Readiness for Enhanced Coping Nursing Diagnosis and Nursing Care Plans

Last updated on May 18th, 2022 at 10:19 am

Readiness for Enhanced Coping Nursing Care Plans Diagnosis and Interventions

Readiness for Enhanced Coping NCLEX Review and Nursing Care Plans

Readiness for Enhanced Coping is a health promotion nursing diagnosis accepted by the North American Nursing Diagnosis Association (NANDA) and is characterized as efficient management of responsive duties by a family member engaged with the patient’s wide range of medical conditions that now illustrates eagerness and willingness for enhanced health and self-growth.

Additionally, here are some of the defining characteristics of readiness for enhanced coping:

  • Demonstrates concern over potential environmental changes
  • Conveys a desire to learn more about stress management strategies
  • Articulates willingness to improve stress management.
  • Demonstrates a desire to increase social support
  • Conveys a goal to expand the usage of emotion-focused methods.
  • Indicates a desire to make better use of the problem 
  • centered strategies
  • Reflects a desire to improve the utilization of spiritual resources

Types of Coping Skills

Before we get into the fundamental skills that can be used to deal with health obstacles, there are several things to remember about coping abilities;

Not all coping mechanisms are created equal. Hence, based on the different areas of focus, there are two coping mechanisms:

  1. Problem-focused strategy. People who employ a problem-focused coping approach will concentrate on the situation at hand, aiming to address the source of the discomfort. Some examples are analyzing the circumstance, working harder, using what they have already learned in their daily lives, and communicating to those who directly impact the situation.
  2. Emotion-focused strategy. Those who utilize an emotion-focused coping approach will direct the efforts toward dealing with their emotions rather than the situation itself. In this circumstance, they may resort to coping techniques such as brooding, fantasizing or magical thinking, ignoring or rejecting, criticizing, or seeking social assistance.

Emotion-focused strategies include the following:

  • Expressing bottled-up emotions
    • Diverting one’s attention
    • Coping with aggressive feelings
    • Meditating
    • Mindfulness exercises
    • Utilizing systematic relaxation techniques

An emotion-focused coping strategy is a stress-relieving mechanism that reduces, diminishes, or prevents psychological consequences. This mechanism can be used in several ways, including:

  • seeking social assistance
    • positive re-evaluation of the stressor
    • accepting accountability
    • utilizing avoidance
    • demonstrating self-control
    • distancing

Moreover, another critical distinction between coping styles is the aim being pursued. The two goal-based coping techniques are as follows:

  1. Active Coping. This coping involves being aware of the health issue or situation causing concern and making conscious efforts to decrease the resulting stress or remove the stressors.
  2. Avoidant Coping. An awareness of the health issue may or may not accompany avoidant coping, but there are no intentional measures to minimize stress or remove the problem. Instead, patients who engage in avoidant coping will disregard or avoid the problem entirely. They may be conscious of a health issue or maybe in denial about it.

Types of Coping Mechanisms

  1. Adaptive Mechanism. Mechanisms in these groupings are good strategies that assist people in coping with stress efficiently. The commonly utilized adaptive mechanisms are listed below:

  • Support. Discussing a stressful experience with a supportive person can be an effective stress-management strategy. Seeking additional assistance rather than isolating oneself and assimilating the effects of stress can significantly reduce the negative impact of challenging circumstances.
  • Relaxation. A variety of relaxation techniques can assist people in dealing with stress. Meditation, relaxation techniques, other calming methods, sitting in nature, or listening to soothing music are all relaxing activities.
  • Problem-solving. This coping mechanism entails recognizing a source of stress and then designing and implementing alternative solutions to effectively manage it.
  • Humor. Being positive during a stressful situation can help people retain perspective and keep things from becoming immense.
  • Physical activity. Exercise can be a healthy and natural way to relieve stress. Running, meditation, water sports, strolling, dancing, athletic events, and various other forms of physical activity can help people cope with stress and the aftermath of medical or health issues.
  1. Attack Mechanism. This mechanism aim to shift a patient’s stress or anguish onto another individual.
  2. Avoidance Mechanism. As the name implies, these methods entirely ignore the health issues that lead to stress.
  3. Behavioral Mechanism. Behavioral coping techniques are efforts to adjust what a patient does to cope with anxiety more successfully.
  4. Cognitive Mechanism. As opposed to behavioral mechanisms, cognitive mechanisms include a person attempting to modify the way he or she perceives to cope with stress.
  5. Conversion Mechanism. These coping mechanisms attempt to alter or modify the health problem, focusing on the positive to make it a favorable situation instead of a stressful one.
  6. Defense Mechanism. This mechanism refers to Freud’s initial edition of defense mechanisms. Some of these mechanisms are widely accepted as accurate representations of people’s mechanisms, while others have little proof to substantiate them.
  7. Self-harm Mechanism. These are the least efficient coping mechanisms because they can cause danger.

