Fear is a distressing emotion caused by impending danger or pain whether the threat is real or imagined. The individual experiencing fear can recognize the person, place, or thing precipitating this feeling. Some of the most common fears are fear of death, pain, and bodily injury. Other fears are derived from a person’s life experiences. Culture, age, or gender affects how fear is expressed and managed. Fear may be unacceptable to some cultures but may also be freely expressed and accepted. One’s individual ways of coping, however, may be cultural as well. Magic, mysticism, or religiosity may be used in some cultures to control fear.
The most common examples of fear a nurse encounters are a fearful patient in the community, a patient may also have fear during diagnostic testing in an outpatient setting, or during hospitalization. The nurse’s role is to identify when patients are experiencing fear and must find ways to help them in a respectful way to face these feelings. The nurse must also learn to distinguish when fear becomes persistent and pervasive that it affects the individual’s ability to perform his or her activities of daily living. Referral to a reliable support system and programs increase the chances of successfully managing, treating, and overcoming phobias and other fears.
Nursing Assessment and Rationales
Assessment is needed in order to identify possible problems that may have lead to Fear.
1. Determine the type of the patient’s fear by thorough, rational questioning and active listening.
The external cause of fear can be known. Patients who find it unacceptable to expose fear may find it convenient to know that someone is willing to listen if they choose to share their feelings at some time in the future.
2. Assess the behavioral and verbal expression of fear.
This information provides a foundation for planning interventions to support the patient’s coping strategies.
3. Evaluate the measures the patient practices to cope with that fear.
This information helps determine the effectiveness of coping strategies used by the patient.
4. Learn to what extent the patient’s fears may be influencing his or her ability to function.
Anti-anxiety medications or referral to specially designed treatment programs is necessary for persistent, immobilizing fears. Patient safety must always be a priority.
Nursing Interventions and Rationales
The following are the therapeutic nursing interventions for Fear nursing care plan and diagnosis:
1. Open up about your awareness of the patient’s fear.
This approach validates the feelings the patient is holding and demonstrates recognition of those feelings.
2. Discuss the situation with the patient and help differentiate between real and imagined threats to well-being.
This approach helps the patient deal with fear.
3. Tell the patient that fear is a normal and appropriate response to circumstances in which pain, danger, or loss of control is anticipated or felt.
This reassurance places fear within the field of normal human experiences.
4. Be with the patient to promote safety, especially during frightening procedures or treatment.
The physical connection with a trusted person helps the patient feel secure and safe during a period of fear.
5. Maintain a relaxed and accepting demeanor while communicating with the patient.
The patient’s feeling of stability increases in a peaceful and non-threatening environment.
6. Familiarize the patient with the surroundings as necessary.
Familiarity with the setting promotes comfort and a decrease in fear.
7. Provide accurate information if irrational fears based on incorrect information are present.
Replacing inaccurate beliefs with accurate information reduces anxiety.
8. If the patient’s fear is a reasonable response, empathize with him or her. Avoid false reassurances and be truthful.
Reassure patients that asking for help is both a sign of strength and a step toward the resolution of the problem.
9. Use simple language and easy-to-understand statements regarding diagnostic procedures.
The patient may find it hard to understand any given explanations during excessive fear. Simple, clear, and brief instructions are necessary.
10. Maintain a quiet environment whether at home or in a hospital setting. Drop any unnecessary stuff around the patient.
The patient’s fear is not reduced and resolved if the environment is unsafe.
11. Provide safety measures within the home when indicated (e.g., alarm system, safety devices in showers or bathtubs).
The patient’s fear will not be reduced or resolved if the home environment is unsafe.
12. Support the patient in recognizing strategies used in the past to deal with fearful situations.
This method allows the patient to think that fear is a natural part of life and can be dealt with successfully.
13. As the fear subsides, encourage the patient to be involved in specific events preceding the onset of the fear.
Recognition and explanation of factors leading to fear are vital in developing alternative responses.
14. Allow the patient to have rest periods.
Relaxation improves the ability to cope. The nurse needs to pace activities, especially for older adults to conserve the patient’s energy.
15. Suggest the patient bring comforting objects when away from home.
This method can enhance feelings of security in a new environment.
16. Access community resources to meet the fearful needs of the patient and family (e.g., spiritual counselor, social worker).
Appropriate resources render organized and regulated patient care that indicates supportive healthcare service.
17. Initiate alternative treatments. Provide verbal and nonverbal (touch and hug with permission) reassurances of safety if safety is within control.
Meditation, prayer, music, Therapeutic Touch, and healing touch techniques help lighten fear.
18. Refer to cognitive behavioral group therapy.
A reward that comes from participating in a group is the opportunity to meet others with the same problem. Even if not everyone will have the same triggers or severity of symptoms, it is helpful to know that the patient realizes that he or she is not alone.
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.
Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.
NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses is reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.