00083 Decision Conflict

Domain 10: vital principles
class 3: congruence between values/beliefs/actions
Diagnostic Code: <00083
Nanda Tag: Decision Conflict
Diagnostic focus: Decision conflict
Approved 1988 • Revised 2006 • Evidence level 2.1

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « decision conflict ” is defined as: uncertainty about the course of the action to be taken when the choice between diverse actions implies risk, loss or a challenge for the values ??and beliefs.

Definite characteristics

  • Decision making delay
  • Express discomfort during decision making
  • Physical signs of suffering
  • physical signs of tension
  • questioning of moral principles while trying to make a decision
  • Questionation of moral rules while trying to make a decision
  • questioning of moral values ??while trying to make a decision
  • Questionation of personal beliefs while trying to make a decision
  • Questioning of personal values ??while trying to make a decision
  • Recognize the unwanted consequences of potential actions
  • Informs uncertainty about the options
  • Attention centered on self
  • Cowing on options

Related factors

  • Conflict with moral obligation
  • Contradictory information sources
  • Inadequate information
  • Inadequate social support
  • Lack of experience in decision making
  • Interference in decision making
  • Moral principles support different mutually contradictory actions
  • Moral rules support different mutually contradictory actions
  • Moral values ??support different mutually contradictory actions
  • Threat perception to the values ??system
  • Little personal beliefs
  • Personal values ??unclear

Suggestions of use

  • (a) The function of nursing personnel consists in helping patients to make supported and logical decisions through information and support. The nursing professional should not try to influence the patient to make a specific decision, (b) should not be assumed that patients who face important decisions, even life or death, are in conflict for it. In some cases it may be very easy to make such decisions.

Suggested alternative diagnostics

Other examples

The patient will be able to:

  • Evaluate the available alternatives based on your personal values ??
  • Manifest that tension or discomfort have decreased
  • Manifest information processing and logical thinking processes
  • Use problems solving the desired results

NIC Interventions

  • Clarification of values: help another person to clarify their own values ??in order to facilitate good decision making
  • Support in decision making: provide information and support to a patient who is making a decision about his health
  • Assertive training: helping the effective expression of feelings, ideas and needs, at the same time respecting the rights of others
  • Learning facilitation: Promote the ability to process and understand information
  • Improvement of health knowledge: help individuals with limited abilities to obtain, process and understand information related to health and disease
  • Orientation on the health system: to facilitate a patient the location and use of adequate health services

Nursing Activities

Valuations

  • Evaluate the patient’s understanding about the available options
  • Assess the patient’s tension or discomfort level
  • Evaluate decision -making skills and their decision -making patterns
  • (NIC) Support in decision making: determine if there are differences between the way in which the patient perceives their own disease and the perception of health professionals

Patient and family education

  • Provide information on the guidelines in advance
  • Teach problems solving and decision -making
  • (NIC) Support in decision making:
    • Inform the patient about alternatives or solutions in a clear and comprehensive way
    • Provide the patient with the information requested

Collaboration activities

  • Use resources as required (for example, a bioethics committee)
  • (NIC) Support in decision making:
    • Act as a link between the patient and other health care professionals
    • Channel to support groups, if necessary
    • Recommend legal help, if necessary
    • Facilitate joint decision making

Others

  • Help the patient identify an action group and modify it, if necessary
  • (NIC) Support in decision making:
    • Establish communication with the patient from their income
    • Facilitate the expression of care objectives
    • Help the patient identify the advantages and disadvantages of each alternative
    • Help the patient explain their decision to others, if necessary
    • Serve as a link between the patient and the family
    • Respect the patient’s right to receive, or not, information

At home

  • Assess whether the patient and the family agree with respect to the decisions made
  • Provide information that helps relatives who consider the possibility of interning the patient in a center of chronic patients
  • Support the person or people who make decisions

Babies and Children

  • As a rule, a tutor (father or guardian) is the one who makes the important decisions for the child. It is necessary to be familiar with the laws and protocols that regulate the necessary age to grant consent, since they can differ in each state

Older people

  • Family members and other people often exclude the elderly from the decision -making process, based on the idea that they are not competent or that said issue could alter them. You must work with the patient and with other people who make decisions to include the patient as much as possible
  • Evaluate the patient’s ability to make decisions and solve problems
  • Value if there is dementia, depression, hearing loss and communication problems that could be the cause of the patient not actively participating in decision making
  • Comment on the need to make decisions about the end of life, if they are avoiding it
  • Comment with relatives about how they could support the patient’s decisions, even if they do not agree