7: Role Relationships

Domain 7
Role Relationships




















































































DOMAIN 7. ROLE RELATIONSHIPS
The positive and negative connections or associations between people or groups of people and the means by which those connections are demonstrated
Class 1. Caregiving Roles
Socially expected behavior patterns by people providing care who are not healthcare professionals
Code Diagnosis Page
00061 Caregiver role strain 279
00062 Risk for caregiver role strain 282
00056 Impaired parenting 283
00164 Readiness for enhanced parenting 286
00057 Risk for impaired parenting 287
Class 2. Family Relationships
Associations of people who are biologically related or related by choice
Code Diagnosis Page
00058 Risk for impaired attachment 289
00063 Dysfunctional family processes 290
00060 Interrupted family processes 293
00159 Readiness for enhanced family processes 294
Class 3. Role Performance
Quality of functioning in socially expected behavior patterns
Code Diagnosis Page
00223 Ineffective relationship 295
00207 Readiness for enhanced relationship 296
00229 Risk for ineffective relationship 297
00064 Parental role conflict 298
00055 Ineffective role performance 299
00052 Impaired social interaction 301

Domain 7. Role Relationships      Class 1. Caregiving Roles


00061


Caregiver role strain


(1992, 1998, 2000)


Defining Characteristics


Caregiving Activities



  • Apprehensiveness about future ability to provide care
  • Apprehensiveness about future health of care receiver
  • Apprehensiveness about potential institutionalization of care receiver
  • Apprehensiveness about well-being of care receiver if unable to provide care
  • Difficulty completing required tasks
  • Difficulty performing required tasks
  • Dysfunctional change in caregiving activities
  • Preoccupation with care routine

Caregiver Health Status: Physiological



  • Cardiovascular disease
  • Diabetes mellitus
  • Fatigue
  • Gastrointestinal distress
  • Headache
  • Hypertension
  • Rash
  • Weight change

Caregiver Health Status: Emotional



  • Alteration in sleep pattern
  • Anger
  • Depression
  • Emotional vacillation
  • Frustration
  • Impatience
  • Ineffective coping strategies
  • Insufficient time to meet personal needs
  • Nervousness
  • Somatization
  • Stressors

Caregiver Health Status: Socioeconomic



  • Change in leisure activities
  • Low work productivity
  • Refusal of career advancement
  • Social isolation

Caregiver–Care Receiver Relationship



  • Difficulty watching care receiver with illness
  • Grieving of changes in relationship with care receiver
  • Uncertainty about changes in relationship with care receiver

Family Processes



  • Concern about family member(s)
  • Family conflict

Related Factors


Care Receiver Health Status



  • Alteration in cognitive functioning
  • Chronic illness
  • Codependency
  • Dependency
  • Illness severity
  • Increase in care needs
  • Problematic behavior
  • Psychiatric disorder
  • Substance abuse
  • Unpredictability of illness trajectory
  • Unstable health condition

Caregiver Health Status



  • Alteration in cognitive functioning
  • Codependency
  • Ineffective coping strategies
  • Insufficient fulfillment of others’ expectations
  • Insufficient fulfillment of self-expectations
  • Physical conditions
  • Substance abuse
  • Unrealistic self-expectations

Caregiver–Care Receiver Relationship



  • Abusive relationship
  • Care receiver’s condition inhibits conversation
  • Pattern of ineffective relationships
  • Unrealistic care receiver expectations
  • Violent relationship

Caregiving Activities



  • Around-the-clock care responsibilities
  • Change in nature of care activities
  • Complexity of care activities
  • Duration of caregiving
  • Excessive caregiving activities
  • Recent discharge home with significant care needs
  • Unpredictability of care situation

Family Processes



  • Pattern of family dysfunction
  • Pattern of ineffective family coping

Resources



  • Caregiver not developmentally ready for caregiver role
  • Difficulty accessing assistance
  • Difficulty accessing community resources
  • Difficulty accessing support
  • Financial crisis (e.g., debt, insufficient finances)
  • Inexperience with caregiving
  • Insufficient assistance
  • Insufficient caregiver privacy
  • Insufficient community resources (e.g., respite, recreation, social support)
  • Insufficient emotional resilience
  • Insufficient energy
  • Insufficient equipment for providing care
  • Insufficient knowledge about community resources
  • Insufficient physical environment for providing care
  • Insufficient social support
  • Insufficient time
  • Insufficient transportation

Socioeconomic



  • Alienation
  • Competing role commitments
  • Insufficient recreation
  • Social isolation

Domain 7. Role Relationships      Class 1. Caregiving Roles


00062


Risk for caregiver role strain


(1992, 2010, 2013; LOE 2.1)


