Psychosocial Nursing Diagnosis Care Plans: Examples and Guide

Psychosocial Nursing Diagnosis Explained

In nursing, a psychosocial nursing diagnosis delves into the intricate relationship between a patient’s mental well-being and their social surroundings, and how these factors significantly impact their overall health. Unlike medical diagnoses that primarily address physical ailments, psychosocial assessments consider the emotional and mental dimensions of health. These encompass conditions like anxiety disorders, clinical depression, and diminished self-esteem, which can manifest as or exacerbate physical health issues. Understanding and addressing these psychosocial aspects is crucial for holistic patient care.

It’s a sobering statistic that approximately 20% of adults in the United States grapple with mental health challenges and substance use disorders. This prevalence underscores the critical importance of psychosocial considerations in healthcare, as these conditions contribute significantly to both morbidity and mortality rates. Psychosocial nursing diagnoses provide a structured framework for nurses to identify, understand, and address these complex patient needs.

Table of Contents

Psychosocial nursing diagnoses are particularly relevant and frequently applied in the care of patients experiencing a wide array of conditions, including:

Anxiety Disorders
Eating Disorders (such as Anorexia Nervosa and Bulimia Nervosa)
Body Image Disturbances
Behavioral Disorders
Bipolar Disorder
Challenges with Coping Mechanisms and Self-Esteem
Depressive Disorders
Post-Traumatic Stress Disorder (PTSD)
Suicidal Ideation and Attempts
Schizophrenia Spectrum Disorders
Substance Use Disorders

The value of psychosocial nursing diagnoses lies in their ability to help nurses recognize the often-overlooked psychological and social elements that contribute to a patient’s overall state. This includes identifying stressors in a patient’s life, their typical coping mechanisms, and the nature of their interpersonal relationships. By adopting a comprehensive, patient-centered approach, nurses can leverage psychosocial diagnoses to gain deeper insights. This, in turn, facilitates the development of nuanced and effective care plans that are tailored to address the patient’s emotional, social, and physical needs in a balanced and integrated manner.

Ultimately, psychosocial diagnoses are indispensable tools for creating patient-centered care plans. These plans are designed to optimize patient outcomes, focusing not only on physical recovery but also on enhancing their overall quality of life by addressing their psychosocial well-being. The goal of a thorough psychosocial evaluation is to provide actionable insights that guide healthcare professionals in supporting patients towards achieving optimal physical health and a significantly improved quality of life.

NANDA-I Psychosocial Nursing Diagnoses List

The North American Nursing Diagnosis Association International (NANDA-I) provides a standardized language for nursing diagnoses, and within this framework, a variety of diagnoses are classified as psychosocial in nature. These diagnoses cover a broad spectrum of mental and emotional health concerns. Below is a list of examples of psychosocial nursing diagnoses recognized by NANDA-I. It is important to note that this list is not exhaustive but represents many commonly used diagnoses in practice:

Disturbed Personal Identity
Hopelessness
Chronic Low Self-Esteem; Situational Low Self-Esteem; Risk for Low Self-Esteem
Social Isolation
Caregiver Role Strain; Risk for Caregiver Role Strain
Impaired Parenting; Risk for Impaired Parenting; Readiness for Enhanced Parenting
Interrupted Family Processes; Readiness for Enhanced Family Processes
Risk for Impaired Parent/Infant/Child Attachment
Dysfunctional Family Processes: Alcoholism
Effective Breastfeeding; Ineffective Breastfeeding; Interrupted Breastfeeding
Ineffective Role Performance
Parental Role Conflict
Impaired Social Interaction
Fear
Anxiety
Death Anxiety
Chronic Sorrow
Ineffective Denial
Grieving; Complicated Grieving; Risk for Complicated Grieving
Ineffective Coping
Disabled Family Coping; Compromised Family Coping; Readiness for Enhanced Family Coping
Defensive Coping
Ineffective Community Coping; Readiness for Enhanced Community Coping
Readiness for Enhanced Coping (Individual)
Stress Overload
Risk-prone Health Behavior

Psychosocial Nursing Care Plans Examples

To effectively address psychosocial nursing diagnoses, tailored care plans are essential. These plans outline specific nursing interventions designed to help patients manage their psychosocial challenges, improve their mental health, and enhance their overall well-being. Evidence-based nursing care plans are crucial in providing structured and effective interventions. Here are detailed examples of psychosocial nursing care plans for common diagnoses: Ineffective Coping, Situational Low Self-Esteem, and Grieving.

