Family coping mechanisms are the behaviors families use to deal with stress or changes imposed from either within or without. Coping mechanisms can be viewed as an active method of problem solving developed to meet lifes challenges. Families may use coping patterns rather consistently over time or may challenge their coping strategies when new demands are made on the family. The success of a family largely depends on how well it copes with the stresses it experiences. Nurses working together with families realize the importance of assessing coping mechanisms as a way of determining how families relate to stress.
The stress that affects an ill person affects the persons family members or significant others. When family is viewed as a system, the behavior of the individuals behavior in turn affects the family. Stressors for the family include changes in the family structure and roles, anger and feelings of helplessness and guilt, loss of control over normal routines, and concern for future financial stability.
The family is disrupted as members abandon their usual activities and focus their energy on restoring family equilibrium. Roles and responsibilities previously assumed by the ill person are delegated to other family members, or those functions may remain undone for duration of the illness. The familys ability to deal with the stress of illness depends on the members coping skills.
Berman, et al, 2008; Taylor, et al, 2005
Intervention and Rationale
I: Provide opportunities for family to talk with client and/or caregiver(s).
R: Reduces anxiety and allows expression of what has been learned and how they are managing, as well as opportunity to make plans for the future and share support.
I: Assess normal coping patterns in the family, including strengths, limitations, and resources.
R: Successful adjustment is influenced by previous coping success. Families with a history of unsuccessful coping may need additional resources.
I: Listen to familys expressions of hope, planning, effect on relationships/life, change of values.
R: Provides clues to avenues to explore for assistance with growth.
I: Provide opportunities for and instruction in how SOs can care for client. Discuss ways in which they can support client in meeting own needs.
R: Enhances feelings of control and involvement in situation in which SOs cannot do many things. Also provides opportunity to learn how to be most helpful when client is discharged from care.
I: Determine ability of family members to provide necessary care.
R: Safe and appropriate care are priority nursing concerns. The nurse may have to intervene with suggestions for additional resources, as appropriate.
I: Provide a role model with which family may identify.
R: Having a positive example can help with adoption of new behaviors to promote growth.
I: Discuss importance of open communication. Role-play effective communication skills of Active-Listening, messages, and problem solving.
R: Helps individuals to express needs and wants in ways that will develop family cohesiveness. Promotes solutions in which everyone wins.
I: Encourage family to learn new and effective ways of dealing with feelings.
R: Effective recognition and expression of feelings clarify situation for involved individuals.
I: Encourage seeking help appropriately. Give information about available persons and agencies.
R: Permission to seek help as needed allows them to choose to take advantage of available assistance/resources.
I: Assist family to support the client in meeting own needs within ability and/or constraints of the illness or condition.
R: Provides a way to allow family member to take an active role in the care of the client.
I: Recognize the primary caregivers need for relief from continuing care responsibility. Assess the role of the client in the family structure.
R: The role of family members varies among culture.
I: Evaluate resources or support systems available to the family.
R: In some situations there may be no readily available resources; however, often family members hesitate to notify other family members or significant others because of unresolved conflicts in the past.
I: May refer to specific support group(s) as indicated.
R: Provides opportunities for sharing experiences; provides mutual support and practical problem solving; and can aid in decreasing alienation and helplessness.
Doenges, et al, 2008; Gulanick, 2007; Kruse, et al, 2003