P3 · Difficulty handling stress
Actual Emotions and mind
Definition
The person's usual ways of coping are not working.- Chronic illness
- job loss
- family strain
- poor support
- many changes
- Irritable
- withdrawn
- poor sleep
- increased substance use
- sense of overload
📋 Scenario
A man with cancer drinks more and refuses to talk about his illness.
Subjective (S): "I don't want to talk about it. I just need a drink."
Objective (O): Drinks more since diagnosis; withdrawn; irritable; poor sleep.
Assessment tools for this scenario: CP-MIND Mood & Mind Screen
Validated scales to consider: PHQ-9, GAD-7, C-SSRS
**CarePath diagnosis:** Difficulty handling stress related to chronic illness, as evidenced by irritable and withdrawn.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Listen. | Listening without judging shows respect and builds trust, which helps a man who does not want to talk begin to share when he is ready. |
| Explore how he copes. | Understanding how he currently copes shows what helps and what harms, such as drinking, so the plan can build on his strengths. |
| Teach relaxation. | Relaxation skills calm the body's stress response and give him a healthier option than alcohol when he feels overloaded. |
| Encourage support. | Support from family, friends or groups reduces isolation and shares the load, which makes the stress of cancer easier to bear. |
| Refer for counseling. | Counselors have training to help people build new coping skills and address alcohol use, which goes beyond what routine ward care can offer. |
| Praise coping efforts. | Praise for healthy coping strengthens those behaviors and boosts confidence, making it more likely he will use them again. |
**Expected outcomes**
- Within 1 week: states 2 healthy ways to cope, accepts support, cuts down alcohol, engages with a counselor.
**Linking the data to the diagnosis**
The man with cancer says, "I don't want to talk about it. I just need a drink." The nurse notes he drinks more since the diagnosis, is withdrawn and irritable and sleeps poorly. His usual coping is failing and harmful coping has replaced it, so the problem exists now and is not just a risk. The plan aims, within 1 week, for him to state 2 healthy ways to cope, accept support, cut down alcohol and engage with a counselor.
CarePath diagnosis
Difficulty handling stress related to chronic illness, as evidenced by irritable and withdrawn.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Listen. | Listening without judging shows respect and builds trust, which helps a man who does not want to talk begin to share when he is ready. |
| 2. Explore how he copes. | Understanding how he currently copes shows what helps and what harms, such as drinking, so the plan can build on his strengths. |
| 3. Teach relaxation. | Relaxation skills calm the body's stress response and give him a healthier option than alcohol when he feels overloaded. |
| 4. Encourage support. | Support from family, friends or groups reduces isolation and shares the load, which makes the stress of cancer easier to bear. |
| 5. Refer for counseling. | Counselors have training to help people build new coping skills and address alcohol use, which goes beyond what routine ward care can offer. |
| 6. Praise coping efforts. | Praise for healthy coping strengthens those behaviors and boosts confidence, making it more likely he will use them again. |
Expected outcomes
- Within 1 week: states 2 healthy ways to cope, accepts support, cuts down alcohol, engages with a counselor.
Linking the data to the diagnosis
The man with cancer says, "I don't want to talk about it. I just need a drink." The nurse notes he drinks more since the diagnosis, is withdrawn and irritable and sleeps poorly. His usual coping is failing and harmful coping has replaced it, so the problem exists now and is not just a risk. The plan aims, within 1 week, for him to state 2 healthy ways to cope, accept support, cut down alcohol and engage with a counselor.