The Nurses’ Roles in Enhancing Coping Mechanism

Nurses monitor their patients’ health, administer medication, handle paperwork, assist doctors in diagnosing patients, and offer advice, but their roles do not end there. According to research, they wear many hats throughout their working hours; one of them is satisfying the emotional needs of their patients.

Moreover, they provide emotional support to their patients by establishing a good rapport with those in pain, calming those who are afraid, and instilling hope in all of them. Emotional care entails being empathetic and acknowledging and treating patients with respect.

Here are some of the roles of the nurse that ensures effective coping mechanism of the patient:

  • The nurse must evaluate defining traits of readiness for improved coping.
  • The nurse must look for factors that cause ineffective coping, such as low self-esteem, grief, a lack of problem-solving skills, insufficient support, or a recent adaptation to new circumstances.
  • The nurse must identify specific sources of stress.
  • Examine for areas of strength, such as connecting facts and identifying the source of stressful situations.
  • The nurse must assess the patient’s comprehension of the difficult situation.
  • The nurse must examine previous coping strategies, such as decision-making and problem-solving.
  • Through continuity of care, the nurse must form a strong relationship with the patient.
  • By actively listening and identifying the client’s current health status, the nurse can help the patient develop suitable coping mechanisms.
  • Recognizing patient disclosures and opinions can provide a forum for understanding perceptions connected to reality, which can help with the treatment plan and establish the accuracy of interventions required.
  • Keep an eye out for any changes in behavior. Any changes in behavior may indicate that the patient is having difficulties and may require assistance.
  • Listen to the patient’s thoughts and emotions and share their own experience. Following a stressful event due to illness, it is critical that the patient feels comfortable sharing their feelings with someone who understands their fears and concerns.

Techniques to Enhance Positive Coping Mechanisms

  • Attempt to alleviate the reasons for stress. How a patient perceives and thinks about a stressor can significantly impact how they respond. It is not always possible to prevent or escape challenging circumstances, but they can reduce the stress they are experiencing. As their nurse, assess whether the patient can improve the outcome that is causing them stress and encourage them to open up.
  • Foster social support. Having a solid support network can enhance coping mechanisms. Therefore, reach out strategically. Some friends or family members may be particularly able to pay attention and empathize. Others may excel at providing practical assistance, such as bringing over a home-cooked meal or covering an hour of patient care. Providing support can also enhance strong feelings while decreasing negative emotions.
  • Pursue adequate nutrition. When faced with a stressful event, the central nervous system emits hormones such as adrenaline and cortisol, which affect the gastrointestinal system and causes other physiological changes. Acute stress can suppress appetite, but prolonged stress can cause sugar and fat cravings resulting in the release of the hormone cortisol. Furthermore, according to research, high cortisol levels combined with high sugar intake may accumulate fat around our internal organs, linked to cardiovascular and metabolic diseases. A diet rich in a range of nutrients can safeguard health while also providing more energy and strength to deal with challenges. There is no need to go vegetarian or give up cookies; aim to include a variety of vegetables and fruits in the daily diet.
  • Meditate. A substantial body of research indicates that insight meditation can minimize emotional stress and anxiety — even brief mindfulness meditation programs are efficient. To begin, set aside five minutes in a quiet location to sit and take a breath. Concentrate on the current moment; recognize them and then let them go if distracting thoughts arise. Gently refocus and divert the attention.
  • Redefine ways of thinking. Cognitive-behavioral therapy, or CBT, is one of the most well-studied therapies for tension and worry. The comprehension that our thoughts impact our emotional responses, which influence our behavior patterns, is at the heart of this therapeutic strategy. Reframing one’s thoughts about a source of stress can help control emotions and enhance coping mechanisms.
  • Maintain a sense of perspective. Keep a long-term point of view and start to consider challenging circumstances in a broader context. Try not to exaggerate the severity of stressful events brought by health issues.
  • Maintain a positive attitude. An optimistic outlook allows one to anticipate good things in life.
  • Avoid drinking alcoholic beverages or drugs to cope with stress. Substances may momentarily relieve the stress, but they will not address the problem. Substances are likely to cause new health issues in people’s lives.

