International Journal of Nursing Knowledge

Consistent efforts to identify and clinically validate new nursing diagnosis within recognized categories are essential to taxonomy development. Mixed incontinence is a clinical condition resulting in leakage of urine associated with increased intra-abdominal pressure (stress) and inability to delay voiding (urge). The presence of mixed incontinence was clinically validated in two populations (n = 9, n = 40) of community-dwelling women and initial defining characteristics were identified. Research findings from both studies support the addition of a proposed sixth nursing diagnosis, mixed incontinence, to the diagnostic category, alteration in urinary elimination.

The purpose of this study was to identify high frequency-treatment priority nursing diagnoses in critical care nursing using survey research methods. Through a mailed survey the prevalence of 135 nursing diagnoses from the NANDA Diagnostic Taxonomy and other diagnoses was rated by a national, random sample of 678 critical care nurses. Six important diagnostic areas were: sleep-rest, activity, nutritional-metabolic, cognitive-perceptual, self-perception (mood state), and health management (risk) patterns. Twenty diagnoses were rated as nearly always or frequently present in their practice by 70% or more of the nurses. Findings can be used to focus clinical studies of the highly prevalent diagnoses.

The authors present an analysis of the concept of communication, and propose a revision of NANDA's taxonomic human response pattern communicating, and its nursing diagnosis, impaired verbal communication. The authors recommend that the definitions of the human response pattern and its diagnosis be modified to incorporate facets other than verbal emissions. The addition of new defining characteristics and related factors also should be considered. New defining characteristics could include modifications of criteria of the American Speech and Hearing Association, highlighting disturbances in speech, language, hearing, and vision in addition to some of the present NANDA defining characteristics. Proposed related factors are classified as alterations in human patterns (developmental, physiological, psychological, social, cultural and environmental).

The authors compare the nursing diagnosis ineffective management of therapeutic regimen with that of noncompliance and with Orem's concept of self-care deficit. The article describes how the diagnosis of ineffective management of therapeutic regimen is more comprehensive than noncompliance. A question of patient autonomy is raised considering how the patient manages his or her therapeutic regimen. The major conclusion is that the nursing diagnosis of ineffective management of therapeutic regimen is based on continuous interaction between patient and nurse. The authors recommend that noncompliance be eliminated as a nursing diagnosis.