Ineffective Role Performance Nursing Diagnosis and Nursing Care Plan

Last updated on May 18th, 2022 at 09:20 am

Ineffective Role Performance Nursing Care Plans Diagnosis and Interventions

Ineffective Role Performance NCLEX Review and Nursing Care Plans

The North American Nursing Diagnosis Association (NANDA-I) defines the nursing diagnosis Ineffective Role Performance as patterns of behavior and self-expression that do not complement environmental factors, social rules, and preconceptions, with a distinguishing feature of conflict about role perspective or performance.

Thus, every human being can have various roles. Some roles are based on age and gender, while some roles are obtained, such as being a parent and a certain occupation.

Other roles are temporary, such as being elected in a particular position or being a team member. Having difficulty to meet the expectation of a particular role can lead to stress and ineffective role performance to the person.

Signs and Symptoms of Ineffective Role Performance

  • Changes in role attitudes
  • Distress
  • Inadequate change adaptation
  • Indifference about one’s role
  • Conflicting roles, befuddlement, and denial
  • Dissatisfaction
  • Uncertainty
  • Stress brought about by certain role
  1. Cognitive Factors
  • Unrealistic role expectations
  • Insufficient role preparation
  • Inadequate education
  • The absence of a role model
  1. Physiologic Factors
    • Transformation of one’s body image
    • Self-esteem issues
    • Neurological defects
  1. Social Factors
    • Conflict
    • Insufficient support network
    • Inappropriate association
    • Healthcare system
    • Job schedule requirements
    • The young age
    • Impairments in cognition
    • Depression and other mental illnesses
    • Pain
    • Level of development
    • Domestic abuse
    • Insufficient role socialization
    • Inadequate resources
    • Scarcity of incentives
    • Low socioeconomic standing
    • Stress

Prevention of Ineffective Role Performance

  • Focus on positive things in life instead of thinking about the conflicts or issues that cause ineffective role performance.
  • Learn to adapt to changes. In life, several modifications will happen. Instead of worrying about these changes, embrace them.
  • Ask for help if necessary.
  • Motivate the patient to discuss any conflicts with family or significant others that affect role performance. There is no need to carry the burden alone.  The patient can be advised to open up with trusted support networks.
  • Determine specific stressors that cause the problems or issues.

Ineffective Role Performance Nursing Diagnosis

Ineffective Role Performance Nursing Care Plan 1

Prolonged Bed Rest

Nursing Diagnosis: Ineffective Role Performance related to reliance on others during care, followed by a desire for independence or self-care when the disease improves secondary to prolonged bed rest as evidenced by alterations in customary norms of obligation or ability to perform a duty, changes in role perceptions, a lack of opportunity to perform a specific role, and dissatisfaction on a given role.

Desired Outcome: Within 48 hours of receiving this diagnosis, the patient and care providers will set reasonable competence objectives and begin self-care.

Ineffective Role Performance Nursing InterventionsRationale
Evaluate the patient’s reaction to the recovery treatment plan.  It is vital to continually raise the patient’s activity and participation in self-care tasks. Thus, excessive activity might lead to fatigue and recuperation delays.  
Prevent from downplaying the patient’s apparent despair. Allow for emotional expression, but foster an environment of compassion, acceptance, and reasonable hope for a positive role change.    Limiting a patient’s report of depression can exacerbate his or her anger and depression. Providing reasonable goals and motivation might help deliver moral comfort on the road to independence. Consistency in articulating expectations of ultimate autonomy is required. Relationships are formed on commitment.
Motivate the patient to be as self-sufficient as necessary within the constraints of stamina, treatment, and discomfort.    Encouragement will foster independence to the greatest extent possible. Allow for brief times of dependence since they allow the patient to replenish the energy reserves required for recuperation.
Involve the patient in cooperative objective planning and alert him or her to areas of undue reliance.  As rehabilitation improves, it is good to start fostering a sense of independence.  
If necessary, provide assistive aids.  Long-handled crutches, wheelchairs, and walkers, for example, can help patients increase their independence with self-care activities.  
When the patient meets or progresses toward objectives, offer positive reinforcement.  Constructive feedback strengthens the patient’s abilities and promotes self-efficacy.  

