Chapter 55 Homework Discuss How Conscious Coping Strategies Such Relaxation

12 Chapter 55Psychologic Responses to Illness____________________________________________________

LESSON 55.1

5

&

6

Slide 24

Maladaptive Coping Mechanisms and Strategies

• Helplessness

• Occurs when individuals have had repeated exposure to events they perceive as

being uncontrollable

• Leads to loss of motivation, feelings of despair or anxiety, and cognitive impairment

TALKING POINTS:

• The expression of anger is really not aimed at the nurse, but is simply an attempt to cope

with feelings of loss of control.

Slide 25

Maladaptive Coping Mechanisms and Strategies (cont.)

• Powerlessness

• A feeling that one’s actions cannot affect an outcome or that one lacks personal

control over certain events or situations

• Characteristics of powerlessness: passivity; nonparticipation in care and decision–

making; dependence on others, which may lead to anger, resentment, or guilt; and

verbal expression of loss of control over situations or outcomes

Slide 26

Maladaptive Coping Mechanisms and Strategies (cont.)

• Denial

• Subconscious blocking out of emotional experiences

• Several forms: verbal denial, minimizing severity of the illness, displacing symptoms

onto another organ system, and engaging in behaviors contrary to medical advice

TALKING POINTS:

• What is the best way to deal with people in denial?

7

Slide 27

Assessment

• Effectiveness of individual coping strategies―seek answers to the following

• Do individuals see themselves as effective in coping with their illness?

• What efforts have individuals made to seek information about their situation?

• How skillful are individuals in caring for themselves?

• What resources do individuals believe are available to them in dealing with their

illness?

• Do individuals effectively adhere to their medical regimen?

Slide 28

Assessment (cont.)

• Questions

• Do individuals feel they have been able to keep a sense of normality in their life

despite their illness?

__________________________________________________ Chapter 55Psychologic Responses to Illness 13

Introduction to Medical-Surgical Nursing, 6th ed.

LESSON 55.1

Slide 29

Nursing Diagnoses

• Anxiety

• Caregiver role strain

• Chronic sorrow

• Complicated grieving

• Compromised family coping

• Decisional conflict

• Defensive coping

• Delayed growth and development

• Disturbed body image

Slide 30

Nursing Diagnoses (cont.)

• Disturbed personal identity

• Fatigue

• Fear

• Ineffective coping

• Ineffective denial

• Ineffective role performance

• Ineffective sexuality pattern

• Interrupted family processes

• Social isolation

• Spiritual distress

Nursing Diagnoses (cont.)

• Powerlessness

Nursing Goals, Outcome Criteria, and Interventions

• Goal of nursing care is to help people manage and successfully cope with their illness

Slide 33

Question 1

• Mentally healthy individuals are able to do all of the following except ____________.

A. perceive reality accurately

B. think clearly and logically

C. communicate ineffectively

D. develop a positive self-concept

14 Chapter 55Psychologic Responses to Illness____________________________________________________

Introduction to Medical-Surgical Nursing, 6th ed.

LESSON 55.1

Slide 34

Question 2

• As described by Maslow, which of the following is not one of the basic physiologic needs?

A. Food

B. Shelter

C. Protection

D. Water

TALKING POINTS:

Activities

Classroom Choose from below to make 30 minutes

Online

1

ASSESS BASELINE

• Have the class complete the Pretest. Collect

their work and use the results to guide how

you teach the class.

DISCUSS

• Discuss the physical, cognitive, affective,

behavioral, and social dimensions of an

individual.

• Discuss the 12 characteristics possessed by

healthy, self-actualized individuals,

according to Maslow.

PRACTICE

• Ask students to write their own definition of

mental health. Ask volunteers to share their

ASSESS BASELINE

• Post the Pretest and the Background

Assessment online and have your class

complete them. Use the results to guide how

you teach the class.

POST AND COMMENT

• Post the following discussion topic online

and have students comment. Think of

instances when nurses must use Maslow’s

hierarchy of needs in patient care. How is

the role of triage nurse affected by the

hierarchy of needs?

