Experiences of Nurses in the Process of Determining a Nursing Diagnosis and Needs for Applying a Nursing Diagnosis: Fostering Understanding to Support the Use of Nursing Diagnoses in Clinical Practice

Purpose: This study illustrates through experiences of nurses while determining nursing diagnoses in terms of thought, behavior, and emotion. It demonstrates current issues in and the needs for support in the use of nursing diagnoses. Methods: Data were collected through conducting semi-structured interviews based on an interview guide concerning the experiences of nurses and their awareness of issues in the process of determining nursing diagnoses. Principal Results and Major Conclusions: Following ten categories were selected upon considering the experiences of nurses in determining nursing diagnoses from a thought perspective: [Comparison with defining characteristics], [Confirmation of defining characteristics, related factors, and definition], [Searching for potential nursing diagnoses from main symptoms and problems], [Considering nursing diagnosis from nursing intervention and outcome], [Patterned thinking relating to specific diagnoses], [Considering some temporary nursing diagnoses and monitoring progress], [Identification of multiple nursing diagnoses], [Comparison of some nursing diagnoses by picking potential diagnoses of defining characteristics or related factors, definition], [Integrating multiple nursing diagnoses], and [Avoiding nursing diagnosis decisions]. From the behavioral and emotional perspectives, emphasis was placed on [Confirming and reviewing with other staff to determine a diagnosis] and [Solo confirmation and review to decide on a nursing diagnosis]. These were found to be driven by: [Pressure to provide a nursing diagnosis], [Sense of burden over task load that goes with nursing diagnoses], [Anxiety when determining a nursing diagnosis], [Negative emotions towards nursing diagnoses], and [Decline of negative emotions towards nursing diagnoses]. Needs for nursing diagnosis application included [Needs for fostering understanding and learning of nursing diagnosis], [Needs for expanding the process of nursing diagnosis], [Needs for nursing diagnosis and nursing intervention for patients in specific situations], [Needs for the application of an electronic health record system], and [Needs for thinking ability in applying nursing diagnosis], suggesting a need to foster understanding of nursing diagnoses and application of examples.