities
- Feelings of being misunderstood or rejected
Objective: (Nurse assesses)
- Reduced eye contact or avoidance of eye contact
- Limited verbal or non-verbal communication
- Inappropriate social behaviors
- Withdrawal from social situations
- Difficulty forming or maintaining relationships
- Inappropriate or exaggerated affect
- Discomfort in group settings
- Limited participation in therapeutic activities
- Observed isolation from peers or family members
Expected Outcomes
The following are common nursing care planning goals and expected outcomes for impaired social interaction:
- The patient will demonstrate improved communication skills within one week
- The patient will engage in at least one social activity daily by discharge
- The patient will express increased comfort in social situations within two weeks
- The patient will form at least one positive relationship with a peer or staff member during hospitalization
- The patient will participate actively in group therapy sessions by the end of the treatment period
- The patient will verbalize understanding of effective social interaction strategies before discharge
Nursing Assessment
- Assess the patient’s current level of social interaction:
Observe the patient’s behavior in various social settings to determine the extent of impairment. - Evaluate communication skills:
Assess the patient’s verbal and non-verbal communication abilities, including eye contact, tone of voice, and body language. - Identify potential barriers to social interaction:
Determine if physical, cognitive, or environmental factors limit the patient’s social engagement. - Assess the patient’s support system:
Gather information about the patient’s family, friends, and community support. - Evaluate the patient’s mental health status:
Screen for underlying mental health conditions that may contribute to impaired social interaction. - Assess cultural factors:
Consider cultural differences that may influence the patient’s social interaction patterns. - Review medical history:
Identify any medical conditions or medications that may affect social functioning. - Evaluate self-esteem and self-concept:
Assess the patient’s perception of self and its impact on social interactions. - Assess coping mechanisms:
Identify the patient’s current strategies for managing social situations and their effectiveness. - Observe group dynamics:
If applicable, observe the patient’s behavior and interactions in group settings.
Nursing Interventions
- Establish a therapeutic relationship:
Build trust and rapport with the patient to create a safe environment for social interaction. - Encourage participation in social activities:
Gradually introduce the patient to appropriate social activities, starting with one-on-one interactions and progressing to group settings. - Provide communication skills training:
Teach and practice effective communication techniques, including active listening and assertiveness skills. - Implement social skills training:
Use role-playing and modeling to help the patient learn and practice appropriate social behaviors. - Address underlying mental health issues:
Collaborate with the mental health team to manage any contributing psychiatric conditions. - Promote self-esteem-building activities:
Engage the patient in activities that enhance self-worth and confidence. - Facilitate family involvement:
Encourage family participation in care and provide education on supporting the patient’s social development. - Create a structured social environment:
Develop a daily schedule that includes regular opportunities for social interaction. - Utilize assistive devices if necessary:
Provide hearing aids, visual aids, or communication boards to support interaction for patients with sensory deficits. - Implement cognitive behavioral therapy techniques:
Work with the patient to identify and modify negative thought patterns that hinder social interaction. - Encourage participation in support groups:
Connect the patient with appropriate support groups to foster peer relationships and shared experiences. - Provide culturally competent care:
Respect and incorporate the patient’s cultural background into social interaction strategies.
Nursing Care Plans
Care Plan #1
Nursing Diagnosis Statement:
Impaired Social Interaction related to anxiety in social situations as evidenced by avoidance of group activities and limited verbal communication.
Related factors/causes:
- Generalized anxiety disorder
- Low self-esteem
- History of social rejection
Nursing Interventions and Rationales:
- Gradually expose the patient to social situations, starting with one-on-one interactions.
Rationale: Gradual exposure helps build confidence and reduces anxiety. - Teach and practice relaxation techniques (e.g., deep breathing, progressive muscle relaxation).
Rationale: Relaxation techniques can help manage anxiety symptoms in social situations. - Implement cognitive behavioral therapy techniques to address negative thought patterns.
Rationale: CBT can help patients identify and modify anxiety-provoking thoughts. - Encourage participation in a social anxiety support group.
Rationale: Peer support can provide validation and coping strategies.
Desired Outcomes:
- The patient will participate in at least one group activity daily within two weeks.
- The patient will report decreased anxiety in social situations using a 0-10 scale within three weeks.
- The patient will demonstrate the use of at least two relaxation techniques when feeling anxious by discharge.
Care Plan #2
Nursing Diagnosis Statement:
Impaired Social Interaction related to communication barriers secondary to hearing impairment as evidenced by frustration during conversations and social withdrawal.
Related factors/causes:
- Severe hearing loss
- Lack of assistive devices
- Embarrassment about hearing difficulty
Nursing Interventions and Rationales:
- Assist the patient in obtaining and using appropriate hearing aids.
Rationale: Proper hearing aids can significantly improve communication ability. - Teach and practice lip-reading techniques with the patient.
Rationale: Lip reading can supplement auditory information and improve understanding. - Educate family and staff on effective communication strategies with hearing-impaired individuals.