• Post the following discussion topic online

and have students comment. Describe a

time in your life when your physiologic needs

__________________________________________________ Chapter 55Psychologic Responses to Illness 15

Introduction to Medical-Surgical Nursing, 6th ed.

LESSON 55.1

2

DISCUSS

• Discuss, define, and describe a stressor.

Define adaptation and how adaptation to

stress affects the whole organism.

• Discuss how personality develops through

each stage of life.

• Discuss conditioning and learned behaviors.

PRACTICE

• Divide the class into four groups. Assign

each group one of these four concepts:

stress, anxiety, adaptation, or homeostasis.

Ask each group to develop an explanation of

the concept as it applies to people of various

ages and life stages, giving several

POST AND COMMENT

• Post the following discussion topic online

and have students comment. Identify three

stressors in nursing school.

• Post the following discussion topic online

and have students comment. Discuss a time

when you were able to tell that another

person was undergoing stress (NO

PATIENT INFORMATION PLEASE). Ask

students to provide constructive comments

on each other’s posts

3

DISCUSS

• Discuss how age affects an individual’s

ability to cope with illness.

• Discuss how cultural beliefs affect an

individual’s ability to cope with illness.

• Discuss how spirituality affects an

individual’s ability to cope with illness.

PRACTICE

• Divide the class into several small groups.

Have each group identify how people in the

POST AND COMMENT

• Post the following discussion topic online

and have students comment. Identify and

discuss how cultural influences and

spirituality can affect a patient’s ability to

cope with illness. (If students are willing,

have them discuss how their culture or

spirituality influences their coping methods.)

Ask students to provide constructive

comments on each other’s posts.

16 Chapter 55Psychologic Responses to Illness____________________________________________________

Introduction to Medical-Surgical Nursing, 6th ed.

LESSON 55.1

4

DISCUSS

• Discuss and define coping, maladaptive

coping, and defense mechanisms.

• Discuss defense mechanisms such as

compensation, denial, rationalization, and

repression and how these mechanisms are

used by individuals to cope with illness.

• Discuss how conscious coping strategies

such as relaxation techniques, therapeutic

touch, and music therapy help an individual

cope with illness.

PRACTICE

• Divide the class into small groups. Ask each

POST AND COMMENT

• Post the following discussion topic online

and have students comment. Think of at

least five defense mechanisms. Describe the

benefits and risks of each defense

mechanism. What would be an appropriate

use of the defense mechanism? When

would it be risky? Ask students to provide

constructive comments on each other’s

posts.

__________________________________________________ Chapter 55Psychologic Responses to Illness 17

Introduction to Medical-Surgical Nursing, 6th ed.

LESSON 55.1

5

DISCUSS

• Discuss the difference between anxiety and

fear.

• Discuss the difference between actual loss

and anticipatory loss.

• Discuss grief and mourning and describe the

symptoms of grief.

PRACTICE

• Divide the class into five groups. Assign

each group one of the following concepts:

anxiety, fear, stress, loss, and grief. Have

each group define the concept and discuss

which of the concepts may be experienced

in the following scenario:

• A 45-year-old man, recently diagnosed

with liver cancer, is scheduled to receive

• Facilitate a class discussion about the

differences between anxiety and fear. Make

a list of the differences on the board. Ask

students how a nurse can help a patient deal

with anxiety. With fear? Discuss the answers

that the students provide.

• Discuss helplessness, powerlessness, and

denial. Describe characteristics of each and

how a nurse can help a patient adopt coping

mechanisms.

POST AND COMMENT

• Post the following discussion topic online

and have students comment. Ask students

to prepare a video mix of songs, using music

only (no lyrics), depicting anxiety, fear, loss,

grief, and mourning. Ask students to provide

constructive comments on each other’s

mixes.

18 Chapter 55Psychologic Responses to Illness____________________________________________________

Introduction to Medical-Surgical Nursing, 6th ed.

LESSON 55.1

6

DISCUSS

• Discuss how self-concept and self-esteem

affect a patient’s ability to cope with illness.

• Discuss how family and community

resources can help a patient cope with

illness.