Ineffective Role Performance Nursing Care Plan 2

Attention Deficit Hyperactivity Disorder (ADHD)

Nursing Diagnosis: Ineffective Role Performance related to being obnoxious or bothersome to siblings or playmates secondary to Attention Deficit Hyperactivity Disorder (ADHD) as evidenced by a long-term pattern of lack of attention, aggressiveness, and impulsivity.

Desired Outcomes:

  • The patient will not cross other people’s boundaries.
  • The patient will display adequate social skills for his or her age.
  • The patient will learn to finish assigned tasks.
  • The patient will comply with instructions.
Ineffective Role Performance Nursing InterventionsRationale
Examine the patient’s medical history. Evaluate if there are long-term patterns of lack of attention, aggressiveness, and hyperactivity.  Parents may claim that their child was fussy and had troubles as a newborn; alternatively, they may not have observed the hyperactive behaviors until the child was a preschooler or joined childcare or school.  
Keep an eye on the patient’s mood and affect.    The patient’s mood may be erratic, even to the point of tantrums or angry outbursts; worry, impatience, and restlessness may also be present.
Examine the patient’s sensory and cognitive processes.      The ability of an ADHD patient to pay close attention or concentrate is significantly hindered; the child’s attention span may be as short as 2 or 3 seconds with severe ADHD or 2 or 3 minutes with milder types of the illness.
Assure the patient’s safety.  Ensure the child’s safety by discouraging them from engaging in risky activities. Close supervision and clear instructions on desirable and undesirable behavior boundaries should be provided.  
Enhance the patient’s role performance.  Provide positive comments to patients who have met their expectations. Manage the surroundings as well by providing a distraction-free atmosphere for work accomplishment.    
Simplify instructions or directions for the patient.    Simplifying instructions or directions by capturing the child’s entire attention, breaking complex tasks down into tiny parts, and allowing breaks.
Encourage a well-structured daily routine for the patient.  Establish a disciplined daily routine and timetable, and keep changes to a minimum.  
Provide knowledge and assistance to the patient and his or her family.  The nurse must listen to the parent’s concerns, and parents must be involved in delivering and planning the care regimen for the kid with ADHD.  

Ineffective Role Performance Nursing Care Plan 3

Postpartum Depression

Nursing Diagnosis: Ineffective Role Performance related to incapacity to do everyday activities secondary to postpartum depression as evidenced by anxiety, fatigue, and an extreme feeling of despair.

Desired Outcomes:

  • The patient will become more involved in social activities.
  • The patient will communicate her emotions and fears.
  • The patient will go about her everyday routines.
  • The patient will understand the value of counseling and will attend it regularly.
Ineffective Role Performance Nursing InterventionsRationale
Prior to her delivery, evaluate the mother’s mental wellbeing.  Before giving birth, it is vital to monitor the patient’s psychological health. It is one of the best strategies to consider to prevent severe depression after delivery.  
Examine the patient’s history of other illnesses as well as previous mental health difficulties.      This intervention will establish whether she requires prenatal counseling to prevent postpartum depression. As we all know, it is preferable to prevent a health condition than to treat it once it has manifested.
Assist the patient in making plans for her everyday activities, such as eating, fitness, and relaxation.  This intervention will help the patient acquire confidence because there is someone who is eager to assist her in planning her daily activities and performing her role. This strategy also seeks to assist and educate the mother about her health by emphasizing healthy nutrition, regular exercise, and adequate sleep.    
Recommend support groups to the woman, so she has a system for sharing her feelings.  Postpartum depression is one of the most challenging situations that a mother can face after giving birth, so she needs a supportive network to assist her in overcoming the difficulties. It is preferable to have a support group to remind the patient that motherhood will not affect her overall role performance.    
Advise the mother to set aside some time each day for herself so that she may take a break from her regular infant care.  This intervention seeks to persuade the woman that having a kid does not imply unsuccessful role performance in other aspects; it will let her realize that she can still do more than take care of the baby.    
Encourage the woman to maintain contact with her social circle, as they can also act as a support network for her.        A strong support network will assist the mother in overcoming postpartum depression.  

Ineffective Role Performance Nursing Care Plan 4

Caregiver Role Strain

Nursing Diagnosis: Ineffective Role Performance related to financial pressures, family life changes, and life transitions secondary to caregiver role strain as evidenced by enormous stress resulting from the abrupt rise in responsibilities.