Rationale: Proper communication techniques can enhance interaction and reduce frustration. - Encourage the patient to advocate for their communication needs.
Rationale: Self-advocacy promotes independence and effective social interaction.
Desired Outcomes:
- The patient will consistently use hearing aids during waking hours within one week.
- The patient will report improved conversation understanding within two weeks of using hearing aids.
- The patient will initiate at least one social interaction daily by discharge.
Care Plan #3
Nursing Diagnosis Statement:
Impaired Social Interaction related to cognitive impairment secondary to early-stage Alzheimer’s disease as evidenced by difficulty maintaining conversations and inappropriate social responses.
Related factors/causes:
- Progressive memory loss
- Decreased attention span
- Impaired judgment
Nursing Interventions and Rationales:
- Establish a consistent daily routine that includes social activities.
Rationale: Routine provides structure and familiarity, reducing confusion and anxiety. - Use memory aids and cues to support social interactions.
Rationale: Visual and verbal cues can help compensate for memory deficits. - Educate family members on effective communication strategies for dementia patients.
Rationale: Proper communication techniques can enhance interaction and reduce frustration. - Engage the patient in reminiscence therapy.
Rationale: Reminiscence can stimulate long-term memory and promote social engagement.
Desired Outcomes:
- The patient will participate in at least two structured social activities daily within one week.
- The patient will demonstrate an improved ability to follow social cues with minimal prompting within three weeks.
- Family members will report increased satisfaction with social interactions with the patient by discharge.
Care Plan #4
Nursing Diagnosis Statement:
Impaired Social Interaction related to altered self-concept secondary to recent facial disfigurement as evidenced by social isolation and verbalized feelings of shame.
Related factors/causes:
- Recent burn injury affecting facial appearance
- Negative body image
- Fear of social rejection
Nursing Interventions and Rationales:
- Provide psychological support and counseling.
Rationale: Emotional support can help the patient cope with changes in appearance and self-concept. - Teach and practice positive self-talk techniques.
Rationale: Positive self-talk can improve self-esteem and confidence in social situations. - Connect the patient with a support group for individuals with facial differences.
Rationale: Peer support can provide validation and coping strategies. - Collaborate with occupational therapy for facial exercises and makeup application techniques.
Rationale: These interventions can improve facial function and appearance, potentially increasing social confidence.
Desired Outcomes:
- The patient will verbalize at least two positive self-statements daily within one week.
- The patient will engage in one social activity outside their room daily within two weeks.
- The patient will express increased comfort with their appearance on a 0-10 scale within three weeks.
Care Plan #5
Nursing Diagnosis Statement:
Impaired Social Interaction related to environmental factors secondary to long-term hospitalization as evidenced by decreased interest in social activities and limited interaction with peers.
Related factors/causes:
- Prolonged isolation from regular social network
- Unfamiliar hospital environment
- Physical limitations due to medical condition
Nursing Interventions and Rationales:
- Facilitate regular video calls with family and friends.
Rationale: Maintaining connections with support systems can reduce feelings of isolation. - Encourage participation in hospital-based social activities and support groups.
Rationale: Structured activities provide opportunities for safe social interaction. - Create a personalized space in the patient’s room with familiar items.
Rationale: A comfortable, personalized environment can increase feelings of security and willingness to engage socially. - Collaborate with recreational therapy to provide engaging activities suited to the patient’s interests and abilities.
Rationale: Tailored activities can increase motivation for social participation.
Desired Outcomes:
- The patient will participate in at least one hospital-based social activity daily within one week.
- The patient will report increased satisfaction with social connections on a 0-10 scale within two weeks.
- The patient will initiate social interactions with staff or other patients at least twice daily by discharge.
References
- American Nurses Association. (2021). Nursing: Scope and Standards of Practice (4th ed.). American Nurses Association.
- Butcher, H. K., Bulechek, G. M., Dochterman, J. M., & Wagner, C. M. (2018). Nursing Interventions Classification (NIC) (7th ed.). Elsevier.
- Carpenito, L. J. (2017). Nursing Diagnosis: Application to Clinical Practice (15th ed.). Wolters Kluwer.
- Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales (15th ed.). F.A. Davis Company.
- Herdman, T. H., & Kamitsuru, S. (Eds.). (2018). NANDA International Nursing Diagnoses: Definitions and Classification 2018-2020 (11th ed.). Thieme.
- Johnson, M., Bulechek, G., Butcher, H., Dochterman, J. M., Maas, M., Moorhead, S., & Swanson, E. (2019). NOC and NIC Linkages to NANDA-I and Clinical Conditions: Supporting Critical Reasoning and Quality Care (4th ed.). Elsevier.
- Townsend, M. C., & Morgan, K. I. (2017). Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based Practice (9th ed.). F.A. Davis Company.
- World Health Organization. (2022). Social isolation and loneliness among older people: Advocacy brief. World Health Organization. https://www.who.int/publications/i/item/9789240033504
