Fear
Deidra Gradishar, RNC, BS
NANDA: Feeling of dread related to an identifiable source that the person validates
Fear is a strong and unpleasant emotion caused by the awareness or anticipation of pain or danger. This emotion is primarily externally motivated and source-specific. The person, place, or thing precipitating this feeling can be identified by the individual experiencing the fear. The factors that precipitate fear are, to some extent, universal; fear of death, pain, bodily injury are common to most people. Other fears are derived from the life experiences of the individual person. How fear is expressed may be strongly influenced by the culture, age, or gender of the person under consideration. In some cultures it may be unacceptable to express fear regardless of the precipitating factors. Rather than manifesting outward signs of fear as described in the defining characteristics, responses may range from risk-taking behavior to expressions of bravado and defiance of fear as a legitimate feeling. In other cultures fear may be freely expressed and manifestations may be universally accepted. In addition to one's own individual ways of coping with the feeling of fear, there are aspects of coping that are cultural as well. Some cultures control fear through the use of magic, mysticism, or religiosity. Whatever one's mechanism for controlling and coping with fear, it is a normal part of everyone's life. The nurse may encounter the fearful patient in the community, during the performance of diagnostic testing in an outpatient setting or during hospitalization. The nurse must learn to identify when patients are experiencing fear, and must find ways to assist them in a respectful way to negotiate through these feelings. The nurse must also learn to identify when fear becomes so persistent and pervasive that it impairs an individual's ability to carry on their activities of daily living. Under these circumstances referral can be made to programs designed to assist the patient in overcoming phobias and other truly debilitating fears.