Ineffective Coping Care Plan

The nursing diagnosis of Ineffective Coping is applied when an individual struggles to manage stressors and challenges in a healthy and productive way. This difficulty can significantly disrupt daily functioning and negatively impact overall health. It is crucial to understand that ineffective coping is not a character flaw but a response to overwhelming stressors or a lack of adequate coping resources.

This diagnosis manifests in various ways, observable through a person’s behavior and reactions to life events. Addressing ineffective coping requires a multifaceted approach, often involving long-term strategies such as counseling or psychotherapy, lifestyle adjustments, and consistent supportive care management. The goal is to equip individuals with the tools and support needed to navigate stress more effectively.

With appropriate intervention and support, individuals can learn to process their emotions, manage stress levels, and develop new, healthier coping mechanisms for future challenges. This plan aims to guide nursing care to achieve these positive outcomes.

Ineffective Coping Related Diagnoses

Several related diagnoses fall under the umbrella of coping difficulties, each highlighting a specific aspect of ineffective coping within different contexts:

Disabled Family Coping
Compromised Family Coping
Defensive Coping
Ineffective Community Coping
Readiness for Enhanced Coping (Individual)
Readiness for Enhanced Family Coping

Ineffective Coping As Evidenced By:

The diagnosis of ineffective coping is supported by a range of observable signs and symptoms, including:

Verbalizing an inability to cope or explicitly asking for help.
Reporting secondary symptoms linked to poor coping, such as loss of appetite, persistent fatigue, or sleep disturbances.
Exhibiting chronic worry and anxiety.
Demonstrating delayed decision-making abilities.
Presenting physical symptoms of stress, like muscle tension, frequent headaches, insomnia, and fatigue.
Showing poor concentration and focus.
Experiencing a higher frequency of illness.
Changes in social interaction patterns, such as withdrawal or increased irritability.
Inappropriate or overuse of defense mechanisms to avoid dealing with reality.

Ineffective Coping Nursing Assessment

A thorough nursing assessment is crucial for accurately diagnosing ineffective coping and tailoring interventions. Key assessment areas include:

Behavioral and Physiological Responses to Stress: Assess for specific behaviors and physical reactions that indicate the patient’s level of difficulty in coping with stress. This might involve observing body language, listening to verbal cues, and noting physiological signs of stress.
Cultural Influences: Evaluate the impact of the patient’s cultural background, values, norms, and beliefs on their perception of what constitutes successful coping. Cultural factors can significantly shape how individuals perceive and respond to stress.
Underlying Causes: Determine potential root causes of ineffective coping. Is it related to unresolved grief, negative self-concept, lack of social support, inadequate problem-solving skills, or recent significant life changes? Identifying the cause is vital for targeted interventions.
Suicide Risk Assessment: Critically assess for any indication of suicidal ideation or risk. If there’s any concern for self-harm, immediate referral to mental health professionals is imperative. Patient safety is the top priority.

Nursing Interventions and Rationale For Ineffective Coping

Effective nursing interventions for ineffective coping are aimed at building resilience and improving coping skills. The rationales behind these interventions are grounded in psychological and therapeutic principles:

Empathy-Based Communication: Intervention: Encourage open communication using empathetic responses. Rationale: Empathy creates a supportive and understanding environment, which is fundamental for helping patients feel safe and understood. This therapeutic relationship can significantly enhance their ability to cope.
Validate Patient’s Situation: Intervention: Acknowledge and validate the patient’s situation and feelings without offering false hope or unrealistic reassurances. Rationale: Honesty and realism are crucial for building trust. False reassurance can be detrimental to the patient-nurse relationship and can undermine the patient’s ability to engage in problem-solving.
Promote Mental and Physical Activities: Intervention: Actively engage the patient in a range of mental and physical activities. Examples include reading, watching movies, playing games, engaging in arts and crafts, exercising, playing sports, and socializing (as appropriate). Rationale: Activities that promote both mental and physical engagement are vital for alleviating symptoms of depression and anxiety, which often accompany ineffective coping. Exercise, nutrition, and relaxation techniques improve body awareness and reduce stress.
Facilitate Realistic Self-Assessment: Intervention: Assist the patient in realistically assessing their accomplishments and current situations. Help them recognize their strengths and areas of success, while also acknowledging challenges. Rationale: Recognizing their capabilities and past successes can boost self-efficacy and empower patients to believe in their ability to manage current difficulties. However, it’s crucial to maintain a realistic and balanced perspective to avoid setting up for potential disappointment.

