Nurse's Pocket Guide

HOPELESSNESS
Defining Characteristics
SUBJECTIVE
Verbal cues (despondent content, “I can’t,” sighing) [believes
things will not change/problems will always be there]
OBJECTIVE
Passivity; decreased verbalization
Decreased affect/appetite/response to stimuli
[Depressed cognitive functions; problems with decisions,
thought processes; regression]
Lack of initiative/lack of involvement in care
Sleep pattern disturbance [increased/decreased sleep]
Turning away from speaker; shrugging in response to speaker;
[withdrawal from environs; closing eyes]
[Lack of involvement/interest in SO(s) (children, spouse)]
[Angry outbursts]
[Substance abuse]
Desired Outcomes/Evaluation
Criteria—Client Will:
• Recognize and verbalize feelings.
• Identify and use coping mechanisms to counteract feelings of
hopelessness.
• Involve self in and control (within limits of the individual situation)
own self-care and ADLs.
• Set progressive short-term goals that develop/foster/sustain
behavioral changes/positive outlook.
• Participate in diversional activities of own choice.
Actions/Interventions
NURSING PRIORITY NO. 1.To identify causative/contributing
factors:
• Review familial/social history and physiological history for
problems, such as history of poor coping abilities, disorder of
familial relating patterns, emotional problems, (leading to
feelings of isolation), recent or long-term illness of client or
family member, multiple social and/or physiological traumas
to individual or family members.
• Note current familial/social/physical situation of client (e.g.,
newly diagnosed with chronic/terminal disease, lack of support
system, recent job loss, loss of spiritual/religious faith,
recent multiple traumas, alcoholism/substance abuse).
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
380 Cultural Collaborative Community/Home Care