Nursing care plan Psychosocial aspects of Care


I. Mind-Body-Spirit Connection
a. When a physiological response occurs, there is a corresponding
psychological response (Anandarajah & Hight,
i. Emotional instability associated with steroid therapy or
Cushing’s syndrome
ii. Irritability of hypoglycemia
iii. Anxiety associated with impaired oxygenation
b. Emotional response during illness is of extreme
i. The stress of illness is well recognized; however, the
effect on the individual is unpredictable.
ii. The client’s perception of, and response to, the event may
result in unmet psychological needs that drain energy
resources needed for healing.
iii. Values brought to the interactions between clients,
families, and healthcare providers affect the care that a
client expects and receives.

II. Psychoneuroimmunology (PNI) provides new information
about how interactions between the mind and the neuroendocrine
and immune systems influence health and healing.
a. Negative emotions or stressful experiences can intensify
health threats, contribute to prolonged infection, and
result in delayed healing (Kiecolt-Glaser et al, 1984;
Kiecolt-Glaser et al, 2002).
i. Chronic stress: decreased T and B cells, decreased natural
killer (NK) cells, increased blood levels of Epstein-Barr virus
ii. Depression: decreased T cells, decreased number and
function of lymphocytes, decreased NK cells
iii. Grieving: decreased lymphocyte proliferation
b. Positive emotions can enhance immune response, facilitate
healing, and slow disease progression.
i. Personal sharing of traumatic experience: increased
lymphocyte response
ii. Support group intervention: increased NK cells and
activity, increased lymphocyte count
iii. Humor and laughter: increased immunoglobulin A,
increased lymphocyte count and activity

Care Setting
Any setting in which nursing contact occurs and care is

Related Concerns
This is an aspect of all care and plans of care.

Nursing Priorities
1. Encourage effective coping skills of client and SO.
2. Reduce anxiety or fear.
3. Facilitate integration of self-concept and body-image
4. Support grieving process.
5. Promote safe environment and client well-being.

Discharge Goals
1. Client and family dealing realistically with current situation.
2. Anxiety or fear manageable.
3. Progressing through stages of grieving.
4. Safe environment maintained.
5. Plan in place to meet needs after discharge.

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