Readiness for Enhanced Coping Nursing Diagnosis

Readiness for Enhanced Coping Nursing Care Plan 1


Nursing Diagnosis: Readiness for Enhanced Coping related to the patient’s desire to maintain normal blood pressure level secondary to hypertension, as evidenced by verbalization to ease tension, alleviate hypertension, and frequent requests for help.

Desired Outcome: The patient will verbalize understanding of potential stressors and employ effective coping behaviors.

Readiness for Enhanced Coping Nursing InterventionsRationale
Evaluate the patient’s understanding of the situation and capacity to make a realistic judgment.Physical or environmental changes can affect the patient’s perception and behavior. It is crucial to acquire baseline data on the patient’s knowledge since this information can assist nurses in modifying the treatment plan or recognizing critical concerns that may interfere with the patient’s recovery.
Instruct the patient to promptly notify their healthcare provider of any new signs or symptoms (e.g., fatigue, irritability, decreased tolerance, inability to cope) they notice.Patients with hypertension should be alert to any warning signs that may appear. The key to successful management is early detection, which prompts quick intervention.
Encourage expression of feelings and assess the patient’s stressors. Note family dynamics, healthcare management, social influences, life, and environmental factors.When patients are given the opportunity to express their emotions openly, they may communicate their expectations and stress issues more effectively. Additionally, this intervention can provide a support system for the patient and a baseline of information for the nurse to curate a more effective program.
Increase patient engagement by involving him/her in the planning process. Discuss available treatment options and goals.By engaging the patient in the planning process, they can better understand their illness and improve their coping abilities. It would also give them a sense of purpose, increasing their willingness to cooperate with healthcare providers. Additionally, this intervention can address critical aspects of the care plan, enabling more individualized care.
Assist the patient in developing a more optimistic outlook and encourage positive statements such as “I am in control.”Redirects the patient’s attention away from the stressful situation, assisting in the management of anxiety, hypertension, and the avoidance of unrealistic expectations. The goal of this intervention is to target the patient’s goal and to optimize wellness.

Readiness for Enhanced Coping Nursing Care Plan 2

Prenatal Substance Abuse

Nursing Diagnosis: Readiness for Enhanced Family Coping related to patient’s willingness to improve personal relations with family members, secondary to prenatal substance abuse, as evidenced by support seeking, acknowledges negative behavior pattern, and verbalized desire to improve quality of life.

Desired Outcome: The patient will demonstrate a willingness to make lifestyle changes and demonstrate effective coping mechanisms.

Readiness for Enhanced Coping Nursing InterventionsRationale
Determine the patient’s support system, the roles of family members, and the underlying causalities of the patient’s substance dependence. Analyze his or her strengths and weaknesses.The patient’s family history can help the nurse obtain baseline information. Moreover, it determines the area of focus for potential change or readjustments.  
Evaluate the patient’s perceptions of previous maladaptive behaviors and the current situation.It identifies goals and concerns on which the care plan can be based. Additionally, this would highlight areas for improvement.
Investigate the patient’s family and significant other/s response to dependency and substance abuse.This intervention will also assist the codependent individual in adapting effective coping mechanisms. It facilitates the resolution of the collaborative problem (old or new) since the addictive behavior of a loved one (patient) consumes the thoughts and attention of the codependent.
Discuss the impact of substance abuse on relationships. Include details on the effects of abstinence.Recognition of the effects of the substance on the body, interpersonal connections, and conflict resolution might promote adherence to the prescribed treatment plan. This would also improve limited communication and decisions/actions within the family unit that may be detrimental to the patient’s health
Assist family members in making judgments about their own behavior.Once codependent members become aware of their role in propagating the patient’s dependence, they can choose to make adjustments. If they do, the patient will be forced to confront the consequences of her own actions, at which point she may choose to improve.

Readiness for Enhanced Coping Nursing Care Plan 3

Suicide Behaviors

Nursing Diagnosis: Readiness for Enhanced Coping related to the patient’s desire to seek relief secondary to suicide behaviors, as evidenced by actively pursuing social support, new strategies, seeking help with negative thought patterns, and verbalization to know more about health management.  

Desired Outcome: The patient will demonstrate improved lifestyle changes and demonstrate effective problem-solving skills.

