Nursing Management for Social Isolation

Social isolation is a state where an individual has decreased or even not at all able to interact with others around them. Patients may feel rejected, not accepted, lonely, and unable to foster meaningful relationships with others.

Social isolation is a lonely condition is expressed by the individual and perceived as being caused by others and as a negative situation that threatens. With characteristics: living alone in the room, inability to communicate, withdrawal, lack of eye contact. Discrepancies or immaturity interests and activities with the development or the age. Preoccupation with his own thoughts, repetition, no meaningful action. Expressing feelings of rejection or loneliness caused by others. Experience different feelings with others, feel uncomfortable with people.

Behavior on the client include:
  • Less spontaneous.
  • Apathetic (not / ignore environment).
  • Moody facial expression.
  • Do not want to take care of himself and not pay attention to personal hygiene.
  • Reduction or absence of verbal communication.
  • No or less conscious environment.
  • Intake disturbed eating and drinking.
  • Urinary retention and vases.
  • Decreased activity.
  • Lack of self-esteem.

Stress triggers, generally include stressful life events such as loss, which affects an individual's ability to relate to others and cause anxiety.

Stress triggers, can be grouped into two categories, among others:
1) sociocultural stressors
Stress is caused by social and cultural communities. Events or changes in the socio-cultural life sparked trouble for dealing with others and how to behave.
2) psychological stressors
Stress is caused due to prolonged anxiety and the individual does not have the ability to cope.

Coping Mechanisms

Defense mechanism that is often used on each social disorder are:
1) regression, the progress or retreat behavior.
2) projection, the weakness and lack of self-posed to others.
3) repression, which override impulse or painful memories.
4) isolation, which shy away from interaction with the outside environment.

Assessment

Assessment in patients with social isolation can be done through interviews and observations:
  1. The Patient tells feeling lonely or rejected by others.
  2. The patient does not feel safe being with other people.
  3. The patient said that does not mean the relationship with others.
  4. The Patient feel slow and tired of spending time.
  5. The patient is not able to concentrate and make decisions.
  6. The patient feel worthless.
  7. The patient not sure it can continue living.

Nursing Diagnosis and Interventions for Social Isolation

Social isolation: Withdrawn

General purpose: Clients can interact with other people.

Specific purpose:

1. Patients can develop a trusting relationship.
2. Patients can be aware of the causes of social isolation.
3. Patients can interact with other people.

Outcomes:
  1. Patients are able to communicate well with the nurses.
  2. Patients can mention the causes and signs of withdrawing.
  3. Patients are able to interact with caregivers, family, and other patients.

Interventions:

1. Fostering a trusting relationship:
  • Say hello to the patient, each time interacting with patients.
  • Acquainted with the patient: introduce full name and the name of the nurse call, and ask the patient's full name and nickname patients.
  • Ask the patient's feelings and complaints at this time.
  • Create a care contract: what nurses will do with the patient, how long it will be done and where the implementation of activities.
  • Explain that the nurses will keep confidential the information obtained for the purposes of therapy.
  • Show empathy to the patient at all times.
  • Fulfill the basic needs of the patient if possible.
2. Helping patients to know the cause of social isolation by means of:
  • Ask the patient habit, about the habits of interacting with others.
  • Ask causes the patient does not want to interact with others.
3. Helping the patient to recognize the benefits associated with others by sharing the benefits if the patient has a lot of friends.

4. Help patients recognize losses not related to the others, with:
  • Discuss the disadvantages, if the patient just shut up and do not get along with others.
  • Explain the effect of social isolation on the physical health of the patient.
5. Provide the opportunity to express their feelings can help reduce stress and causes feelings withdraw.


Therapy

Therapeutic group activities: socialization
Therapeutic group activities: socialization is an effort to facilitate the client's ability to socialize with a number of social relationship problems.

Goals:
1. The client is able to introduce their own self-
2. The client is able to get acquainted with members of the group
3. The client is able to converse with members of the group
4. The client is able to convey and discuss the topic conversation
5. The client is able to convey and discuss personal problems to others
6. The client is able to work together in a group socialization game
7. The client is able to express an opinion on the benefits of the activities undertaken.

Setting:
1. Client and therapist, sitting together in a circle
2. The room was comfortable and quiet

Tools
1. Tape recorder
2. Cassette
3. Tennis ball
4. Notebook and pen
5. Schedule patient activity

Methods:
1. Group dynamics
2. Discussion and Q & A
3. Playing the role / simulation

Step activity
1. Preparation
a. Selecting the client as indicated
b. Make contracts with clients
c. Prepare equipment and meeting place

2. Orientation
At this stage the therapist do:
a. Give therapeutic greetings: greetings from therapists
b. Evaluation / validation: asking patients at this time
c. contract:
1) identifies the purpose of activities, which introduce self-own.
2) Explain the following rules
- If there are clients who will leave the group to ask for permission to the client
- Length of activity 45 minutes
- Each client follow up activities completed

3. stage of work
a. Describe the activity, ie cassette tape recorder is turned on and the ball will be circulated counter-clockwise (ie towards the left) and when the tape off the members of the group who held the ball introduce himself.
b. Turn on the tape recorder and tape the opposite tennis balls circulate clockwise.
c. When the tape off, members of the group that holds the ball can turn to mention: greetings, full name, nicknames, hobbies and origin started by therapists as an example.
d. Write nicknames on paper / board name and paste / use
e. Repeat the activity b, c, d until all members of the group gets a turn
f. Give credit to the success of each member of the group members applause.

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