00148 Fear

Domain 9: coping/stress tolerance
Class 2: coping responses
Diagnostic Code: 00148
Nanda label: fear
Diagnostic focus: fear
Approved 1980 • Revised 1996, 2000, 2017, 2020 • Evidence level 3.2

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « fear ” is defined as: basic and intense emotional response generated by the detection of an imminent threat that implies an immediate alarm reaction (American Psychological Association). P>

Definite characteristics

Physiological factors

  • Anorexia
  • Diaphoresis
  • Diarrhea
  • Dyspnea
  • Increase in blood pressure
  • Increase in heart rate
  • Increased respiratory rate
  • Increase in sweating
  • Muscle voltage
  • Nausea
  • paleness
  • Pupillary dilation
  • Urinary frequency
  • Vomiting
  • xerostomy

  • apprehension
  • Concentration in the source of fear
  • Decrease in self -confidence
  • Express alarm
  • Express fear
  • Express intense fear
  • Express tension
  • Impulsive behaviors
  • Increase in alert state
  • Inephic impulse control
  • nervousness
  • Psychomotor agitation

Related factors

  • Barriers in communication
  • Answer learned to the threat
  • Response to phobic stimuli
  • Non -family situation

Risk population

  • Children
  • People exposed to traumatic situations
  • People living in areas with increased violence
  • People who receive terminal care
  • People separated from the Source of Social Support
  • People who suffer surgical intervention
  • People with family history of posttraumatic shock
  • People with a history of falls
  • Older adults
  • Pregnant women
  • Women
  • Women who experience lighting

Associated problems

  • Sensitivity disorders

Suggestions of use

  • See use suggestions for anxiety diagnosis.

Suggested alternative diagnostics

  • Anxiety
  • Postraumatic syndrome
  • Traumatic violation syndrome

NOC Results

  • Fear self -control: personal actions to eliminate or reduce disabling feelings of apprehension, tension or discomfort, produced by an identifiable source
  • Fear level: severity of the apprehension, tension or discomfort manifested, which result from an identifiable source
  • Fear Level: Child: Severity of the apprehension, tension or discomfort manifested, which result from an identifiable source in a child from one to 17 years of age
  • Evaluation objectives and criteria

  • • The patient presents self -control of fear, which is manifested by the following indicators (specify from 1 to 5: never, rarely, once, often or usually):
    • Look for information to reduce fear
    • Watch time between episodes
    • Keep control over your life
    • Keep your performance role and social relations
    • Control response to fear
    • It continues to be productive
  • NIC Interventions

    • Security improvement: intensification of the physical and psychological safety of the patient
    • 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
    • Presence: Be with another person, both physically and psychologically, during difficult times
    • Anxiety reduction: minimize apprehension, fear, omen or discomfort related to the anticipation of an unknown danger of origin
    • Rehabiting technique: reduce anxiety in patients who suffer acute nerve tension

    Nursing Activities

    • See also nursing activities for anxiety diagnosis.

    Valuations

    • • Evaluate the subjective and objective fear responses of the patient
    • • (NIC) Improvement of coping: Evaluate the patient’s understanding about the disease process

    Patient and family education

    • • Explain all the evidence and treatments to the patient and the family
    • • Help patients differentiate between rational and irrational fears
    • • Teach the patient and his family to use guided imagination when they feel fear

    Collaboration activities

    • • Evaluate the need for the intervention of social services or psychiatric care
    • • Promote a conversation between patient and doctor about their fears
    • • Organize a meeting on the patient’s multidisciplinary care to prepare a care plan

    Others

    • • Provide frequent positive reinforcement when the patient has behaviors that could reduce or eliminate fear
    • • Stay with the patient during new situations or when fear is very intense
    • • Eliminate the patient’s fear source, whenever possible
    • • Communicate the acceptance of the perception of the patient’s fear to promote open communication on the source of fear
    • • Offer continuity in patient care through the assignment of this and the application of the care plan
    • • Provide frequent verbal and nonverbal reaffirmation to help reduce the patient’s fear state; Avoid stereotypes
    • • (NIC) Improvement of coping:
      • Evaluate and analyze the possible responses to the situation
      • Follow a calm and reassuring method
      • Help the patient to make an objective evaluation of the event
      • Motivate an attitude of realistic hope to handle the feelings of hopelessness
      • They advise decision making when the patient is under great tension
      • Promote the gradual control of the situation
      • Present the patient to people or groups that have surpassed with
      • Success the same experience
      • Motivate the verbal expression of feelings, perceptions and fears
      • Reduce environmental stimuli that could be misunderstood as threatening

    At home

    • • above interventions can be applied to home care
    • • Identify whether there are sources of fear at home (for example, a dangerous neighborhood or a member of the abusive family)
    • • Organize that someone is with the patient during periods of greatest fear (as a home health assistant)

    Babies and Children

    • • Have the same caregivers, as far as possible
    • • Offer a suck to the baby
    • • Sustain the child in arms or wicked him
    • • Place a nocturnal auxiliary light in the room
    • • Encourage parents to spend the night at the hospital with the child
    • • Institute game therapy as a healthy expression mode of feelings
    • • Do not dismiss children’s fears as “unreal”
    • • Do not make fun of the child’s fears
    • • Offer explanations or some way of controlling fear (for example, “I don’t see a ghost in your room, but I will leave the light on and I will be close in case you call me”)

    Older people

    • • Offer the most consistent possible schedule with respect to caregivers
    • • Offer a consistent and safe environment with the minimum possible changes