There are instances when a person feels like his or her life is worthless and will never get better. This is a common example of hopelessness and can often occur when individuals seem to be feeling discouraged, depressed, or anxious about a sudden event. In the case of a patient suffering from spinal cord injury, he or she may feel hopeless in response to permanent paralysis.
Hopelessness can result when someone is going through difficult times or unpleasant experiences. A person may feel overwhelmed, trapped, or insecure, or may have a lot of self-doubts due to multiple stresses and losses. He or she might think that challenges are unconquerable or that there are no solutions to the problems and may not be able to mobilize the energy needed to act on his or her own behalf.
Patient living in social isolation, who lacks social support system and resources, may also experience hopelessness. Other factors include poverty, being homeless, with limited access to health care, and loss of belief in God’s care or loss of trust in prior spiritual beliefs.
Goals and Outcomes
Here are the common goals and expected outcomes for Hopelessness nursing diagnosis.
- The patient will express a greater sense of hope and positivity about the future.
- The patient will demonstrate an increased ability to cope with stress and negative emotions.
- The patient will report an improvement in their mood and a decrease in feelings of hopelessness.
- The patient will participate in activities that bring a sense of accomplishment.
- The patient will demonstrate an increased sense of control over their lives and decisions.
- The patient will have an increased sense of social support and connection with others.
Nursing Assessment and Rationales
Assessment is needed in order to recognize possible difficulties and events that may have lead to Hopelessness.
1. Assess physical appearances such as grooming, posture, and hygiene.
Patients who are experiencing hopelessness may not have the urge to participate in self-care activities.
2. Ascertain the role that illness presents in the patient’s hopelessness.
The patient’s current situation may affect his or her physical functioning. Cancer often makes patients’ perceptions to extremes.
3. Assess the patient’s understanding of the situation, belief in self, and his or her own abilities.
Patients may consider the peril is greater than their resources to manage it.
4. Assess the patient for and point out reasons for living.
Interventions that build awareness of reasons for a living may lower feelings of hopelessness and reduce suicidal thoughts.
5. Assess the patient’s willingness to eat, sleeping patterns, and daily activities.
Alterations from these regular patterns are apparent during hopelessness. Patients may have decreased appetite and poor activity level. Patients may sleep more or experience insomnia.
6. Evaluate the patient’s ability to establish goals, make decisions, and solve problems.
Patients who are hopeless often think he or she is unable to meet established goals and are incompetent to make any decisions and solve problems.
7. Determine the patient’s social support system and possible source of hope.
Patients in social isolation find it hard to improve their condition. Assessment and evaluation of the support group may render the assistance the patient needs at this time.
8. Ascertain the patient’s expectations for the future.
Dependence on others for help and treatments and uncertainty about events can add to a feeling of hopelessness.
Nursing Interventions and Rationales
The following are the therapeutic nursing interventions for Hopelessness:
1. Take time to listen to verbalization of hopelessness, suicidal thoughts, and lack of self-worth.
Suicidal ideation and behaviors are usually present in patients experiencing hopelessness.
2. Acknowledge acceptance of the expression of feelings.
Active listening may help patients express themselves.
3. Learn whether the patient perceives unachieved outcomes as failures or emphasizes failures instead of accomplishments.
Feelings of hopelessness might develop when the patient sees failure as the end result of every effort he or she makes.
4. Encourage a positive mental perspective, discourage negative thoughts, and brace patient for negative results.
Accurate information is generally favored by families; surprise information concerning a shift in status may cause the family to worry that information is being withheld from them.
5. Provide openings for the patient to verbalize feelings of hopelessness.
The nurse promotes a supportive environment by taking time to listen to the patient in a nonjudgemental way.
6. Manage to have consistency in staff appointed to care for the patient.
This approach establishes trust, reduces the patient’s feeling of isolation, and may promote coping and restore hope.
7. Identify previous coping strategies and their effectiveness.
Successful coping is determined by past experiences.
8. Assist the patient with looking at options and establishing goals that are relevant to him or her.
Mutual goal setting guarantees that goals are achievable and help to restore a cognitive-temporal sense of hope.
9. Encourage the patient to recognize his or her own strengths and abilities.
Promoting awareness can facilitate the use of these strengths.
10. Work with the patient to set small, attainable goals.
Mutual goal setting guarantees that goals are achievable and help to restore a cognitive-temporal sense of hope.
11. Render physical care that the patient is unable to achieve and respect the patient’s abilities.
This approach overcomes weakness, guilt, and other negative perceptions.
12. Stay and spend time with the patient. Use empathy; try to understand what the patient is saying, and communicate this understanding to the patient.
These approaches can inspire hope. Experiencing warmth, empathy, genuineness, and unconditional positive regard can greatly reduce feelings of hopelessness.
13. Assist the patient in establishing realistic goals by recognizing short-term goals and revising them as needed.
Supervising the patient little by little makes the problem more manageable. Setting realistic goals is important so as not to be frustrated with the chance of not accomplishing them.
14. Help the patient in developing a realistic appraisal of the situation.
Patients may not be aware of all the available resources and support groups that can help them move through this stressful life situation.
15. Promote an attitude of realistic hope.
Stressing the patient’s intrinsic worth and seeing the immediate problem as manageable in time may provide support. Giving unrealistic hopes will not help the patient and might worsen the situation.
16. Send feelings of acceptance and understanding. Avoid false reassurances.
An honest relationship facilitates problem-solving. False reassurances are never helpful to patients.
17. Provide time for the patient to initiate interactions.
Patients who have feelings of hopelessness require a special moment to initiate relationships and sometimes are not able to.
18. Strengthen the patient’s relationship with significant others; allow them to take part in the patient’s care.
Enhancing a sense of connectedness fosters hope. Concern from others may help change the patient’s focus from self.
19. Encourage family and significant others to display care, hope, and love for the patient.
Encouraging the family to present patient support, to understand the patient’s feelings, and to be physically present and involved in care are approaches that allow the family to change the patient’s hope state.
20. Practice touch, if appropriate and with authority, to show care, and encourage the family to do the same.
This approach provides comfort and is necessary for the development of hope.
21. Present opportunities for the patient to manage the care setting.
When a hopeless patient is given opportunities to make choices, his or her perception of hopelessness may be reduced.
22. Promote the use of spiritual resources as desired.
Religious practices may provide strength and inspiration.
23. Provide plant or pet therapy if possible.
Taking care of pets or plants promotes redefining a patient’s identity and makes him or her feel needed and loved.
24. Refer the patient to self-help groups such as I Can Cope and Make Today Count.
These groups enable the patient to acknowledge the love and care of others, and they foster a sense of belonging.
Recommended nursing diagnosis and nursing care plan books and resources.
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 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.
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.