Expected Outcomes for Ineffective Coping Care Plan

Measurable outcomes are essential for tracking progress and evaluating the effectiveness of the care plan. Expected outcomes for patients with ineffective coping include:

Behavioral Awareness: Within 24-48 hours, the patient will be able to identify specific behaviors that are disruptive to their daily life and hinder effective coping.
Strategy Identification: The patient will be able to communicate and identify effective coping strategies and available resources aimed at preventing ineffective coping mechanisms.
Demonstrated Coping Ability: The patient will demonstrate an improved ability to cope with identified stressors and will actively seek support when necessary, indicating a proactive approach to managing challenges.

Situational Low Self-Esteem Care Plan

The nursing diagnosis of Situational Low Self-Esteem is recognized when an individual experiences a temporary decline in their self-worth and confidence, typically triggered by a specific negative event or circumstance. This is distinct from chronic low self-esteem, which is a long-term pattern. Situational low self-esteem often arises from traumatic experiences, significant losses, or challenging life circumstances such as abuse, job loss, or poverty.

This condition can profoundly affect a person’s life, leading to social withdrawal, difficulty making decisions, avoidance of commitments, and increased vulnerability to depression and anxiety. Recognizing and addressing situational low self-esteem promptly is crucial to prevent these negative consequences.

Seeking support from a trained nurse or therapist is vital for individuals experiencing situational low self-esteem. With professional guidance, individuals can learn to challenge negative self-perceptions, rebuild their self-esteem, and develop resilience to thrive even in difficult situations.

Currently, there isn’t a universally accepted diagnostic test for low self-esteem. However, the Rosenberg Self-Esteem Scale (RSE) is a widely used and validated tool for assessing self-esteem levels. Developed in 1965, it remains a valuable instrument in clinical practice and research.

Situational Low Self-Esteem Related Nursing Diagnosis

Several nursing diagnoses are related to situational low self-esteem, reflecting different facets of self-perception and social interaction:

Chronic Low Self-Esteem
Disturbed Body Image
Risk for Situational Low Self-Esteem
Situational Low Self-Esteem
Social Isolation

Situational Low Self-Esteem As Evidenced By:

The diagnosis of situational low self-esteem is supported by observable behaviors and expressed feelings, including:

Exhibiting self-critical behavior and making frequent negative self-statements.
Using humor that is self-deprecating or rooted in self-loathing, and demonstrating a perceived lack of personal power.
Neglecting personal achievements while excessively focusing on perceived failures or negative aspects.
Constantly comparing oneself negatively to others.
Engaging in self-blame or blaming others when things go wrong, often disproportionately.
Showing heightened sensitivity and irritation in response to criticism or disapproval from others.
Loss of interest in activities that were previously enjoyed and found pleasurable.

Situational Low Self-Esteem Nursing Assessment

A comprehensive nursing assessment is critical for understanding the depth and nature of situational low self-esteem. Key assessment areas include:

Satisfaction with Performance: Assess the patient’s level of satisfaction and comfort with their own performance in various life roles and activities.
Unresolved Grief: Evaluate for the presence of unresolved grief, as loss and grief can significantly impact self-esteem. Unprocessed grief can be a major contributing factor to feelings of inadequacy.
Confidence in Abilities: Assess the patient’s level of confidence in their abilities to perform tasks and meet personal and external expectations. Lack of confidence is a hallmark of low self-esteem.

Nursing Interventions and Rationale for Situational Low Self-Esteem

Nursing interventions for situational low self-esteem focus on fostering a supportive environment and promoting self-acceptance. The rationales are based on principles of therapeutic communication and self-esteem enhancement:

Create a Supportive Environment: Intervention: Establish a supportive environment where the patient feels safe to express their feelings openly. Encourage them to verbalize emotions and concerns in a healthy way. Model assertive communication using “I” statements to promote self-responsibility in communication. Rationale: A supportive environment is crucial for emotional processing. “I” statements encourage patients to take ownership of their thoughts and feelings, which is empowering.
Normalize Reactions to Change: Intervention: Acknowledge and normalize the impact of life changes on self-esteem. Reassure the patient that fluctuations in self-esteem are common responses to significant life events. Rationale: Understanding that their feelings are normal and not unique can reduce self-blame and isolation. Self-esteem often fluctuates in response to life’s ups and downs, and normalization is a powerful validation.
Dedicated Time and Privacy: Intervention: Dedicate specific time to spend with the patient and ensure privacy during interactions. Rationale: Dedicated time shows the patient that they are valued and their concerns are important. Privacy is essential for fostering trust and allowing for open and honest communication about sensitive feelings.
Active Listening and Open-Ended Questions: Intervention: Employ active listening techniques and use open-ended questions to facilitate patient expression. Rationale: Active listening conveys respect and encourages the patient to explore their thoughts and feelings without feeling judged. Open-ended questions prompt deeper reflection and verbalization of concerns, worries, and thoughts, fostering a sense of being heard and understood.