Readiness for Enhanced Coping Nursing InterventionsRationale
Conduct patient education on the defining characteristics of suicide. Reiterate rationale in identifying contributing behaviors (drinking, withdrawal, procrastination, denial, etc.) and assess his/her previous coping strategies.  The patient may not have basic understanding of good coping skills and may exhibit inappropriate expression to rumination. This intervention will also provide awareness and avenues to discuss coping styles. By using reports of the patient’s experiences, fears, or concerns, the nurse can equip them with different methods of coping.
Educate the patient on factors that affect their socially deviant behavior and coping behavior (e.g., family member, hopelessness, dependency, legal problem, etc.)The patient can better identify factors affecting his/her adaptive mechanisms. Moreover, this will aid in the development of individualized care plans since predisposing factors have been identified.
Assist the patient in adopting healthy coping strategies (e.g., relaxation, expression of feelings, problem-solving skills).The patient will be able to cope more effectively with life stresses and suicide threats and will develop healthy outlets.
Determine whether or not the patient requires assertiveness training.Frustration, rage, and hostility can develop when a patient is unable to express their needs. With assertive training, the patient can better express their needs and wants to their healthcare providers. In addition, it enables patients to instill a sense of control.
Affirm the patient’s preferred coping style such as relaxing activities, privacy, vacations, trips, stress management, or education.There are various outlets to foster positive feelings, confidence, and self-esteem. It is vital to establish the preferred coping mechanism to allow information seeking and goal-setting (establishing limits to the activity).

Readiness for Enhanced Coping Nursing Care Plan 4

Inflammatory Bowel Disease

Nursing Diagnosis: Readiness for Enhanced Coping related to the patient’s desire to use effective bowel elimination techniques secondary to inflammatory bowel disease (IBD), as evidenced by request for assistive devices, verbalized desire to employ lifestyle and dietary changes.

Desired Outcome: The patient will report improved bowel movements and demonstrate effective strategies to avoid relapse.

Readiness for Enhanced Coping Nursing InterventionsRationale
Evaluate the patient’s and significant others’ knowledge of the disease process. Determine prior coping strategies to deal with the disease by asking open-ended questions.Understanding the patient’s and SO’s current knowledge enables the nurse to get baseline information to prepare a tailored care plan. Additionally, there is no guarantee that knowledge gained during health education will be kept, as factors such as fear and the introduction of new concepts may impede recall. This intervention also aims to open up discussion of concerns regarding the condition and what to expect.
Offer assistance and emotional support to the patient, such as active listening, the reiteration of no right or wrong feelings, a non-judgmental approach, and having open communication for questions and concerns.Open dialogues help reassure the patient that their feelings are valid, thus fostering a sense of self-worth in the event that he or she begins to have negative views about oneself. It prevents the patient from feeling ashamed or like a burden (use of assistive devices, hyperactive bowel sounds, use of bedpan, and adaptive devices). Moreover, depreciation in the patient’s self-esteem could partially diminish his/her coping mechanism.
Encourage the use of stress-reducing activities such as regular exercises, relaxation techniques, deep-breathing exercises, goal setting, reframing, and guided imagery.In the event of rumination, use stress management approaches to bring back the patient’s progress, problem-solving skills, and the desire to enhance his/her sense of control.
Assess the patient’s external stressors.This intervention establishes familial, societal, and environmental issues that could interfere with the patient’s level of wellness. Identifying these predisposing factors is beneficial in the effective implementation of the program.

Readiness for Enhanced Coping Nursing Care Plan 5

Personality Disorders

Nursing Diagnosis: Readiness for Enhance Coping related to the patient’s desire for mood stabilization and reduced impulsiveness secondary to personality disorders, as evidenced by a desire to recognize effective strategies against self-mutilation, seeking social support, verbalized want to participate and achieve independence.

Desired Outcome: The patient will report improved self-control and mood stabilization.

Readiness for Enhanced Coping Nursing InterventionsRationale
Evaluate the patient’s history of self-harm.Determining the patient’s past history of self-mutilation can help the nurse develop individualized care plans, allocate responsibilities, health teaching, and strategies.
Provide an outline of the patient’s responsibilities. Teach him/her the set of rules for acceptable conduct.For hospitalized patients, it is important that he/she is aware of unit rules. This will reframe how the patient conducts himself/herself and thereby prevent negative behaviors. Moreover, assigning responsibilities promotes active engagement and participation.
Devise a plan for avoiding self-harm by initiating healthy outlets. Explain the need to modify daily living choices to meet the patient’s goals.  Alternative outlets for tension can improve the patient’s adaptive behavior. Providing them with a plan can give them concrete activities that will refocus their attention away from self-mutilation. Moreover, this will target specific needs and give them a sense of purpose and obligation.
Maintain a non-judgmental and neutral approach when self-destruction behavior starts to arise.A neutral and nonpunitive approach prevents blaming and fosters a desirable situation of self-disclosure. This intervention seeks to create a secure environment for the patient in order for them to avoid developing anxiety or abandoning coping mechanisms.

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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