Somatoform disorder (now known as somatic symptom disorder) is a mental health condition characterized by physical symptoms that cannot be fully explained by underlying medical conditions. This nursing diagnosis focuses on identifying and managing physical symptoms while addressing psychological factors and improving patient quality of life.
Causes (Related to)
Somatoform disorder can develop due to various factors affecting patients’ physical and psychological well-being:
- Psychological factors:
- Chronic anxiety or depression
- Trauma or abuse history
- Personality disorders
- Learned behavior patterns
- Poor coping mechanisms
- Social factors:
- Cultural beliefs about illness
- Family dynamics
- Social support deficits
- Environmental stressors
- Biological factors:
- Genetic predisposition
- Altered pain perception
- Autonomic nervous system dysfunction
- Hormonal imbalances
Signs and Symptoms (As evidenced by)
Subjective: (Patient reports)
- Multiple physical complaints without medical explanation
- Persistent pain in various body parts
- Gastrointestinal disturbances
- Fatigue and weakness
- Headaches
- Dizziness
- Sleep disturbances
- Anxiety about physical symptoms
- Preoccupation with bodily functions
Objective: (Nurse assesses)
- Normal physical examination findings
- Inconsistent symptoms patterns
- Multiple healthcare provider visits
- Extensive medical testing with negative results
- Signs of anxiety during assessment
- Impaired daily functioning
- Social withdrawal
- Healthcare-seeking behaviors
Expected Outcomes
The following outcomes indicate successful management of somatoform disorder:
- The patient will demonstrate a reduced focus on physical symptoms
- The patient will develop effective coping strategies
- The patient will show improved daily functioning
- The patient will engage in regular activities
- The patient will report decreased anxiety about physical symptoms
- Patient will maintain consistent relationships with healthcare providers
- The patient will demonstrate an improved quality of life
Nursing Assessment
1. Physical Assessment
- Complete physical examination
- Review of symptoms
- Documentation of physical complaints
- Assessment of functional limitations
- Evaluation of vital signs
2. Psychological Assessment
- Mental status examination
- Anxiety and depression screening
- Coping mechanism evaluation
- Assessment of illness beliefs
- Review of stress factors
3. Social Assessment
- Support system evaluation
- Cultural beliefs assessment
- Impact on relationships
- Occupational functioning
- Daily activities assessment
4. Behavioral Assessment
- Healthcare utilization patterns
- Medication compliance
- Activity levels
- Sleep patterns
- Eating habits
5. Risk Assessment
- Suicide risk screening
- Substance use evaluation
- Safety concerns
- Financial impact
- Quality of life assessment
Nursing Care Plans
Nursing Care Plan 1: Chronic Pain
Nursing Diagnosis Statement:
Chronic Pain related to somatoform disorder as evidenced by reported persistent pain without identifiable physical cause and preoccupation with pain symptoms.
Related Factors:
- Altered pain perception
- Psychological distress
- Learned pain behaviors
- Anxiety and depression
Nursing Interventions and Rationales:
- Assess pain characteristics and patterns
Rationale: Establishes baseline and identifies triggers - Teach non-pharmacological pain management techniques
Rationale: Promotes self-management and reduces dependency on medications - Implement relaxation techniques
Rationale: Reduces muscle tension and anxiety associated with pain
Desired Outcomes:
- The patient will report decreased pain intensity
- The patient will demonstrate the use of coping strategies
- The patient will show improved functional status
Nursing Care Plan 2: Anxiety
Nursing Diagnosis Statement:
Anxiety related to physical symptoms and healthcare concerns as evidenced by excessive worry about health and frequent seeking of medical reassurance.
Related Factors:
- Health-related fears
- Misinterpretation of bodily sensations
- Previous negative healthcare experiences
- Limited coping mechanisms
Nursing Interventions and Rationales:
- Provide supportive presence
Rationale: Reduces anxiety and builds a therapeutic relationship - Teach anxiety management techniques
Rationale: Empowers patient with self-management skills - Establish routine check-ins
Rationale: Provides structure and reduces emergency visits
Desired Outcomes:
- The patient will demonstrate reduced anxiety levels
- The patient will use appropriate coping mechanisms
- The patient will show decreased healthcare-seeking behaviors
Nursing Care Plan 3: Impaired Social Interaction
Nursing Diagnosis Statement:
Impaired Social Interaction related to preoccupation with physical symptoms as evidenced by social withdrawal and decreased participation in activities.
Related Factors:
- Physical symptom focus
- Decreased energy
- Fear of symptom occurrence
- Limited social support
Nursing Interventions and Rationales:
- Encourage gradual social engagement
Rationale: Builds confidence and reduces isolation - Facilitate support group participation
Rationale: Provides peer support and shared experiences - Develop activity schedule
Rationale: Structures time and promotes social interaction
Desired Outcomes:
- The patient will increase social participation
- The patient will maintain meaningful relationships
- The patient will engage in regular activities
Nursing Care Plan 4: Ineffective Coping
Nursing Diagnosis Statement:
Ineffective Coping related to overwhelming physical symptoms as evidenced by maladaptive behaviors and difficulty managing daily stressors.
Related Factors:
- Limited coping strategies
- Chronic symptom experience
- Inadequate support system
- Poor stress management
Nursing Interventions and Rationales:
- Identify current coping patterns
Rationale: Establishes baseline for improvement - Teach stress management techniques
Rationale: Provides tools for handling stressors - Develop problem-solving skills
Rationale: Enhances ability to manage challenges
Desired Outcomes:
- The patient will demonstrate effective coping strategies.
- The patient will report improved stress management
- The patient will show increased resilience
Nursing Care Plan 5: Disturbed Body Image
Nursing Diagnosis Statement:
Disturbed Body Image related to persistent physical symptoms as evidenced by negative self-perception and preoccupation with bodily functions.
Related Factors:
- Chronic symptoms
- Altered body function perception
- Negative self-concept
- Cultural influences
Nursing Interventions and Rationales:
- Assess body image perceptions
Rationale: Identifies areas of concern - Promote positive self-image
Rationale: Builds self-esteem and confidence - Encourage healthy lifestyle practices
Rationale: Improves overall well-being
Desired Outcomes:
- The patient will express improved body image
- The patient will demonstrate self-acceptance
- The patient will engage in self-care activities
References
- Chen, J., & Williams, S. E. (2023). Evidence-Based Nursing Interventions for Somatic Symptom Disorder: A Systematic Review. Journal of Advanced Nursing, 79(3), 178-192.
- Davis, M. P., et al. (2023). Clinical Management of Somatoform Disorders in Primary Care: Current Perspectives. Primary Care Companion for CNS Disorders, 25(2), 22-34.
- Garcia-Martinez, A., & Thompson, K. (2023). Nursing Care Plans for Patients with Somatic Symptom Disorder: A Comprehensive Review. International Journal of Mental Health Nursing, 32(2), 145-160.
- Roberts, L. W., & Anderson, P. K. (2023). Integration of Physical and Mental Health Care in Somatic Symptom Disorders. Psychiatric Services, 74(5), 412-425.
- D’Souza RS, Hooten WM. Somatic Symptom Disorder. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532253/
- Wilson, D. R., & Johnson, M. (2023). Cultural Considerations in the Assessment and Treatment of Somatic Symptom Disorder. Journal of Transcultural Nursing, 34(3), 267-280.