Expected Outcomes for Situational Low Self-Esteem Care Plan

Expected outcomes for patients with situational low self-esteem are centered around improved self-perception and coping mechanisms:

Understanding Causes: The patient will be able to identify and describe the specific causes and contributing factors to their situational low self-esteem.
Self-Esteem Building Strategies: The patient will implement at least two concrete strategies aimed at building self-esteem and reducing self-care deficits, showing active engagement in self-improvement.
Increased Self-Worth: The patient will verbally acknowledge feeling more confident and experiencing an increased sense of self-worth, indicating a positive shift in self-perception.

Grieving Care Plan

Grief is a natural and deeply personal emotional response to loss. It is a universal human experience, yet each individual’s grieving process is unique. Nursing diagnoses related to grief are essential for addressing the complex needs of individuals and families coping with loss.

Nurses play a vital role in supporting patients through the grieving process. This involves assessing the stage of grief, diagnosing related nursing needs, and creating individualized care plans. Key nursing interventions include active listening, providing accurate and empathetic information about the grieving process, suggesting healthy coping strategies, and connecting patients with additional support resources.

Through a compassionate and attentive approach, nurses can ensure that the patient’s emotional healing remains a central focus of care, and that their grief is addressed with sensitivity and thoroughness. The goal is to facilitate a healthy and adaptive grieving process.

Grieving Related Nursing Diagnosis

Several related nursing diagnoses are associated with grieving, each highlighting different aspects and potential complications of the grief process:

Anticipatory Grieving
Risk for Complicated Grieving
Risk for Anxiety
Risk for Knowledge Deficit related to the grieving process

Grieving As Evidenced By:

Observable signs and symptoms that support a diagnosis of grieving include:

Verbal expressions of distress, sadness, and sorrow related to a loss.
Denial of the reality or significance of the loss.
Changes in eating habits, such as decreased appetite or overeating.
Disturbances in sleep patterns, including insomnia or excessive sleeping.
Disorganization and difficulty concentrating or focusing.
Experiencing psychological distress, such as anxiety, depression, or emotional lability.

Grieving Nursing Assessment

A thorough nursing assessment is crucial for understanding the patient’s experience of grief and tailoring appropriate interventions. Key assessment areas include:

Phase of Grief: Assess the current phase of grief the patient and their family are experiencing. Grief is not linear, but understanding the stage (e.g., denial, anger, bargaining, depression, acceptance) can inform interventions.
Congruence of Grief Stages: Assess whether the patient and their loved ones are grieving at different stages. Discrepancies in grief stages within a family can lead to misunderstandings and conflict.
Decision-Making Ability: Evaluate the patient’s ability to make sound decisions. Grief can impair cognitive function and decision-making, requiring support in practical matters.
Need for Referrals: Determine if referrals to social services, grief support groups, or legal consultants are needed. Grief often has practical and legal implications that require interdisciplinary support.

Nursing Interventions and Rationale for Grieving

Nursing interventions for grieving focus on providing emotional support, facilitating healthy expression of grief, and promoting adaptive coping. The rationales are based on grief counseling principles and supportive care:

