00071 Defensive Coping

Domain 9: coping/stress tolerance
Class 2: coping responses
Diagnostic Code: <00071
Nanda label: defensive coping
Diagnostic focus: coping
Approved 1988 • Revised 2008 • Evidence Level 2.1

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « defensive coping is defined as: repeated projection of a falsely positive self -evaluation based on a protective pattern that defends the person of what he perceives as threats underlying his self -esteem positive.

Definite characteristics

  • Alteration in confirmation of reality
  • Denies the problems
  • Denies the weaknesses
  • Difficulty to establish personal relationships
  • Difficulty to maintain personal relationships
  • Grandiosity
  • Hostile laugh
  • Hypersensitivity to unfortunates
  • Hypersensitivity to criticism
  • Inappropriate treatment of treatment
  • Inadequate participation in the therapeutic regime
  • Projection of guilt
  • Projection of responsibility
  • Rationalization of failures
  • Distortion of reality
  • ridicule others
  • Attitude of superiority regarding others

Related factors

  • Conflict between self -perception and the values ??system
  • Fear of failure
  • Fear of humiliation
  • Fear of repercussions
  • Confidence in other inadequate
  • Inadequate psychological resilience
  • Inadequate personal trust
  • Inadequate social support
  • Uncertainty
  • Non -realistic own expectations

Suggestions of use

  • This diagnosis is less specific than ineffective denial, which is actually one of the many manifestations of defensive coping.
  • The most specific diagnosis should be used when coping attempts are abuse or inappropriate use of denial. As impotence can lead to defensive coping, it is important to determine what the center of the intervention should be, if both are presented.

Suggested alternative diagnostics

  • Ineffective coping
  • Health risk behavior, a tendency to adopt
  • Impotence
  • ineffective denial

NOC Results

  • Acceptance: Health status: Reconciliation with a significant change in the state of health
  • Adaptation to physical disability: adaptive response to an important functional change due to a physical disability
  • coping: personal actions aimed at handling the stressful factors that test the resources of an individual
  • Self -esteem: Personal judgment of one’s worth
  • Social interaction skills: personal behaviors that promote effective relationships
  • Participation in health care decisions: Personal involvement in the choice and evaluation of health care alternatives to achieve the desired result

Evaluation objectives and criteria

  • The patient does not use defensive coping, which is manifested by acceptance of: health status, adaptation to physical disability, effective coping, positive self -esteem and social interaction skills, as well as participation in health care decisions < /li>
  • demonstrates coping, which is manifested by the following indicators (specify from 1 to 5: never, rarely, once, often, usually):
    • Modify your lifestyle to reduce stress
    • Look for truthful information about disease and treatment
    • Receive help from a health care professional
    • Verbally express that you accept the situation
    • Use effective coping strategies
  • Other examples

    The patient will be able to:

    • Recognize specific problems and conflicts that interfere with social interactions and relationships
    • Demonstrate a decrease in the defensive pattern
    • Express feelings concerning changes in your health
    • Express feelings of personal worth
    • Reformulate the previous health concept
    • Maintain effective interactions with other people

    NIC Interventions

    • Emotional support: provide comfort, acceptance and encouragement during moments of tension
    • Advice: use of an interactive process of help focused on the needs ”problems or feelings of the patient and the closest people, to improve or strengthen the coping, solution of problems and interpersonal relationships
    • Increased self -awareness: helping a patient to explore and understand their thoughts, feelings, motivations and behaviors
    • Establishment of complex relationships: establish a therapeutic relationship with a patient who has difficulty interacting with other people
    • Facilitation of personal responsibility: encourage a patient to assume greater responsibility for their own behavior
    • Improvement of self -esteem: help a patient improve the way he judges his personal value
    • Improvement of coping: help the patient adapt to stressful factors, changes or perceived threats that interfere with the satisfaction of the demands and the roles of life
    • Behavior modification: favor a behavior change
    • Behavior modification: social skills: help the patient develop or improve their interpersonal social skills

    Nursing Activities

    In general, nursing activities for this diagnosis focus on establishing a therapeutic relationship, reducing stressful factors and raising self -esteem

    Valuations

    • Evaluate the degree of defense and denial that interferes with personal evaluation
    • Assess the level of self -esteem
    • Evaluate the presence of feelings of impotence
    • Evaluate a possible substance abuse

    Patient and family education

    • Teach alternative behaviors to achieve a positive assessment through group therapy, individual therapy and roles modeling

    Collaboration activities

    • Channel to adequate community resources (for example, family or couple orientation, substance abuse groups)
    • Channel to a mental health professional if necessary, especially if the patient is dealing with a traumatic event

    Others

    • Transmit acceptance, express respect and give credit to the patient’s concerns
    • Help the patient recognize negative coping behaviors
    • Identify and talk about issues, situations and people who trigger negative coping behaviors
    • Provide feedback in a support environment on the way in which others perceive their behavior
    • Provide reality evidence in the face of great behaviors, denial of obvious problems, and projection of guilt and responsibility
    • Use group situations in which the patient can receive feedback on the way in which others perceive their use of denial
    • (NIC) Improve personal awareness:
      • Help the patient identify the influence of the disease on the Autoconception
      • Talk about the way the patient denies reality, if appropriate
      • Help the patient identify life priorities
      • Help the patient identify their positive characteristics

    At home

    • Assess functionality and support in family communication patterns, if required
    • Include family in treatment, as required
    • Channel to the domiciliary services of Psychiatry
    • Resort to the religious beliefs of the family as a method of coping

    Older people

    • Assess the presence of depression and dementia, which may be contributing to defensive coping