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Murray James A.; Haynes, Mallie P.
Journal of Neuroscience Nursing: August 1996
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Boone and Hartman identified the phenomenon of benevolent overreaction to describe the enmeshment seen in parents and their chronically ill children. The cycle of the benevolent overreaction begins with the child's diagnosis with a chronic illness and the subsequent natural protective behaviors of the parents. However, overprotection may become pathologic if these protective behaviors persist and delay or prevent the child's achieving developmental goals. This ego boundary deficit is one of the most frequently seen phenomena in families with chronically ill children. On the Comprehensive Epilepsy Unit this phenomenon was repeatedly observed. The purpose of this investigation was to ascertain the frequency of benevolent overreaction seen on the unit, and to identify the nursing interventions used to address this issue. A chart review was used to identify the frequency of the phenomenon during the past year, the discipline first identifying the phenomenon and nursing interventions applied to the phenomenon. Nursing staff interviews were then conducted, using unit census records of the past year, to identify staff recall of the phenomenon. Nursing staff frequently identified the components of benevolent overreaction in the inpatient population, however, consistent intervention for the phenomenon was less frequently seen. Autonomy, empowerment and self-advocacy for families are goals of the Comprehensive Epilepsy Unit. Consistent application of the nursing process to this phenomenon is vital to providing quality patient care.

Questions or comments about this article may be directed to: James A. Murray RN, MSN 749-A Mountainwood Road, Charlottesville, Virginia 22903. He is a Clinician III at the University of Virginia Health Science Center, Comprehensive Epilepsy Unit in Charlottesville, Virginia.

Mallie P. Haynes RN. is the utilization management coordinator for neurology at the University of Virginia Health Science Center in Charlottesville, Virginia.

© 1996 American Association of Neuroscience Nurses