After “Where is the NANDA-I diagnosis list?”, here is the second most common question
we receive: “What are the nursing diagnoses for [insert any disease here you would think of]?”.
Students will often think that every pathophysiological aspect of a disease must be represented
by a nursing diagnosis. Also, when learning about language standardization, they might be
misled into thinking that the proposal of the NANDA-I Classification is standardizing individuals
with the same medical diagnoses.
Studies focusing on the most frequent human responses/nursing diagnoses in
populations with specific medical diagnoses are welcome and helpful to pattern recognition.
Nevertheless, a nursing diagnosis should not be assumed based solely on a medical diagnosis.
People with the same health conditions and/or experiencing the same life processes may
present with different human responses. Furthermore, people with the same nursing diagnosis
can manifest it through different clinical indicators, as caused by different etiological factors.
Mrs. Jones, living with Aids, may suffer from stigmatization and fear of rejection. These
etiological factors are enough to collaborate so that Mrs. Jones expresses loneliness,
helplessness and underestimates her ability to deal with her situation. On the other hand, Mrs.
Raymond, who also lives with Aids, has low self-efficacy and impaired religiosity. For Mrs.
Raymond, this specific set of related factors come together as sufficient cause for her to
underestimate her ability to deal with this situation, and to express purposelessness and
Both Mrs. Jones and Mrs. Raymond could be diagnosed with Situational low self-esteem
(00120). However, their individual etiological factors will determine the choice of different
nursing interventions. Likewise, their different defining characteristics will require the
measurement of distinct outcome statuses. Although Mrs. Jones and Mrs. Raymond have been
diagnosed with Situational low self-esteem (00120), their individual assessments might lead to
identification of several other distinct diagnoses. Mrs. Jones might present with Ineffective
health self-management (00276) and Ineffective home maintenance behaviors (00300), whereas Mrs. Raymond presents with Decreased diversional activity engagement (00097) and
Readiness for enhanced health self-management (00293).
Even though the diagnostic language to represent human responses is standardized,
experiences are lived by individuals, caregivers, families, groups and communities in their own
ways, producing particular clinical evidence. Thus, diagnosing is inseparable from individualized
assessment, data analysis and interpretation.
Camila Takao Lopes, Director of Diagnosis Development, NANDA International
Herdman, T.H., Kamitsuru, S. & Takao Lopes, C. (2020). NANDA International nursing diagnoses:
Definitions and classification, 2021-2023. New York: Thieme Publishers
de Oliveira Lopes, M. V., da Silva, V. M., & Herdman, T. H. (2017). Causation and Validation of
Nursing Diagnoses: A Middle Range Theory. International journal of nursing
knowledge, 28(1), 53–59. https://doi.org/10.1111/2047-3095.12104