Nursing diagnosis: interrupted Family Processes/impaired Parenting related to situational transition and/or crises—illness, trauma, disabling and/or expensive treatments; shift in health status of a family member; modification in family finances or social status; lack of or ineffective role model; lack of support between or from SO(s); separation from parent; interruption in bonding process; lack of appropriate response of child to parent or parent to child; lack of knowledge; unrealistic expectation for self, child, partner
Possibly evidenced by
Changes in communication patterns, participation in decision making
Expressions of conflict within family
Frequent verbalization of disappointment in child, resentment toward child, inability to care for or discipline child
Lack of parental attachment behaviors
Growth and/or developmental lag in child
Desired Outcomes/Evaluation Criteria—Parent/Caregiver Will
Verbalize positive feelings about parenting abilities.
Be involved in problem-solving solutions for current situation.
Develop skills to deal with present situation.
Strengthen parenting skills.
Nursing intervention with rationale:
1. Determine existing situation and parental perception of the problems, noting presence of specific factors such as psychiatric or physical illness, and disabilities of child or parent.
Rationale: Identification of the individual factors will aid in focusing interventions and establishing a realistic plan of care.
2. Identify developmental stage of the family—first child, new infant, school-age or adolescent children, or stepfamily.
Rationale: These factors affect how family members view current problems and choices of solutions.
3. Determine cultural and religious influences on parenting and expectations of self and child.
Rationale: This information is crucial to helping the family identify and develop a treatment plan that meets its specific needs, enhancing likelihood of success.
4. Assess parenting skill level, considering intellectual, emotional, and physical strengths and limitations.
Rationale: Identifies areas of need for further education, skill training, and factors that might interfere with ability to assimilate new information.
5. Note attachment behaviors between parent and child(ren), recognizing cultural background. Encourage parent(s) to hold and spend time with child, particularly newborn or infant.
Rationale: Lack of eye contact and touching may indicate bonding problems. Failure to bond effectively with newborn is thought to affect subsequent parent-child interaction.
6. Observe interactions between parent(s) and child(ren).
Rationale: Identifies relationships, communication skills, and feelings about one another.
7. Note presence and effectiveness of extended family support systems.
Rationale: Provides role models for parent(s) to help them develop own style of parenting. Note: Role models may be negative and/or controlling.
8. Emphasize positive aspects of situation, maintaining a positive attitude toward parent’s capabilities and potential for improving.
Rationale: Helping parent(s) to feel accepting about self and individual capabilities will promote growth.
9. Involve all members of the family in learning activities.
Rationale: Learning new skills is enhanced when everyone is participating and interacting.
10. Encourage parent(s) to identify positive outlets for meeting own needs, such as going to a movie or out to dinner. Discuss use of home care and respite services, as appropriate.
Rationale: Parent often believes it is “selfish” to do things for own self, that children are primary. However, parents are important, children are important, and the family is important. As a rule, when parents take care of themselves, their coping abilities are enhanced and they are better parents. Note: Siblings also require time with parents to attend to their needs, and to have positive interactions.