Psychosocial Integrity / Topic 5

Make sure to:

  • Assess the resources available to the client.
  • Evaluate the client's adaptability.
  • Provide support to clients experiencing changes in body image.

Clients entering healthcare facilities are confronted with both predictable and unpredictable events requiring effective coping strategies. Nurses play a pivotal role in facilitating these coping mechanisms, aiding clients in their journey back to wellness or achieving optimal health.

In this learning experience, learners will acquire knowledge and insights into effective coping mechanisms designed for clients undergoing stress.

5.1 Assessment of Client Resources

Nurses must consider the resources available to their clients during stressful life events, as these resources significantly influence their responses (Kaplan Nursing, 2023). Essential resources include their client's support systems and skills (Kaplan Nursing, 2023).

Support System

Clients may have access to various support systems, such as family members and community groups.

Skills

Clients need effective problem-solving and decision-making skills, alongside defense mechanisms, to cope with stress-related challenges (Kaplan Nursing, 2023). These challenges can range from financial difficulties, divorce, relocation, death of a loved one, parenthood and stressors of daily living (Burke, 2023). Such stresses can significantly disrupt client's mental, emotional, and physical well-being. Nurses are tasked with identifying the defense mechanisms employed by their clients and evaluating their effectiveness. By doing so, nurses can support the continued use of beneficial defense mechanisms and educate those unfamiliar with these strategies on how they contribute to returning to wellness or achieving optimal health (Kaplan Nursing, 2023). According to Kaplan Nursing (2023) these defense mechanisms include:

  • Denial: Completely denies any feelings or thoughts.
  • Suppression: Attempts to conceal a vague feeling or thought.
  • Projection: Attributes a negative feeling or thought to another person.
  • Acting out: Engages in intense behavior to express thoughts or feelings that seem otherwise inexpressible.
  • Displacement: Shifts emotions from one person or object to another.
  • Isolation of affect: Experiences a disconnect between feelings and thoughts.
  • Intellectualization: Avoids emotional response by focusing on logical explanations.
  • Regression: Reverts to earlier, childlike behaviors as a means of expressing emotions.
  • Reaction formation: Displays feelings opposite to what is truly felt.
  • Rationalization: Justifies a situation in various ways to defend it, while ignoring personal emotions.
  • Sublimation: Channels emotions into an activity that is deemed socially beneficial.
  • Dissociation: Experiences a detachment from time and/or self, adopting an alternative representation of oneself to persist in the moment.

5.2 Assessment of Client Adaptability

The care of clients coping with adverse events includes the assessment of their adaptability. Nurses play a pivotal role in aiding these individuals to adjust to changes, whether temporary and permanent (Burke, 2023). Some clients may experience temporary changes that:

  • Require their absence from work due to illness such as back pain.
  • Involve psychological issues, like substance abuse, which impede their ability to care for their child or children.
  • Include physical challenges, such as a fractured leg, that prevents them from looking after their child or children.

Clients may better adjust to temporary changes by accepting help from their support network, thus protecting their self-worth and self-esteem from negative effects.

Conversely, other clients face permanent changes, including:

  • The devastating loss of a child due to child neglect or abuse.
  • Paralysis, which restricts a parent's ability to care for their child or children.

Clients undergoing such permanent changes may display signs of anxiety.

Assessing clients' adaptability and their responses to changes enables nurses to provide individualized interventions in their care (Burke, 2023). These interventions encompass:

  • Offering support to clients when they express their feelings.
  • Fostering an open, sincere, and trusting nurse-client relationship.
  • Collaborating with clients who have experienced permanent changes to establish alternative and attainable goals.

5.3 Support of Clients with Body Image Changes

Burke (2023) discusses how nurses care for clients experiencing changes in body image due to various factors:

  • Life stages, including puberty during adolescence, menopause for women, and male climacteric during the middle age, as well as the aging process in the elderly clients.
  • Physical disability or disfigurement resulting from a severe accident.
  • Alopecia caused by chemotherapy in cancer treatment.
  • Disfiguring surgeries, such as orchiectomy and radical mastectomy.
  • Therapeutic interventions, for example, the creation of a colostomy.
  • It is important to assess client's feelings about their body image

At the end of this learning experience, the learner will have acquired knowledge about the coping mechanisms clients employ during stressful situations. The main goals are to prepare learners for success in the NCLEX examination and to enhance their clinical competency.

After reviewing the resources, identify particular areas needing further improvement and focus on enhancing skills and deepening knowledge in these identified areas.

  • Burke, A. (2023, October 12). Coping Mechanisms: NCLEX-RN. https://www.registerednursing.org/nclex/coping-mechanisms/#assessing-clients-support-systems-available-resources

  • Kaplan Nursing. (2023). Next Generation NCLEX-RN Prep 2023-2024: Practice Test + Proven Strategies (9th ed.). Kaplan Test Prep.

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Readings

Videos

  • Dr. Tracey Marks. (2021, July 7). Coping Skills and Psychological Defenses: An Introduction [Video]. YouTube. https://youtu.be/JZgZSM-t5Jg