Hopelessness

Ineffective coping experienced post-operatively can be due to negative self-concept, disapproval by others, inadequate problem-solving, loss-related grief, sudden change in life pattern, recent change in health, inadequate support systems, unanticipated stressful events, occurrence of several major events in a short period of time, unrealistic goals.

The nurse can help the patient post-operatively by:

• Assessing the patient’s present coping status. Identify coping strategies.

• Demonstrate to the patient that you believe her/his desire to help — avoid challenging, minimizing patient’s feelings, arguing or trying to reason with her/him.

• Offering support as the patient talks — reassure that their feelings must be difficult. Provide a more helpful, realistic perspective if the patient is pessimistic. Document your strategies.

• Assisting the patient to problem solve in a constructive manner (What is the problem? Who or what is reasonable for the problem? What are the options? (make a list) What are the advantages and disadvantages of each option?

• Discussing possible alternatives (talking over problem with those involved, trying to change the situation, or doing nothing and accepting the consequence).

• Helping the patient to identify problems that she/he cannot control directly and help her/him to produce stress-reducing activities for control.

• Teaching patient relaxation techniques.

• Having patient describe previous encounters with conflict and how she/he managed to resolve them.

• Giving options — but leaving decision-making to the patient. Give many choices.

• Coordinating possible multidisciplinary activities to serve patient’s best interests. Consult with Enterostomal Therapy, Clinical Nurse Specialist, Social Work, Psychiatry as needed.

• Encouraging patient to deal directly with individuals with whom there are conflicts (do not put self in middle).

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