00114 Transfer Stress Syndrome

Domain 9: coping/stress tolerance
Class 1: posttraumatic responses
Diagnostic Code: 00114
NANDA Tag: Transfer Stress Syndrome
Diagnostic focus: transfer stress syndrome
approved 1992 • Revised 2000, 2017

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « transfer stress syndrome is defined as: physical and/or psychological disorder after the transfer from one environment to another.

Definite characteristics

  • Ira behaviors
  • Anxiety (00146)
  • Decrease in self -concept
  • Depressive symptoms
  • Express anger
  • Express frustration
  • Fear (00148)
  • Increase in morbidity
  • Increase in physical symptoms
  • Increased needs verbalization
  • Loss of identity
  • Loss of independence
  • Low self -esteem
  • Pessimism
  • Concern
  • Express alteration of the sleep-vigilia cycle
  • Concern report for the transfer
  • Informs feeling alone
  • Informs to feel insecure
  • Informs to feel alone
  • Social alienation
  • You have no desire to move

Related factors

  • Barriers in communication
  • Control of the inappropriate environment
  • Inadequate orientation before transfer
  • Inadequate social support
  • Ineffective coping strategies
  • Impotence
  • Situational challenge to the worth itself
  • Social isolation

Risk population

  • People face unpredictable experiences
  • People who move from one environment to another
  • People with a history of losses

Associated problems

  • Depression
  • Decrease in mental competition
  • Deterioration of health status
  • Deterioration of psychosocial functioning

Suggestions of use

  • Since it is the diagnosis of a syndrome, an etiology is not required. The diagnosis of a nursing syndrome represents a group of nursing diagnoses that occurs together.
  • If only one or two of the defining characteristics (for example, anxiety, loneliness) are presented, separate nursing diagnoses must be written for such answers (for example, anxiety), instead of using translation stress syndrome.

Suggested alternative diagnostics

  • Chronic affliction
  • Anxiety
  • Acute confusion
  • Desperateness
  • Complicated duel
  • Impotence
  • Insomnia
  • loneliness, risk of
  • Spiritual suffering

NOC Results

  • Adaptation of the child to hospitalization: adaptive response of a child from 3 to 17 years of age to hospitalization
  • coping: personal actions aimed at handling the stressful factors that test the resources of an individual
  • Psychosocial adjustment: change of life: psychosocial response of adaptation of a person to a significant change of life
  • Quality of life: positive perception of current life circumstances
  • Severity of loneliness: severity of the response to emotional, social or existential isolation
  • Anxiety level: severity of apprehension, tension or manifest discomfort, whose origin is not identifiable
  • Depression level: severity of melancholic mood and loss of interest in life events
  • Stress level: severity of referred physical or mental tensions, secondary to factors that alter the previous balance

Evaluation objectives and criteria

  • • Demonstrates coping, as manifested by the following indicators (specify from 1 to 5: Never, sometimes, sometimes, often or usually):
    • Verbally express that you accept the situation
    • It manifests a reduction in negative feelings
    • It manifests a reduction in physical symptoms of stress
    • Modify your lifestyle to reduce stress
  • • Demonstrates psychosocial adjustment: change of life, as manifested by the following indicators (specify from 1 to 5: never, sometimes, sometimes, often or usually):
    • maintains its self -esteem
    • It states to feel useful
    • Use available social support
  • Other examples

    The patient will be able to:

    • • Demonstrate the ability to adapt to a new environment
    • • Verbally express satisfaction with the new lifestyle
    • • Express optimism about the present and the future
    • • Express satisfaction with life achievements
    • • Participate in recreational activities (for example, hobbies)

    The child will be able to:

    • • Adapt to hospitalization (for example, will not show agitation, regressive behaviors, anxiety, fear or anger)
    • • Respond to games therapy and measures to reassure it
    • • Prove that you have overcome separation anxiety

