00056 Breeding Deterioration

Domain 7: role/relationships
Class 1: caretaker roles (a)
Diagnostic Code: 00056
Nanda label: breeding deterioration
Diagnostic focus: parenting
Approved 1978 • Revised 1998, 2017, 2020 • Level of evidence 3.1

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « breeding deterioration is defined as: limitation of the main caregiver to nurture, protect and promote the child’s optimal growth and development, using the proper exercise of empathic authority and the right behavior in response to the child’s needs.

Definite characteristics

Parental outsourcing symptoms

  • Hostile parenting behaviors
  • Impulsive behaviors
  • Intrusive behaviors
  • Negative communication

Parental internalization symptoms

  • Decreased involvement in parents-child relationships
  • Decrease in positive temperament
  • Subjective decrease in the quality of care
  • Extreme changes of mood
  • Failure in the provision of a safe domestic environment
  • Inadequate response to the behavioral keys of the infant
  • Preparations for inappropriate child care
  • Reject the child
  • Social alienation

infant or child

  • Anxiety
  • Behavior problems
  • Delay in cognitive development
  • Depressive symptoms
  • Difficulty to establish healthy interpersonal intimate relationships
  • Difficulty in social functioning
  • Difficulty to regulate emotion
  • Extreme changes of mood
  • Low academic performance
  • Obesity
  • Change of roles
  • Somatic complaints
  • Inappropriate use of substances

Related factors

  • Alteration in the parental role
  • Decreased recognition of emotional skills
  • Depressive symptoms
  • Difficulty in managing a complex therapeutic regime
  • Dysfunctional family processes
  • Emotional instability
  • High use of internet connected devices
  • Inappropriate knowledge about the child’s development
  • Inappropriate knowledge about the maintenance of child’s health
  • Inadequate parental role model
  • Inadequate problem solving skills
  • Inadequate social support
  • Inappropriate transport
  • Lack of attention to the child’s needs
  • Increased anxiety symptoms
  • Low self -efficacy
  • Marital conflict
  • Non-repairing sleep-vigilia
  • Perceive economic tension
  • Social isolation
  • Inappropriate use of substances
  • Intimate violence against the unmarked couple

Risk population


  • teenagers
  • People at economic disadvantage
  • Homeless people
  • People who experience inappropriate use of substances in the family
  • People who experience situational crises
  • People with family history of posttraumatic shock
  • People with a history of abuse
  • People with a history of being abusers
  • People with a history of abandonment
  • People with a history of exposure to violence
  • People with a history of inadequate prenatal care
  • People with prenatal stress history
  • People with low educational level
  • Single parents

infant or child

  • Children who experience prolonged separation from parents
  • Children with difficult temperament
  • Children with sex different from that desired by parents
  • Children with a history of hospitalization in neonatal intensive care units
  • Premature infants

Associated problems


  • Depression
  • Mental disorders

infant or child

  • Behavioral disorder
  • Complex treatment regime
  • Emotional disorder
  • Neurodevelopment disorders

Suggestions of use

Paternity and motherhood are usually maturation processes for adjustment, which only require nursing interventions to prevent possible problems and promote health. This label represents a less healthy level of operation than the diagnosis of conflict of the parental role, in which one or both parents have shown adequate functioning, but face situational challenges (for example, divorce, disease) that create a conflict and conflict a confusion of the roles. An unresolved parental role conñict can become impairment of paternity.

Suggested alternative diagnostics

  • coping (specify)
  • disproportionate growth, risk of
  • Growth and development, delay in
  • Caregiver, tiredness of the role of
  • Caregiver, risk of fatigue of the role of
  • Development, risk of delay in
  • Ineffective performance of the role
  • Paternity, risk of deterioration of
  • Family processes, interruption of the
  • Parental role, conflict of

NOC Results

  • Safe at home: physical provisions to reduce as much as possible the environmental factors that could cause physical damage or home injuries
  • Parental infant/child: behaviors of the parents and the child who demonstrate a solid emotional bond
  • Social support: other people’s reliable help
  • Child development (2, 4, 6 and 12 months; 2, 3, 4 and 5 years; intermediate childhood and adolescence): milestones of physical, cognitive and psychosocial progress to (specify years or months) of age. ( Note : Noc has separate results and indicators for each age)
  • Parental role performance: congruence between the behavior of the role of an individual and the expectations of the role
  • Paternity: Psychosocial security: parents’ actions to protect a child from social contacts that could damage or injure it
  • Parental role: Shares of father and mother intended to provide the child with a physical, emotional and social, constructive and positive environment

Evaluation objectives and criteria

  • Also see the evaluation objectives/criteria for growth and development diagnoses, delay in the paternity, risk of deterioration of the.

  • Demonstrates parental infant-child attachment, as manifested by the following indicators (specify from 1 to 5: Never, sometimes, sometimes, often or usually):
    • One or the two parents:
    • They verbally express positive feelings towards the child
    • They touch, hug, give palmaditas, kiss and smile at the child
    • They go to the Cierra
    • They speak to the child
    • They are placed face to face and maintain visual contact
  • Demonstrates parental role (father and mother), as manifested by the following indicators (specify from 1 to 5: never, sometimes, sometimes, often or usually):
    • Cover the child’s physical needs
    • Stimulate cognitive and social development
    • Stimulate emotional and spiritual development
    • shows a relationship of affection
    • Provides preventive health care periodically
    • Demonstrates the performance of the parental role, as manifested by the following indicators (specify from 1 to 5: nothing, slightly, moderately, substantially or totally adequate):
    • Parental role behavior performance
    • meets the expectations of the role
  • demonstrates a safe atmosphere at home, as manifested by the following indicators (specify from 1 to 5: nothing, slightly, moderately, substantially or totally adequate):
    • Maintenance of smoke detectors
    • Adequate waste of medications
    • Safe firearms storage
    • Safe storage of hazardous materials
    • Use of a safe game area
    • Use of protectors for electric shots
  • Other examples

    one or the two parents are capable of:

