Psychosocial needs are the emotional, social, and spiritual parts of a client's health. Illness, hospital stays, and life changes can cause anxiety and make it hard to cope. Your priorities are building trust, easing anxiety, and connecting the client with support.
Each care plan below follows the nursing process (ADPIE).
Anxiety
- Unfamiliar setting and uncertain diagnosis
- Fear of pain, procedures, or loss of control
- Changes in role or finances
- Client says they feel nervous or worried
- Restlessness and trouble sleeping
- Increased heart rate
- Asking the same questions many times
- Client rates anxiety as lower within 24 hours
- Client uses one calming technique when anxious
- Client manages anxiety with healthy coping skills
- Anxiety level using a 0 to 10 scale or direct questions
- Physical signs such as heart rate and restlessness
- Sources of fear or worry
- Usual coping methods
| INTERVENTION | RATIONALE |
|---|---|
| Stay with the client and use a calm, clear voice | A calm presence helps the client feel safe. |
| Explain procedures in simple words before doing them | Knowing what to expect lowers fear. |
| Teach slow deep breathing or grounding | These techniques calm the body's stress response. |
| Give anti-anxiety medications as ordered if needed | Medication can help when anxiety is severe. |
EVALUATION
- Client rates anxiety lower
- Client uses deep breathing when anxious
- Client sleeps better
Ineffective Coping
- Major life change or new diagnosis
- Limited support system
- Few healthy coping skills
- Client says they cannot cope
- Withdrawal from others
- Poor problem solving
- Not following the treatment plan
- Client names two stressors and two healthy ways to cope within 48 hours
- Client uses healthy coping strategies and support resources after discharge
- Current stressors and how the client is handling them
- Support system and spiritual needs
- Signs of depression or thoughts of self-harm
| INTERVENTION | RATIONALE |
|---|---|
| Use active listening and open-ended questions | Feeling heard builds trust and helps the client express feelings. |
| Help the client break problems into small steps | Small steps feel manageable and build confidence. |
| Involve family or friends with permission | Support from others helps the client cope. |
| Refer to social work, chaplain, or support groups | These services meet needs outside nursing scope. |
EVALUATION
- Client names stressors and coping strategies
- Client takes part in care decisions
- Client accepts referrals to support services
Practice this in SBAR Shift Master
Give a clear handoff that includes your client's emotional and social needs.
Play SBAR Shift MasterQuick answers
Which response best shows therapeutic communication?
An open-ended statement such as "Tell me more about what is worrying you." Avoid false reassurance like "Everything will be fine."
What should the nurse do if a worried client says they feel hopeless?
Ask directly about thoughts of self-harm. Hopelessness is a warning sign that needs follow-up.
For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.