    NIC Interventions

    • Clarification of values: Help another person to clarify their own values ??in order to facilitate good decision making
    • Spiritual support: patient assistance to feel in balance and connected with a higher power
    • Promotion of family participation: facilitation of family participation in the emotional and physical care of the patient
    • Inspiration of hope: Facilitation of the development of a positive perspective in a given situation
    • mood management: provision of security, stability, recovery and maintenance for a patient who abnormally experiences a depressed or elevated mood
    • Security improvement: increased sensation of physical and psychological security of the patient
    • Improvement of Socialization: Facilitation of a person’s ability to interact with others
    • Improvement of coping: patient assistance to adapt to stressful factors, changes or perceived threats, which interfere with the satisfaction of the demands and the roles of life
    • Anxiety reduction: minimization of apprehension, fear, omen or discomfort, related to the feeling of a danger of unknown origin
    • Stress reduction caused by the transfer: assistance to the individual to prepare to, and A, face the change from one environment to another
    • Traumatic situations therapy: Child: application of an interactive help process to solve the traumatic experience of a child

    Nursing Activities


    • • Evaluate the orientation, mood (for example, depressed, angry, anxious) and the patient’s physiological state at the time of admission and every ________
    • • Identify the patient’s previous schedules and routines
    • • Assess the disposition for the discharge
    • • (NIC) Improvement of coping-, evaluate the needs of social support of the patient

    Collaboration activities

    • • Maintain as much as possible the consistency in caregivers and care routines; Consider the possibility of a case management
    • • Use other resources to help the new environment
    • • Coordinate channeling to health providers and institutions to reduce the impact of transfer or relocation


    • • Orient the patient in the new environment, as required
    • • Ensure that the new environment and the previous one is as close as possible to maintain a consistency in the placement of personal objects, furniture, images, etc.
    • • To facilitate the transfer, encourage family members to keep the patient, take home objects and favor socialization with family
    • • Avoid sudden or not planned transfers; Also, avoid transfers at night or during shift changes
    • • (NIC) Improvement of coping:
      • Help the patient evaluate the event objectively
      • Act in a quiet and comforting way
      • Try to understand the patient’s point of view of the stressful situation
      • They advise decision making when the patient is very stressed
      • Promote the constructive expression of anger and hostility
      • Generate situations that foster the patient’s autonomy
      • Present the patient with people (or groups) who have successfully overcome the same experience
      • Motivate the verbal expression of feelings, perceptions and fears (on the transfer)
    • • (NIC) Security improvement:
      • Offer to remain with the patient in a new environment during the first interactions with people
      • Present the changes gradually
    • • Inform if the transfer will be temporary or permanent
    • • Help the patient and family members remember and appreciate previous achievements and experiences
    • • Provide an environment in which the patient can practice their religion
    • • To the extent possible, involve the patient actively in their own care

    At home

    • • Most previous nursing activities can be adapted for home use

    Babies and Children

    • • Try to avoid the transfer during the school year. If necessary, help the child or adolescent during the transition to the new environment (for example, assign an “older sister” or provide psychological guidance)
    • • Support parents to move to provide treatment to their child
    • • Take into account the degree of development of the child when evaluating their answers to the transfer
    • • Wait changes to eating and sleeping habits in young children and preschool age
    • • Hug a small child, as required
    • • Encourage parents to stay at night in the hospital with the child
    • • Ask parents to take the child’s favorite toys to the hospital

    Older people

    • • Make arrangements so that older people can remain at home as long as possible
    • • Help the family accept that, to some extent, it is preferable to experience difficult conditions in the home than to intern a larger relative
    • • Supervise security in the home environment to favor the patient to remain at home as long as possible
    • • Organize domestic assistance services, home meals, or similar, to help the patient in daily life activities and that, in this way, can remain at home
    • • Offer as many alternatives for the transfer (for example, schedule, transport form, service choice)
    • • Assess depression and hopelessness, as well as anger and feelings of helplessness, especially when transferring the patient to a resting house
    • • Assess the risk of suicide
    • • When a patient is admitted to a long -term care institution, the patient’s ability and his spouse should be assessed to face the situation; Put support systems available to the spouse
    • • Plan with the patient very anticipated its admission to a long -term care institution