Introduction for Nursing Diagnosis: Automutilation
NANDA International (Nursing and Midwifery Development Agency) approves nursing diagnoses provided with their Definitions, Defining Characteristics, Risk Factors, Associated Factors, Suggestions of Use and Alternative Diagnoses. Automutilation is one such diagnosis related to self-impact or harmed conduct which increases the risk of harm or mortality due to self-inflicted wounds.
Nursing Diagnosis Definition
Automutilation: An intentional, direct assault upon body tissue, most often by self-injury, not being socially sanctioned.
Defining Characteristics
Subjectives
- Expresses psychological distress in terms of physical pain
- Reports feeling isolated, vulnerable, hopeless, worthless, or out of control
- Lack of insight
- Refusal to discuss behavior
Objectives
- Cutting, burning, head-banging, embedding objects into skin
- Injury inflicted on self
- Depressed affect
- Suicidal ideation with plan
- Tendency to mutilate inside or covered areas of body
- Psychological: Depression, side effects of substance use/abuse, grief, psychosis, history (prior to self-mutilation).
- Environmental: Stressful life situations (abuse, isolation, family/social instability, lack of social network).
- Cognitive deficits: Inability to control impulse, poor problem-solving skills.
- Genetic: Predispositions and hereditary elements that contribute to psychological disorders.
Risk Population
The risk population includes people who have behavioural health concerns or mental illnesses, and those who experienced child abuse, trauma or neglect.
Associated problems
Associated problems may arise from the consequences of automutilation such as physical damage, psychological and social difficulties like sleep disturbances, reduced self-esteem, recurrent automutilative attempts, depression, anxiety and social withdrawal.
Suggestion of Use
Automutilation care plans can be useful when creating individualized plans of care. This can help to develop and set safe approaches in managing the level of distress of the client in an appropriate manner. Care plans should focus on reducing self-harm behaviours, addressing associated psychological issues and enhancing the positive outcomes and safety of the patient.
Suggested Alternative Nursing Diagnoses
- Self-Care Deficit related to physical, cognitive and emotional limitations.
- Risk for Suicide related to feelings of hopelessness, uncertainty, and helplessness.
- Impaired Social Interaction related to misinterpretation of social cues.
- Readiness for Enhanced Self-Care related to the need for assistance in developing coping strategies.
Usage Tips
- It is important to assess patient’s mastery and to facilitate an environment that allows a sense of security.
- Set mutually agreed upon goals for recovery that focus on triggers for self-harm.
- It should include assessment of the severity, frequency and type of self-destructive behaviours.
- Be aware of triggers and watch out for verbal and nonverbal cues that a person focuses on self-harm.
NOC Results
- Safety Status: The patient's ability to remain protected from inferences or dangers that may lead to physical or psychological harm.
- Coping: The patient's ability to successfully manage changes and adversities.
- Family Coping: The family's ability to manage the illness or injury of its members.
- Self-care: The patient's ability to perform self-care activities according to the stages of development and cultural standards.
- Social Interaction: The patient's ability to interact effectively with others.
NIC Interventions
- Assessment: Examining the patient and gathering relevant data about his or her physical and psychological functioning, identifying factors and resources necessary for an effective plan of care.
- Crisis Intervention: Assisting a patient in recognizing, assessing and responding to threats of suicide or self-mutilation through conducting a structured assessment, discussing strategies, selecting interventions and determining a follow-up plan.
- Habilitation Training: Constructing a plan to teach and encourage adaptive behaviour that replaces damaging behaviour, while providing individuals with skills they need to be successful in their interactions with people and the environment.
- Discharge Planning: Developing a plan before the patient leaves the facility, ensuring continuity of care and safety within the home setting.
- Supportive Care: Providing individualized comfort, empathy and understanding during times of crisis.
Conclusion and FAQ
Autummutilation is a serious mental health concern among adolescents and adults. It requires a complete assessment and personalised treatment to reduce the risk of harm or mortality. Nurses should be aware of nursing diagnosis and need to provide appropriate interventions and care plans that promote safety and encourage recovery.
FAQs like what is automutation, what is associated risk population etc can be addressed in this section.
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