Desired Outcomes:

  • Allow the care receiver to deal with the circumstance in his or her way.
  • Communicate a more practical knowledge of the care receiver’s needs and expectations.
  • Show behavior or lifestyle modifications to cope with and resolve troublesome factors.
  • Report better general wellbeing and situational awareness.
Ineffective Role Performance Nursing InterventionsRationale
Examine the caregiver’s knowledge and competence to provide patient care, such as bathing, nourishment, delivering medications, and ambulation.  The information serves as a starting point for educational programs. Fundamental counsel may alleviate caregiver stress and improve the relationship.  
Examine the caregiver-patient relationship.  Relationships that are mutually rewarding generate a healthy caregiving experience. Unhealthy relationships can lead to inefficient, fragmented care or neglect and abuse.  
Encourage additional family members to participate in easing stress on the sole caregiver.  Taking care of a family member may be a genuinely pleasant and gratifying experience for the entire family. However, because people are deferring to having children until later in life, standard family sizes are shrinking, and subsequent generations will have fewer nuclear members of the family to rely upon.    
Encourage the caregiver to make time for themselves.    Assist the caregiver in determining which items bring them calm and relaxation. Caregivers may require reminders to address their own physical and emotional needs. This approach conserves both emotional and physical energies.  
Introduce the caregiver to stress-reduction techniques.  The caregiver must have time to unwind and reinvigorate emotionally during the day before taking on care tasks.  
Allow the caregiver to take part in the support group.  Groups formed for mutual support might be beneficial in terms of education and anticipatory assistance.  
Allow the caregiver the opportunity to chat about problems, worries, and feelings.    Inquire about the caregiver’s wellbeing. Nurses are in a fantastic position to provide psychological support and assistance throughout this trying time.
Encourage the caregiver to be aware of any available friends or relatives who can help with caregiving.    Caretaking should not be just the obligation of one individual.

Ineffective Role Performance Nursing Care Plan 5

Personality Disorders

Nursing Diagnosis: Ineffective role performance related to personality qualities that have become inflexible, rigid, and dysfunctional, obstructing an individual’s view and connection with situations and people secondary to personality disorders as evidenced by substantial difficulties and limitations in the family, social events, education, career, as well as other functional roles.

Desired Outcomes:

  • The patient will take the necessary steps to carry out his or her responsibilities.
  • The client will show problem-solving abilities.
Ineffective Role Performance Nursing InterventionsRationale
Ensure patient safety all the time.  Patients with personality disorders may be prone to self-harm, especially if they believe they cannot perform their role effectively. This emotion could be caused by self-pity due to their health condition. With that, the nurse must constantly consider suicidal ideation with the development of a strategy, access to means for carrying out the plan, and self-harm behaviors must be observed seriously and implement necessary treatments  Encourage an effective therapeutic relationship.  In any clinical situation, the nurse must give structure and limit setting in the therapeutic relationship; in a clinical context, this may entail seeing the patient for regular visits of a certain length rather than whenever the client shows and requires the nurse’s urgent attention.  
Collaborate with the patient and the diverse team to develop a reward system for meeting clearly stated expectations.  Patients’ positive actions can be strengthened by concrete reinforcement for satisfying expectations.  
Address the patient’s plans for the future with him or her.  Set reasonable short-term goals with the client. Identify abilities that need to be acquired to assist the client in reaching his or her objectives. Looking forward reduces concentrating on the past and negative self-rumination. When patients achieve realistic short-term goals, they can feel a feeling of success, purpose, and meaning in life. Achieving goals can increase one’s sense of control and improve self-perception. This intervention will assist the patient in not overthinking the notion that he is no longer capable of executing his duty in various aspects.  
Address questions positively and actively; assist the patient in refocusing on the present and looking ahead.  This intervention allows the client to see prior behaviors in a new light and provides the client the impression that he or she has choices and decisions in the future. Encourage the patient by assuring him that his current health condition will not impact his role performance for the rest of his life.  
Re-shape the patient’s thought habits.    Cognitive restructuring is a strategy that helps clients detect negative ideas and feelings and focus on positive thinking patterns; thought pausing is a method that alters the cycle of unpleasant or self-critical thinking patterns. This approach is helpful so the patient will not pity himself and be motivated to perform whatever roles he has.

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. (2018). 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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