Expect Exaggerated Affective Behavior: Intervention: Anticipate and expect an increase or exaggeration of affective behaviors (emotional expressions). Rationale: Grief often intensifies emotional responses. In older adults, thoughts of death or uncertainty may become prominent. Unexpected loss can lead to anger and resentment. Regression to earlier coping mechanisms may occur. Understanding this range of emotional responses is key to providing appropriate support.
Therapeutic Communication: Intervention: Engage in therapeutic communication with patients and their family members, actively encouraging them to verbalize their feelings and experiences related to the loss. Rationale: Sharing feelings with a healthcare provider in a safe and supportive environment can help patients find meaning in their loss experience and begin to process their emotions.
Support and Validation: Intervention: Provide consistent support to patients and their significant others as they share their fears, concerns, hopes, and future plans. Rationale: Open communication, without keeping secrets, is vital during times of stress and loss. Facing grief together can foster family growth and resilience, even amidst pain.
Highlight Strengths and Progress: Intervention: Regularly highlight the patient’s strengths and any progress made in the grieving process. Rationale: Reviewing progress provides positive reinforcement and helps both the nurse and patient gauge how the grieving process is unfolding. Recognizing small steps forward can be encouraging.
Coach Significant Others: Intervention: Provide coaching and guidance to significant others on how to effectively support the patient during their hospital stay and beyond. Rationale: Grief impacts the entire family system. Educating family members on how to provide support strengthens the patient’s overall support network. Normal routines are disrupted during grief, and addressing these disruptions is part of holistic care.
Community Resources: Intervention: Develop a plan for providing additional support and resources, including spiritual support and community resources. Rationale: Spiritual support can be a significant comfort for many patients and families. Community support groups offer valuable peer support and shared experiences that can normalize grief and reduce feelings of isolation.
Encourage Normal Life Activities: Intervention: Encourage the patient to gradually resume normal life activities and routines as they are able. Rationale: Re-engaging in normal life activities provides a sense of normalcy and continuity during a time of significant disruption. It reinforces the idea that life continues even after loss.
Provide Community Resource Information: Intervention: Offer specific information about community resources available to support the patient and family through their grieving process. Rationale: Providing concrete resources empowers patients and families to access ongoing support beyond the immediate healthcare setting. Community groups offer long-term support and understanding from others who have experienced similar losses.

Expected Outcomes for Grieving Care Plan

Expected outcomes for patients undergoing a grieving care plan focus on healthy emotional processing and adaptation to loss:

Expected Grief Symptoms: The patient will experience and express expected symptoms of grief in a manner that is considered within the normal range of grieving.
Adaptive Coping Strategy: The patient will adopt at least one healthy and adaptive grief coping strategy to manage their emotions and experiences.
Future-Oriented Perspective: The patient will be able to express plans and hopes for the future, indicating a movement towards acceptance and reinvestment in life after loss.

Psychosocial Nursing Diagnosis Case Study Examples

Real-world case studies provide valuable insights into how psychosocial nursing diagnoses are applied in practice. Here’s an example of a case study focusing on Risk for Suicide, illustrating the diagnostic process, interventions, and expected outcomes.

Risk for Suicide Case Study Example

Scenario:

A 35-year-old homeless male was brought to the emergency department by EMS following a suicide attempt after his brother’s suicide. He is placed on an involuntary psychiatric hold and requires constant 1:1 observation by a sitter for safety.

The patient was found by his spouse with self-inflicted bloody wounds to his neck and wrists, and a broken mirror nearby. His medical history is significant, including schizophrenia, major depressive disorder, alcohol use disorder with a history of complicated withdrawal seizures, intravenous drug use, and a prior suicide attempt by exsanguination requiring two liters of packed red blood cells due to hypovolemic shock.

Currently, the patient is experiencing a psychotic episode characterized by euphoria, grandiosity, and rapid speech, but denies any homicidal thoughts. He expresses a belief that he will succeed in a future suicide attempt, having learned from this “failed” attempt. He is refusing blood draws for lab work and medication administration. Vital signs upon admission are: Temperature 98.4°F, Blood Pressure 175/102 mmHg, Pulse 127 bpm, Respirations 22 breaths/min, SpO2 95% on room air.

Nursing Diagnosis

Risk for Self Harm related to feelings of loneliness, grief over brother’s suicide, homelessness, and hopelessness secondary to the psychiatric disorder schizophrenia, as evidenced by suicidal ideations and self-inflicted wounds.

Subjective Data

The patient verbalizes understanding of how to modify his suicide plan for a future attempt, indicating ongoing suicidal ideation and planning.

Objective Data

Vital Signs: T 98.4°F, BP 175/102 mmHg, P 127 bpm, R 22 breaths/min, SpO2 95% on room air.
Physical Assessment: Multiple neck wounds requiring wound care, hypertension, tachycardia, and tachypnea.
Psychiatric Presentation: Psychotic behavior including rapid, grandiose, and incoherent speech, and euphoria.
History: History of schizophrenia, major depressive disorder, alcohol abuse disorder with withdrawal seizures, IV drug use, and prior suicide attempt.
Behavior: Refusal to submit to lab work and medication administration.

