00058 Risk Of Deterioration Of Linking

Domain 7: role/relationships
Class 2: family relationships
Diagnostic Code: 00058
NANDA Tag: Risk of Linking Deterioration
Diagnostic focus: Linking
Approved 1994 • Revised 2008, 2013, 2017 • Evidence level 2.1

NANDA Nursing Diagnosis Definition

The Nanda nursing diagnosis « risk of deterioration of linking is defined as: susceptible to an interruption of the interactive process between parents or significant person and the child, process that encourages the development of an enriching and reciprocal protection relationship.

Risk factors

  • Anxiety
  • The child’s condition prevents the effective initiation of parental contact
  • Disorganized infant behavior
  • Inability of parents to meet personal needs
  • Insufficient intimacy
  • The parental condition prevents the effective initiation of contact with the infant
  • Separation of parents and the child
  • Parental conflict because of the disorganized behavior of infant
  • Physical barriers
  • Inappropriate use of substances

Risk population

  • Premature infants

Suggestions of use

  • Use this diagnosis when one or the two parents are at risk of attachment problems. If signs of attachment are observed, use risk of parental deterioration associated with alteration of the childhood in the infant/child.

Suggested alternative diagnostics

NOC Results

  • ATTENGE FATHER-SON: behaviors of the parents and the child who demonstrate a solid affective bond
  • Knowledge: parental role: scope of knowledge about the offer of a constructive and educational environment to a child between one and 17 years of age
  • Parental role performance: congruence of an individual’s role behaviors with the expectations of the role
  • Parental role: Actions of parents aimed at providing the child with a physical, emotional and social, constructive and breeding environment

Evaluation objectives and criteria

note : parents’ behavior can vary according to cultural norms.

  • Demonstrate father-son attachment, revealed by the following indicators (specify from 1 to 5: never, rarely, often, often, usually):
    • The parent will be able to:
      • Practice healthy behaviors during pregnancy
      • Assign concrete attributes to the fetus
      • Prepare to receive the baby before birth
      • Load in arms, touch, stroke, kiss and smile at the baby
      • Talk to the baby
      • Use the position of the face and visual contact
      • Play with the baby
      • Respond to infant signals
      • Consider and calm the baby
      • Keep the infant clean, dry and hot
    • The baby will be able to:
    • Look at the parent
    • Respond to the parent’s signals
  • Demonstrates parental role, or parents, which manifests through the following indicators (specify from 1 to 5: never, rarely, once, often, usually):
    • Stimulate cognitive and social (child) development
    • Stimulate emotional and spiritual growth (of the child)
    • shows a love relationship (with the child)
    • Verbalize positive qualities of the child
  • NIC Interventions

    • Paternal education: Child: Instructions on parenting and the necessary physical care during the first year of life
    • Promote paternity: provide information on paternity, support and coordination of all services, high -risk families
    • Attachment promotion: facilitate the development of the relationship with parents
    • Development promotion: structure the environment and offer care in response to behavioral impulses and states of premature neonate
    • Management of the environment: attachment process: manipulate the patient’s environment to facilitate the development of the parents/infant relationship
    • Improvement of roles: helping a patient, their family and nearby people, to improve relationships clarifying and explaining concrete behavior of role performance

    Nursing Activities

    In general, nursing actions in this diagnosis focus on evaluating risk factors and attachment behaviors; Teach, promote parents/baby interaction after birth and manipulate the environment (for example, ensuring privacy) to facilitate attachment.

    Note : It is necessary to be sensitive to cultural origin when nursing activities are chosen, since cultural norms about parenting are very variable.

    Valuations

    • Evaluate the learning needs of parents
    • Assess the factors that could cause attachment problems (pain, substance abuse, premature baby)
    • Observe the parents/infant attachment indicators (see

    Evaluation objectives and criteria

    • Identify the arrangement of parents to learn about baby care
    • Evaluate parents’ ability to recognize the physiological needs of the baby (for example, the signs that are hungry)
    • (NIC) Attachment promotion:
      • Make sure that before birth the parents have chosen names for children and girl
      • Talk about the paternal reaction to pregnancy
      • Patient and family education
    • Teach and demonstrate the care to the newborn (for example, food, bathroom)
    • Instruct parents about the child’s development
    • Help parents interpret the changing messages and needs of the baby or child (for example, nonverbal language, cries and vocalizations)
    • Teach techniques to calm and increase parents’ ability to relieve child’s discomfort
    • (NIC) Attachment promotion:
      • Inform parents about the care that is being provided to the newborn
      • Explain how the equipment is used to monitor the baby in the Ciero
      • Prove how a baby can be touched in the incubator
      • Share with the parents the information obtained in the initial physical examination of the newborn
      • Comment with the parents the characteristics of the baby’s behavior

    Others

    Prenatal Period

    • (NIC) Attachment promotion:
      • Give parents the opportunity to listen to the fetal beat as soon as possible
      • Give parents the opportunity to see the ultrasound image of the fetus
      • Encourage parents to attend prenatal classes (or paternity)
    during childbirth

    • (NIC) fom
    • Encourage the father or be loved to participate in childbirth and birth (if they wish)
    • Place the newborn on the mother’s body immediately after birth
    • Give parents to see, hold and observe the newborn immediately after birth
    • Provide privacy to the family during the initial interaction with the newborn
  • (NIC) Environment Management: APEGE PROCESS:
    • Limit the number of people present in the delivery room
    • Provide a comfortable seat to the most relative father or relative
    • Maintain a low level of stimulation in the patient’s environment and her family
  • Neonatal Period

    • (NIC) Attachment promotion:
      • Help parents participate in baby care
      • Strengthen the behavior of the caregiver role
      • Highlight the normal aspects of a baby with some alteration
      • Encourage parents to carry personal objects, such as toys or photographs, to put them in the incubator or the baby’s cradle
      • Inform parents of care that are being provided to the baby in another hospital
      • Comment with the parents the characteristics of the baby’s behavior
      • Point out those baby behaviors that indicate that it responds to parents
      • Whenever possible, leave the baby with the parents after birth
      • Encourage parents to give massages to the baby
      • Encourage parents to touch and talk to the newborn
    • (NIC) Environment Management: APEGE PROCESS:
      • Allow the most relative father or relative to sleep in the mother’s room (if you wish)
      • Reduce hospital staff interruptions
    at home

    • A good part of postpartum care is done through home tracking visits. Continue with the interventions described above. In addition, assess whether there is postpartum depression and other complications that may arise after the woman returns home.