Nursing diagnosis: risk for Social Isolation
Risk factors may include
Altered state of wellness, changes in physical appearance
Perceptions of unacceptable social or sexual behavior, values
Inadequate resources and/or fear of losing personal resources
Possibly evidenced by
(Not applicable; presence of signs and symptoms establishes an actual diagnosis)
Desired Outcomes/Evaluation Criteria—Client Will
Identify stable support system and supportive individual(s).
Use resources for assistance, as appropriate.
Express increased sense of self-esteem.
Nursing intervention with rationale:
1. Determine client’s response to condition, feelings about self, concerns or fears about response of others, sense of ability to control situation, and sense of hope.
Rationale: How the individual accepts and deals with the situation will help decide the plan of care and interventions.
2. Assess coping mechanisms and previous methods of dealing with life problems.
Rationale: May reveal successful techniques that can be used in current situation.
3. Discuss concerns regarding employment and leisure involvement. Note potential problems involving finances, insurance, and housing.
Rationale: Clients with this potentially terminal illness, which carries a stigma, face major problems with possible loss of employment, medical insurance, housing, and care sources if they become unable to independently care for themselves.
4. Identify availability and stability of support systems including SO, immediate and extended family, and community.
Rationale: This information is crucial to help client plan future care.
5. Encourage honesty in relationships, as appropriate.
Rationale: As a rule, acquaintances do not need to be informed of client’s health status. However, information should be shared with close relationships such as SO, family, and sexual partners. Honesty can help identify stable support persons.
6. Encourage contact with SO, family, and friends.
Rationale: Many clients fear telling SO, family, and friends for fear of rejection, and some clients withdraw because of tumultuous feelings. Contact promotes sense of support, concern, involvement, and understanding. Supporting loved ones as they learn of the diagnosis is beneficial and can provide optimism for the long term.
7. Assist client to problem-solve solutions to short-term and/or imposed isolations, such as communicable disease measures or severely compromised immune system.
Rationale: Anticipatory planning can defuse sense of isolation and loneliness that can accompany these situations.
8. Help client differentiate between isolation and loneliness or aloneness, which may be by choice.
Rationale: Provides an opportunity for client to realize the control he or she has to make decisions about the choice to take care of self about these issues.
9. Be alert to verbal and nonverbal cues, such as withdrawal, statements of despair, and sense of aloneness. Determine presence and level of risk of suicidal thoughts.
Rationale: Indicators of despair and suicidal ideation may be present. When these cues are acknowledged, client is usually willing to divulge thoughts and sense of isolation and hopelessness.
10. Identify community resources, self-help groups, and rehabilitation or drug cessation programs, as indicated.
Rationale: Provides opportunities for resolving problems that may contribute to sense of loneliness and isolation, transmission risks, and sense of guilt.