Hopelessness

Definition
Subjective state in which an individual sees limited or no alternatives or personal choices
available and is unable to mobilize energy on own behalf
Defining Characteristics
Alteration in sleep pattern; decrease in affect; decrease in appetite; decrease in initiative;
decrease in response to stimuli; decrease in verbalization; despondent verbal cues (e.g., “I can’t,”
sighing); inadequate involvement in care; passivity; poor eye contact; shrugging in response to
speaker; turning away from speaker
Related Factors (r/t) Chronic stress; deterioration in physiological condition; history of
abandonment; loss of belief in spiritual power; loss of belief in transcendent values; prolonged
activity restriction; social isolation

Bowel Incontinence
Definition
Change in normal bowel elimination habits characterized by involuntary passage of stool
Defining Characteristics
Bowel urgency; Constant passage of soft stool; Does not recognize urge to defecate; Fecal odor;
Fecal staining of bedding; Fecal staining of clothing; Inability to delay defecation; Inability to
expel formed stool despite recognition of rectal fullness; Inability to recognize rectal fullness;
Inattentive to urge to defecate; Reddened perianal skin
Related Factors
Increase in abdominal pressure; Abnormal increase in intestinal pressure; Alteration in cognitive
functioning; Chronic diarrhea; Colorectal lesion; Deficient dietary habits; Difficulty with
toileting self-care; Dysfunctional rectal sphincter; Environmental factor (e.g., inaccessible
bathroom); Generalized decline in muscle tone; Immobility; Impaction; Impaired reservoir
capacity; Incomplete emptying of bowel; Laxative abuse; Lower motor nerve damage;
Pharmaceutical agent; Rectal sphincter abnormality; Stressors; Upper motor nerve damage