PRACTICE

• Divide the class into groups. Ask each group

to review the following scenarios. Based on

the scenarios, what are some factors that

might promote adaptive coping mechanisms

POST AND COMMENT

• Post the following discussion topic online

and have students comment. Discuss the

availability of community resources that can

help a patient cope with illnesses. How

affordable are the resources? Which

resources are either free or very

inexpensive? How would a person who

cannot use a computer locate these

resources? Ask students to provide

comments on each other’s posts.

7

DISCUSS

• Discuss questions a nurse can pose during

the assessment to determine an individual’s

ability to cope with illness.

• Discuss examples of nursing diagnoses

made for patients with inadequate coping.

• Discuss examples of nursing goals, outcome

criteria, and interventions that can apply to

individuals with acute illness, chronic illness,

or terminal illness.

PRACTICE

• Have the students work in pairs or small

groups. Ask each group to select a nursing

POST AND COMMENT

• Post the following discussion topic online

and have students comment. Discuss ways

the nurse can determine the effectiveness of

an individual’s coping strategies. The

individual has a chronic health condition.

How can the nurse help an individual who is

having difficulty coping? Ask students to

provide constructive comments on each

other’s posts.

__________________________________________________ Chapter 55Psychologic Responses to Illness 19

Introduction to Medical-Surgical Nursing, 6th ed.

LESSON 55.1

Critical Thinking Question

A 36-year-old African-American patient has recently been diagnosed with multiple sclerosis.

He is married and has three children, attends church regularly, and is very involved in his

community. What are some factors that might influence the way he copes with his illness

and how might they affect his coping?

Discussion Guidelines: There are many factors that affect the way a person copes with illness.

Instructor Notes/Student Feedback

20 Chapter 55Psychologic Responses to Illness____________________________________________________

Introduction to Medical-Surgical Nursing, 6th ed.

55

Assessments for

Psychologic Responses to Illness

CHAPTER OBJECTIVES

Lesson 55.1:

2. Discuss the concepts of stress, anxiety, adaptation, and homeostasis.

4. Identify some basic coping strategies (defense mechanisms).

6. Describe several factors that may precipitate adaptive or maladaptive coping behaviors in response

to illness.

7. Discuss implementation of the nursing process to enhance a patient’s mental health as the patient

deals with the stresses of illness.

Assessments by Lesson & Objective

Lesson 55.1

1

Study Guide

• Part IC: 1, 2 (p. 380)

Evolve Instructor Resources

• Test Bank: 1, 2, 25, 26

Evolve Student Resources

• Prioritization: 2

2

Study Guide

• Part IIE: 5, 6, 9 (p. 381)

Evolve Student Resources

• NCLEX Review: 1

3

Study Guide

• Part IIE: 2, 4, 8 (pp. 380-381)

Evolve Instructor Resources

• Test Bank: 5-8; 10, 24

• Open Book Quiz: 2, 3

Evolve Student Resources

• NCLEX Review: 5-7

• Prioritization: 3

__________________________________________________ Chapter 55Psychologic Responses to Illness 21

Introduction to Medical-Surgical Nursing, 6th ed.

Assessments by Lesson & Objective

4

Study Guide

• Part IA: 1-8 (p. 379)

• Part IB: 1, 2 (p. 380)

• Part IIE: 1, 10, 16 (pp. 380-381)

Evolve Instructor Resources

• Test Bank: 18, 19, 23

• Open Book Quiz: 5, 6

Evolve Student Resources

Evolve Instructor Resources

• Test Bank: 12, 14-17, 20, 21

• Open Book Quiz: 4, 7

Evolve Student Resources

• NCLEX Review: 8

6

• NCLEX Review: 3

Study Guide

• Part IIE: 14 (p. 381)

Evolve Instructor Resources

• Test Bank: 9

• Open Book Quiz: 8, 9

Evolve Student Resources

7

Study Guide

• Part IIE: 3, 12 (p. 382)

• Part IIIF: 1 (p. 382)

• Part IIIG: 1, 2 (p. 382)

Evolve Instructor Resources

• Test Bank: 11, 13, 22

• Open Book Quiz: 10

Evolve Student Resources

Instructor’s Notes/Student Feedback