BY
NIA AYU SURIDATY
 Certain emotional and psychological responses can be
expected in patient with any illness
 The nurse can anticipate responses patients must be
assessed carefully to determine how they have
responded to their circumstances
 In assessing the psychological responses to the patient, the nurse
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should do following :
Observe the patient’s behavior when alone and interacting
with others
Establish rapport with the patient: provide opportunities for
communication in whatever way possibilities, depending on
which communication skills
Focus comunication on the patient by using openden
questions, provided the patient has adequate neurological
function to respond
Listen to what the patient has to say and how it is said
Collect information from the patient and family
Validate the information collected with the appropriate person
Validate perceptions
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Fear
Personality Identity Disturbance
Anxiety
Hopelessness
Powerlessness
Body image disturbance
Altered role performance
Impaired social interaction
Altered family processes
Impaired verbal communication
Ineffective individual coping
Impaired adjusment
Ineffective family coping : compromised
 Anxiety
Anxiety is feeling of uneasiness, apprehension or dread
that is associated with unrecognized, subjective source of
anticipated danger
 Nursing Intervention
Anticipate potential sources of anxiety and provide
information
Explaining to the patient what is going to be done before
beginning and then keep patient apprised of what is being
done while care is administered
Providing information and comfort the patient
Giving relaxation therapy
 Frustation is the feeling that occurs when a course of
action or activity cannot be carried out or brought to a
desirable conclusion
 Nursing Intervention
Identify the basis of frustation
Identify realistic goals
Asking patient to express the frustation
 Anger is an intense feeling of displeasure and
antagonism in response to mounting frustation,
conflict or anxiety
 Nursing Interventions
Identify cause of anger
Giving quiet environment
Giving anger management
 Fear is feeling of extreme apprehension or dread
associated with a potential or real threat to the well
being of individual
 Nursing interventions
Identify the basis of patient’s fear
Identify the source of the fear
Verify the patient’s understanding and perceptions of
information
 Denial is defense mechanism, sometimes called a
temporary protective mechanism whereby the persons
refuse to acknowledge the existence or significance of
known fact
 Nursing Interventions
Giving support for adaptation
Giving time to hear the patient and back patient to the
reality
 Depression is a feeling of sadness and self
depreciations accompinied by difficulty in thinking
and conducting usual activities and responbilities
 Nursing interventions
Identify cause of depression
Preventing suicide action
 Powerlessness is defided as a perceived or real lack of
control over one’s body mind, environment or life.
 Nursing interventions :
Helping the patient to recogize the power that they
have and should be encouraged to use it appropriately
Participating in rehabilitation program
 Neurological illness has serious consequences not only
for the patients but also for family members and
significants other
 Family members will react to illness indivually
including anxiety, anger, depression, denial, grieving
and fear
 Talk to the family to determine their understanding
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and perceptions of the patient’s illness
Allow to the family members to express their feling
Correct misinformation and provide data as necessary
Allow the family to become involved in the care of the
patient
Support the family in their decision about patient’s
care or plan for posthospital care
Be prepared to repeat information
 Common job related stressor include caring for patient
who have the following conditions :
1. Neurological injury as a result of trauma ( e.g motor
vehicles accidents)
2. Dignose of terminal illness especially if they are
young
3. Cognitive and emotional disabilities
4. Tracheostomy tubes, ventilators and support
equipment
5. Being designated as brain dead