Desired Outcomes

Safety Contract: Within 24-48 hours of hospitalization, the patient will agree to a contract for safety, committing to refrain from self-harm during hospitalization and to express feelings of self-harm instead of acting on them.
Family Education: The patient’s family will be able to verbalize at least three strategies for recognizing impending self-harm in their loved one.
Emergency Resources: Upon discharge, the patient will be instructed to contact a 24-hour emergency hotline if feeling suicidal and will verbalize understanding of this plan.
Trigger Identification: The patient will participate in identifying personal thoughts, feelings, behaviors, and external triggers that contribute to suicidal ideation.
Coping Skills Development: The patient will verbalize at least three techniques for developing coping skills to manage stressful situations effectively.

Nursing Interventions

Constant Observation: Ensure the patient is under continuous 1:1 observation throughout hospitalization to prevent self-harm.
Safety Contract: Educate the patient about the meaning and purpose of a safety contract and evaluate their understanding and willingness to contract for safety within 24-48 hours of admission.
Therapeutic Listening: Encourage the patient to verbalize feelings about wanting to harm himself and actively listen without judgment.
Family Education on Self-Harm Recognition: Educate the patient’s family on at least four warning signs that may indicate impending self-harm.
Trigger and Ideation Identification Education: Educate the patient on the importance of recognizing thoughts, feelings, and behaviors that precede suicidal ideation.
Coping Skills Education: Educate the patient on at least three effective techniques for developing coping skills to use during stressful times.
Mental Health Referral and Resources: Refer the patient to appropriate mental health professionals as needed and provide resources such as crisis centers, suicide prevention hotlines, grief counseling services, and local emergency mental health services. Ensure the patient verbalizes understanding of these resources.

Psychosocial NCLEX Questions

The National Council Licensure Examination (NCLEX) includes content on psychosocial integrity, emphasizing its importance in nursing practice. Approximately 9% of NCLEX questions relate to Psychosocial Integrity. Here are sample NCLEX-style questions to test your understanding of psychosocial concepts:

Question 1: A client diagnosed with borderline personality disorder engages in self-harming behavior. What is the priority nursing intervention?

Answer: The priority intervention is to ensure the client’s immediate safety and prevent further self-harm. This may involve physical intervention to stop the behavior, providing a safe and supportive environment, and initiating crisis management protocols. Subsequently, the nurse should assess the client’s mental and emotional state, engage in therapeutic communication, and collaborate with the healthcare team to develop an individualized care plan.

Question 2: A 60-year-old male patient attempts to leave his room to go to the cafeteria, despite having restrictions on his privileges. When kindly asked to return to his room and offered assistance with ordering food, the patient becomes verbally abusive. What is the most appropriate nursing approach?

Answer: The most appropriate approach is to firmly and calmly escort the patient back to his room, and request additional staff assistance if needed to ensure safety and de-escalation.

STAFF NOTE: Original Community Post

This article was developed in response to a question from our nursing community, highlighting the practical needs of nurses seeking to understand psychosocial nursing diagnoses better. The original question was:

Quote: Could someone please tell me what a Psychosocial Nursing Diagnosis is? I’m not sure if I’m headed in the right direction… I was thinking “Anxiety” would fall under that topic… But in the book I have, there’s nothing that specifically says Psychosocial and Anxiety falls under Coping/Stress Tolerance.

This article aims to address such questions and provide a comprehensive guide to psychosocial nursing diagnoses and care plans.

References

Committee on Developing Evidence-Based Standards for Psychosocial Interventions for Mental Disorders; Board on Health Sciences Policy; Institute of Medicine; England MJ, Butler AS, Gonzalez ML, editors. Psychosocial Interventions for Mental and Substance Use Disorders: A Framework for Establishing Evidence-Based Standards. Washington (DC): National Academies Press (US); 2015 Sep 18. 1, Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK321284/
Mughal S, Azhar Y, Mahon MM, et al. Grief Reaction. [Updated 2022 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507832/
Kourakou A, Tigani X, Bacopoulou F, Vlachakis D, Papakonstantinou E, Simidala S, Ktena E, Katsaouni S, Chrousos G, Darviri C. The Rosenberg Self-Esteem Scale: Translation and Validation in the Greek Language in Adolescents. Adv Exp Med Biol. 2021;1339:97-103. doi: 10.1007/978-3-030-78787-5_13. PMID: 35023095.
Oates JR, Maani-Fogelman PA. Nursing Grief and Loss. [Updated 2022 Sep 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518989/
https://www.kaptest.com/study/NCLEX/whats-tested-on-the-NCLEX-psychosocial-integrity/