Powerlessness/Hopelessness Definition: powerlessness is a Medical condition under the category of mental Health diseases; it is the state in which an individual or a group perceives a lack of personal control over certain events on situations. Most of the individuals are subject to feelings of powerlessness in varying degrees in various situations: this diagnosis can be used to describe individuals who respond to loss of control with apathy, anger, or depression. Prolonged state of powerlessness may lead to hopelessness and both can be devastating consequences to those afflicted by these conditions for being a medical problem it carries a loss of self confidence, loss morale, bleak future expectations, negative perception of one’s life, if urgent interventions and counseling are not met, in some situations hopelessness can be encountered to an environmental change if the perception is a hostile occupation hardship relations. What are the Defining Characteristics? Chronic onset: (Must be present) overt or covert expressions of dissatisfaction over inability to control a situation causative agents are (occupation, civil war, illness, feeling oppressed, poor prognosis, poor care, poor recovery rate, feeling ass ethnically marginalized, natural disasters, death of a loved one, sudden financial loss, infertility, losing opportunities , divorce. Acute :( May be present): Patient refuses or is reluctant to participate in decision making accompanying signs and symptoms are: Apathy Aggressive behavior Violent behavior Resignation Uneasiness Anxiety Depression Acting out behavior Patho-physiological Related Factors: Any disease process acute or chronic can contribute to powerlessness, some common sources are the following (CVA) cerebrovascular accident , Guillain –barre syndrome, intubation), inability to perform the daily activities (Due to CVA, cervical trauma, Myocardial infarction ,terminal cancer, mental illness,substance abuse, Disfigurement. SITUATIONAL: Personal environment Lack of knowledge Relocation Social displacement Sexual harassment No privacy Perceived double bind conflicts Social isolation Involvement in a hostile situation Insufficient Finances Burglary Abuse Assault Outcome Criteria and Intervention tools: The Person will: Identify factors that can be controlled by self • Explain all procedures rules and options to the person. • Allow time to answer questions, ask person to write questions down so as not to forget them. • Keep the person informed about condition, treatments and results. • Anticipate questions /interest and offer information • While being realistic: point out positive changes in the persons condition • Provide opportunity for the individual to control decisions • Allow the person to manipulate surroundings such as deciding what is to be kept where( shoes under bed picture on window) • Provide assistance to etiological cause of the problem, and give daily recognition of progress HOPELESSNESS Definition: Hopelessness is a sustained subjective emotional state in which an individual sees no alternatives or personal choices available to solve problems or to achieve his ambitions, or inability to mobilize his energy. the person sees no solution to solve his problems and attains a total lack of control of one’s life. Defining Characteristics: Expresses profound, overwhelming apathy in response to a situation perceived as impossible with no solutions (overt or covert).examples of expressions are: The future seems vague and uncertain, I might as well give up because I can’t make things better, Things never work out as I wanted I am too bad to have no lucky I know I will never get what I want to. Life looks unpleasant when I look ahead, PHYSIOLOGICALY: person shows slowed responses to stimuli, lack of energy, increased sleep. Emotionally: the hopeless person has difficulty experiencing feelings, like: Unable to seek good fortune, Doubts out of Allah’s good Expectations, He/she has no meaning to purpose in life, Empty and drained A sense of loss and deprivation Helpless Incompetent Entrapped, passiveness ,decreased verbalization, decreased affect , lack of ambition, initiative, and interest, decreased problem solving, and decreased decision making capabilities, deals and focuses with past mistakes rather than focusing to change, unable to identify desired objectives and goals, unable to plan, organize, or make decisions. PHYIOLOGICAL SYMPTOMS: Anorexia, weight loss, poor self-care, emotionally the person feels “a lump in the throat” discouraged with self and others, person exhibits poor eye contact turns away from the speaker, apathy, shrugs in response to speaker ,social withdrawal ,destructiveness, despondency, sighing, regression resignation, anger, depression, inability to communicate effectively, decreased ability to recall from the past, unrealistic perception in relation to hope, coveys negative messages, CAUSES AND RELATED FACTORS: Any chronic or terminal illness, can cause or contribute to hopelessness( Heart disease, kidney disease, cancer, AIDS,) impaired body image to accident such as amputation, face disfigurement, prolonged consumption of narcotics, fail air in studies, prolonged unemployment, Situational: Prolonged activity restriction,(fractures, spinal cord injury, separation, from significant member parents spouse, children others, inability to achieve goals, loss of someone value, loss of caregivers, loss of independence, loss of a job of a career, loss financial assets and entity. WHAT ARE THE INTERVENTIONS Share suffering openly with constructive encouragement, convey empathy to promote verbalization of doubts, fears, and concerns. Asses and mobilize the persons internal resources (autonomy, independency, rationale, cognitive thinking, flexibility and spirituality. Assist the person to understand that he or she can deal with the hopelessness aspects by separating them from the hopeful aspects. Plan for the person to develop realistic short term and long term goals by indicating and assuring the time And type of assistant. Initiate to help the person engage in spiritual clubs and at last refer to a psychologist therapy…….. Prepared and written by Mohamed Hassan Adam algebra