(also refer to chemotherapy)

Fear/death Anxiety may be related to situational crises, threat to/change in health/socioeconomic status, role functioning, interaction patterns; threat of death, separation from family, interpersonal transmission of feelings, possibly evidenced by expressed concerns, feelings of inadequacy/helplessness, insomnia; increased tension, restlessness, focus on self, sympathetic stimulation.

Grieving may be related to potential loss of physiologic well-being (body part/function), perceived separation from significant other(s)/lifestyle (death), possibly evidenced by anger, sadness, withdrawal, choked feelings, changes in eating/sleep patterns, activity level, libido, and communication patterns.

acute/chronic Pain may be related to the disease process (compression of nerve tissue, infiltration of nerves or their vascular supply, obstruction of a nerve pathway, inflammation), or side effects of therapeutic agents, possibly evidenced by verbal reports, self-focusing/narrowed focus, alteration in muscle tone, facial mask of pain, distraction/guarding behaviors, autonomic responses, and restlessness.

Fatigue may be related to decreased metabolic energy production, increased energy requirements (hypermetabolic state), overwhelming psychological/emotional demands, and altered body chemistry (side effects of medications, chemotherapy), possibly evidenced by unremitting/overwhelming lack of energy, inability to maintain usual routines, decreased performance, impaired ability to concentrate, lethargy/listlessness, and disinterest in surroundings.

impaired Home Maintenance may be related to debilitation, lack of resources, and/or inadequate support systems, possibly evidenced by verbalization of problem, request for assistance, and lack of necessary equipment or aids.

compromised/disabled family Coping may be related to chronic nature of disease and disability, ongoing treatment needs, parental supervision, and lifestyle restrictions, possibly evidenced by expression of denial/despair, depression, and protective behavior disproportionate to client’s abilities or need for autonomy.

readiness for enhanced family Coping may be related to the fact that the individual’s needs are being sufficiently gratified and adaptive tasks effectively addressed, enabling goals of self-actualization to surface, possibly evidenced by verbalizations of impact of crisis on own values, priorities, goals, or relationships.