Risk Factors



  • Alteration in cognitive functioning in care receiver
  • Care receiver discharged home with significant needs
  • Care receiver exhibits bizarre behavior
  • Care receiver exhibits deviant behavior
  • Caregiver health impairment
  • Caregiver isolation
  • Caregiver not developmentally ready for caregiver role
  • Caregiver’s competing role commitments
  • Caregiving task complexity
  • Codependency
  • Congenital disorder
  • Developmental delay
  • Developmental delay of caregiver
  • Excessive caregiving activities
  • Exposure to violence
  • Extended duration of caregiving required
  • Family isolation
  • Female caregiver
  • Illness severity of care receiver
  • Inadequate physical environment for providing care
  • Ineffective caregiver coping pattern
  • Ineffective family adaptation
  • Inexperience with caregiving
  • Instability in care receiver’s health
  • Insufficient caregiver recreation
  • Insufficient respite for caregiver
  • Partner as caregiver
  • Pattern of family dysfunction prior to the caregiving situation
  • Pattern of ineffective relationship between caregiver and care receiver
  • Prematurity
  • Presence of abuse (e.g., physical, psychological, sexual)
  • Psychological disorder in caregiver
  • Psychological disorder in care receiver
  • Stressors
  • Substance abuse
  • Unpredictability of illness trajectory

Domain 7. Role Relationships      Class 1. Caregiving Roles


00056


Impaired parenting


(1978, 1998)


Defining Characteristics


Infant or Child



  • Behavior disorder (e.g., attention deficit, oppositional defiant)
  • Delay in cognitive development
  • Diminished separation anxiety
  • Failure to thrive
  • Frequent accidents
  • Frequent illness
  • History of abuse (e.g., physical, psychological, sexual)
  • History of trauma (e.g., physical, psychological, sexual)
  • Impaired social functioning
  • Insufficient attachment behavior
  • Low academic performance
  • Runaway

Parental



  • Abandonment
  • Decrease in ability to manage child
  • Decrease in cuddling
  • Deficient parent-child interaction
  • Frustration with child
  • History of childhood abuse (e.g., physical, psychological, sexual)
  • Hostility
  • Inadequate child health maintenance
  • Inappropriate care-taking skills
  • Inappropriate child-care arrangements
  • Inappropriate stimulation (e.g., visual, tactile, auditory)
  • Inconsistent behavior management
  • Inconsistent care
  • Inflexibility in meeting needs of child
  • Neglects needs of child
  • Perceived inability to meet child’s needs
  • Perceived role inadequacy
  • Punitive
  • Rejection of child
  • Speaks negatively about child
  • Unsafe home environment

Related Factors


Infant or Child



  • Alteration in perceptual abilities
  • Behavior disorder (e.g., attention deficit, oppositional defiant)
  • Chronic illness
  • Developmental delay
  • Difficult temperament
  • Disabling condition
  • Gender other than desired
  • Multiple births
  • Parent-child separation
  • Prematurity
  • Temperament conflicts with parental expectations

Knowledge



  • Alteration in cognitive functioning
  • Ineffective communication skills
  • Insufficient cognitive readiness for parenting
  • Insufficient knowledge about child development
  • Insufficient knowledge about child health maintenance
  • Insufficient knowledge about parenting skills
  • Insufficient response to infant cues
  • Low educational level
  • Preference for physical punishment
  • Unrealistic expectations

Physiological



  • Physical illness

Psychological



  • Alteration in sleep pattern
  • Closely spaced pregnancies
  • Depression
  • Difficult birthing process
  • Disabling condition
  • High number of pregnancies
  • History of mental illness
  • History of substance abuse
  • Insufficient prenatal care
  • Sleep deprivation
  • Young parental age

Social



  • Change in family unit
  • Compromised home environment
  • Conflict between partners
  • Economically disadvantaged
  • Father of child not involved
  • History of abuse (e.g., physical, psychological, sexual)
  • History of being abusive
  • Inability to put child’s needs before own
  • Inadequate child-care arrangements
  • Ineffective coping strategies
  • Insufficient family cohesiveness
  • Insufficient parental role model
  • Insufficient problem-solving skills
  • Insufficient resources (e.g., financial, social, knowledge)
  • Insufficient social support
  • Insufficient transportation
  • Insufficient valuing of parenthood
  • Legal difficulty
  • Low self-esteem
  • Mother of child not involved
  • Relocation
  • Single parent
  • Social isolation
  • Stressors
  • Unemployment
  • Unplanned pregnancy
  • Unwanted pregnancy
  • Work difficulty

Domain 7. Role Relationships      Class 1. Caregiving Roles


00164


Readiness for enhanced parenting


(2002, 2013; LOE 2.1)

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Mar 21, 2017 | Posted by in NURSING | Comments Off on 7: Role Relationships

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