    • Demonstrate a constructive discipline
    • Identify effective forms of expression of anger and frustration that do not harm the child
    • Participate actively in classes for parents and psychological advice
    • Identify and use community support resources for home care
    • Identify people who can offer emotional information and support when necessary
    • Show disposition to ask for help to others

    The child will be able to:

    • Achieve physical, cognitive and psychological milestones at expected times (consult the corresponding age group to obtain specific development standards)

    NIC Interventions

    • Support in protection against abuse: child: identification of actions and dependency relationships of the child that are at high risk, to avoid possible or greater physical, sexual or emotional damage, or negligence of the basic vital needs
    • Family support: promotion of family values, interests and objectives
    • Newborn care: neonate management during transition to extrauterine life and the subsequent stabilization period
    • Parental Education: Adolescent: Help parents to understand and support their teenage children
    • Parental Education: Family and upbringing: Assistance to parents to understand and promote growth and physical, psychological and social development of their young children, in preschool or school age
    • Parental Education: Infant: Provision of instruction on food and the necessary physical care during the first year of life
    • Promotion of family integrity: promotion of cohesion and family unit
    • Promotion of family integrity: family and parenting: facilitation of the growth of individuals or families that add a child to the family unit
    • Promotion of family participation: facilitation of family participation in the emotional and physical care of the patient
    • Promotion of paternity: Provision of information to parents, as well as support and coordination of complete services to high -risk families
    • Attachment promotion: facilitation of the development of the child’s relationship with the parents
    • Development promotion: Adolescent: Facilitation of optimal physical, cognitive, social and emotional growth, of individuals during the transition from childhood to adulthood
    • Development Promotion: Child: Facilitation or teaching to parents and caregivers to achieve optimal cognitive, social, emotional development, of thick and fine motor skills, and the language of preschool and school children
    • Support Group: Use of a group environment to provide its members emotional support and health -related information
    • Risk identification: family and parenting: identification of a person or family who probably experiences difficulties in parenting and establishing priorities in strategies to prevent parenting problems
    • Kangaroo mother: Promotion of closeness between parents and a physiologically stable premature infant, through the preparation of parents and the creation of an adequate environment for physical contact skin to skin
    • Management of the environment: attachment process: manipulation of the patient’s environment to facilitate the development of the child’s relationship with the parents
    • Environment management: Security: Control and manipulation of the physical environment to favor security
    • Maintenance of family processes: Reduction of the effects of the destabilization of family processes
    • Improvement of coping: Help the patient adapt to stressful factors, changes or threats, perceived, that interfere with the satisfaction of the demands and roles of life
    • Improvement of the role: assistance to a patient, his family and more relatives, to improve relationships by clarifying and complementing specific role of role.
    • Improvement of the support system: facilitation to the support patient by family, friends and the community
    • Surveillance: Security: Collection and analysis, continuous and with a purpose, information about the patient and the environment to promote and maintain their safety

    Nursing Activities

    • See the nursing activities of Paternity Diagnosis, risk of deterioration of the.


    • Assess postpartum depression and other types
    • Determine if there is any kind of abuse between parents
    • Assess the symptoms of paternity deterioration (see the previous defining characteristics)

    Collaboration activities

    • Offer the first telephone call to the corresponding community resources
    • (NIC) Abuse protection: Child:
      • Channel to families to humanitarian and professionals in psychological advice, as required
      • Provide information to parents about community resources, including the address and telephone numbers of agencies that offer care for emergency child care, domestic assistance, treatment for substance abuse, psychological advice services (Ministry (Ministry ) low cost, food wineries, clothing distribution centers, health services, humanitarian services, emergency telephone care lines and shelters for victims of domestic abuse
      • Report suspicions of abuse or negligence to the competent authorities
      • Chanting parents to support groups, as required


    • Motivate the expression of feelings (for example, guilt, anger, ambivalence) related to the role of parents
    • Help parents identify deficiencies and alterations in these skills
    • Offer frequent opportunities for interaction between parents and the child
    • Model parents’ skills
    • Help identify realistic expectations of parents’ role
    • Recognize and strengthen the strengths and skills of being parents
    • (NIC) Promotion of family integrity.
      • Establish a relationship of trust with relatives
      • Help the family resolve conflicts
      • Help the family overcome feelings of guilt or responsibility unrealistic, if so requires
      • Promote an environment of unity in the family
      • Promote open communication among relatives
      • During the EM Barazo
    • (NIC) Attachment promotion:
      • Talk about parents’ reaction to pregnancy
      • Allow parents to listen to the fetal beat as soon as possible
      • Talk about the reaction of the parents when listening to the fetal beat, see the image of ultrasound, and so on
      • Help the father or couple while participating in labor and birth
      • In childbirth
    • (NIC) Attachment promotion:
      • Place the neonate on the mother’s body immediately after birth
      • Offer the father the opportunity to load the newborn in the birth zone
      • Provide analgesics to the mother
      • Provide privacy to the family during the start of interaction with the newborn
      • Motivate parents to caress and speak to the newborn

    At home

    • Many of the previous interventions can be adapted for their application at home
    • Assess the interaction of parents and the child in the home
    • Value the home environment to detect indications of inappropriate skills for care (for example, unleashed food remains, overflowing garbage dumps, lack of food in the refrigerator or in the cupboard)

    Older people

    • Instruct parents and grandparents about the importance of grandparents in the child’s development