Plan of Care for: .

Ineffective Health management

NANDA-I

Definition

Pattern of regulating and integrating into daily living a therapeutic regimen for the treatment of illness and
its sequelae that is unsatisfactory for meeting specific health goals.

Defining Characteristics

Difficulty with prescribed regimen; failure to include treatment regimen in daily living; failure to take action
to reduce risk factor; ineffective choices in daily living for meeting health goal

Related Factors

Decisional conflict; difficulty managing complex treatment regimen; difficulty navigating complex health
care systems; excessive demands; family conflict; family pattern of health care; inadequate number of
cues to action; insufficient knowledge of therapeutic regimen; insufficient social support; perceived barrier;
perceived benefit; perceived seriousness of condition; perceived susceptibility; powerlessness

At-Risk Population

Economically disadvantaged

NOC (Nursing Outcomes Classification)

Suggested NOC Outcomes

Health Beliefs: Perceived Control, Perceived Threat; Knowledge: Disease Process; Knowledge:
Treatment Regimen; Participation in Health Care Decisions

Example NOC Outcome with Indicators

Knowledge: Treatment Regimen as evidenced by the following indicators: Extent of understanding of

prescribed medication, activity, exercise, and specific disease process. (Rate the outcome and indicators
of Knowledge: Treatment Regimen: 1 = no knowledge, 2 = limited knowledge, 3 = moderate
knowledge, 4 = substantial knowledge, 5 = extensive knowledge [see Section I].)

Client Outcomes

Client Will (Specify Time Frame)

 Describe daily food and fluid intake that meets therapeutic goals
 Verbalize ability to manage therapeutic regimens

NIC (Nursing Interventions Classification)

Suggested NIC Interventions

Adherence Behavior; Health Education; Health System Guidance; Learning Facilitation; Learning
Readiness Enhancement; Teaching: Prescribed Diet, Prescribed Exercise, Prescribed Medication

Example NIC Activities—Learning Facilitation

Present the information in a stimulating manner; Encourage the client's active participation

Nursing Interventions and Rationales

Note: This diagnosis does not have the same meaning as the diagnosis Noncompliance. This diagnosis
is made with the client, so if the client does not agree with the diagnosis, it should not be made. The
emphasis is on helping the client direct his or her own life and health, not on the client's compliance with
the provider's instructions.

 Explore the client's perception of their illness experience and identify uncertainties and needs
through open-ended questions. EBN: A research team qualitatively explored perceptions and
preferences of older adults (N = 13) and their family members about a fall risk assessment
system when aging in place and to develop better technology to promote safety. Results
demonstrated an acceptance of the technology after participants adapted, and acceptance
was a process that grew in stages as the patient became used to technology ( Galambos et al,
2017 ). EB: Lee and Chen (2017) studied perceptions about smoking after distributing a
humorous antitobacco video on health-related social medial. After viewing the video
respondents reported a higher level of risk perception of smoking, less positive attitude toward
smokers, and a higher level of intention to avoid smoking in the future than others who viewed
it on non–health-related social media sites.
 Help the client identify and modify barriers to effective self-management. EB: Researchers
examined patients (N = 14) with type 2 diabetes and severe mental illness because this group
of patients experiences significantly poorer health outcomes than type 2 diabetic patients
without diabetes. Participants were aware of the risks and stated that family and health care
provider support was important in their self-maintenance ( Mulligan et al,
2017 ). EB: Bovenkamp and Dwarswaard (2017) performed a qualitative study to gain insight
into patients’ self-maintenance or self-management practices and found after intervening with
patients (N = 20) with chronic conditions that the practice is dependent on personal and social
dynamics, patients’ ideas of the good life, and their interactions with care professionals.
 Help the client self-manage his or her own health through education about strategies for
changing habits such as overeating, sedentary lifestyle, and smoking. EB: Pappa
(2017) investigated the activity behavior and analyzed the message content participants (N =
107,886) in LoseIt (r/loseit), an online weight management community of the online social
network Reddit, over 30 days and found that the most discussed topics were healthy food,
clothing, calorie counting, workouts, looks, habits, support, and unhealthy food. EB: Cruz et al
(2017) performed a prospective, cross-sectional, and correlational study with teenagers (N =
150), aged 15 to 17, to determine whether weight, age, and gender have an influence on
physical fitness and found that the participants who had normal weight had regular physical
fitness and women had more obesity than men.
 Develop a contract with the client to maintain motivation for changes in
behavior. EB: Researchers adapted an existing interprofessional asthma program to fit a
smaller practice to promote asthma management and provided a weekly asthma-
management clinical for pediatric patients and their families. The results included a 69% and
92% reduction in emergency department (ED)/urgent care visits and hospitalizations,
indicating that consistent intervention motivated behavioral changes to improve health
( Kwong et al, 2017 ). EBN: Leine et al (2017) studied patients (N = 6) with chronic obstructive
 pulmonary disease (COPD) and their understanding and treatment adherence using a
partnership-based nursing practice program. Interviews revealed two themes: feeling safe and
comforted, and motivation to take better care of themselves.

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Terms and Conditions | Privacy Policy | Contact Us | Copyright © 2014 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
Evolve® is a registered trademark of Elsevier Inc. in the United States and other jurisdictions.
For problems or suggestions regarding this service, submit a ticket at http://evolvesupport.elsevier.com/.