Dysfunctional Grieving

ADS
Extended unsuccessful use of intellectual and emotional responses by which individuals, families, and communities attempt to work through the process of modifying self-concept based on the perception of loss

NOTE: It is now recognized that sometimes what was previously diagnosed as Dysfunctional Grieving might instead be Chronic Sorrow, in which grief lingers and is reactivated at intervals (Eakes, Burke, Hainsworth, 1998). Refer to the nursing diagnosis Chronic Sorrow if appropriate.

Defining Characteristics:
  • Repetitive use of ineffectual behaviors associated with attempts to reinvest in relationships; 
  • crying; 
  • sadness; 
  • reliving of past experiences with little or no reduction (diminishment) of intensity of the grief; 
  • labile affect; 
  • expression of unresolved issues; interference with life functioning; 
  • verbal expression of distress at loss; 
  • idealization of lost object (e.g., people, possessions, job, status, home, ideals, parts and processes of the body); 
  • difficulty in expressing loss; 
  • denial of loss; 
  • anger; 
  • alterations in eating habits, sleep patterns, dream patterns, activity level, libido, concentration and/or pursuit of tasks; 
  • developmental regression; 
  • expression of guilt; 
  • prolonged interference with life functioning; 
  • onset or exacerbation of somatic or psychosomatic responses
Related Factors:
Actual or perceived object loss (e.g., people, possessions, job, status, home, ideals, parts and processes of the body)


NOC Outcomes (Nursing Outcomes Classification)

Suggested NOC Labels
  • Grief Resolution
  • Family Coping
  • Coping
  • Psychosocial Adjustment: Life Change

Client Outcomes
  • Expresses appropriate feelings of guilt, fear, anger, or sadness
  • Identifies problems associated with grief (e.g., changes in appetite, insomnia, nightmares, loss of libido, decreased energy, alteration in activity levels)
  • Seeks help in dealing with grief-associated problems
  • Plans for future one day at a time
  • Identifies personal strengths
  • Functions at a normal developmental level and performs activities of daily living (ADLs) after an appropriate length of time
NIC Interventions (Nursing Interventions Classification)

Suggested NIC Labels
  • Grief Work Facilitation
  • Grief Work Facilitation: Perinatal Death
  • Guilt Work Facilitation

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