Nursing Care Plan Schizophrenia | Social Isolation

This care plan is designed for patients with schizophrenia with a nursing diagnosis of social isolation may be related to disturbed thought processes that result in mistrust of others/delusional thinking; and environmental deprivation, institutionalization (as a result of long-term hospitalization) possibly evidenced by difficulty in establishing relationships with others; social withdrawal/isolation of self, expressions of feelings of rejection, and dealing with problems using anger/hostility and violence.

Desired Outcomes: (1) Verbalize willingness to be involved with others; (2) Participate in activities/programs with others; and (3) Develop 1:1 trust-based relationship.

Nursing intervention with rationale:
1. Assess presence/degree of isolation by listening to client’s comments about loneliness.
Rationale: Mistrust can lead to difficulty in establishing relationships, and client may have withdrawn from close contacts with others.

2. Spend time with client. Make brief, short interactions that communicate interest, concern, and caring.
Rationale: Establishes a trusting relationship. Consistent, brief, honest contact with the nurse can help the client begin to reestablish trusting interactions with others.

3. Plan appropriate times for activities (by limiting withdrawal, varying daily routine only as tolerated).
Rationale: Consistency in 1:1 relationship and sameness of milieu are required initially to enable client to decrease withdrawn behavior. Motivation is stimulated by the humanistic sharing of a 1:1 experience.

4. Assist client to participate in diversional activities and limited/planned interaction situations with others in group meeting/unit party, etc.
Rationale: With toleration of 1:1 relationship and strengthened ego boundaries, client will be able to increase socialization and enter small-group situations. Brief encounters can help the client to become more comfortable around others and provide an opportunity to try out new social skills.

5. Identify support systems available to the client (e.g., family, friends, coworkers).
Rationale: Support is an important part of the client’s rehabilitation, providing a network to assist in social recovery.

6. Assess family relationships, communication patterns, knowledge of client condition.
Rationale: Problems within family (poor social/relationship skills, high expressed emotion) may interfere with client’s progress and indicate need for family therapy.

7. Note client’s sense of self-worth and belief about individual identity/role within milieu and setting.
Rationale: When client feels good about self and own value, family interactions with others are enhanced.