Domain 10. Life principles
Class 3. Value-belief-action congruence
Diagnostic Code: 00083
Nanda label: Decisional conflict
Diagnostic focus: Decisional conflict
Decisional conflict is one of the most common and challenging nursing diagnoses that nurses often encounter. This type of decisional conflict can occur when a nurse has been asked to make a difficult decision or any kind of choice, and finds himself or herself unable to decide which option would be best. Decisional conflict can be a debilitating and overwhelming experience for a nurse, which can lead to professional burnout. This article will provide an overview of decisional conflict, including the NANDA nursing diagnosis definition, defining characteristics, related factors, recommendations for use, suggested alternative NANDA nursing diagnoses, usage tips, NOC Outcomes and NIC interventions, nursing activities, conclusion, and 5 FAQs.
NANDA Nursing Diagnosis Definition
Decisional conflict is defined as a state in which an individual experiences difficulty in making a choice between two worthwhile alternatives due to competing internal and external influences.
Defining Characteristics
Subjectives
- Expresses concern regarding decision-making process
- Yields no clear conclusion
- Confusion about what is important
- Anxiety and indecisiveness
- Feelings of frustration, guilt, and/or ambivalence
Objectives
- Unclear criteria or strategy for choosing between options
- Decreased level of functioning
- Assessment of risk factors
- Indecision during plans of care
- Periods of inactivity
Some of the related factors to consider with decisional conflict include:
- Lack of knowledge or expertise in the situation being assessed
- Psychosocial issues such as fear of failure/success
- Expectation of negative outcomes
- Uncertainty of consequences
- Unexpected events changing the options available
Suggestions for Use
In order to effectively manage decisional conflict, it is critical that the nurse assesses the situation thoroughly. It is also important to provide adequate education and support to the individual to help him or her navigate this difficult process. Nurses should also be aware of the impact of decisional conflict on an individual’s mental and physical functioning and should provide appropriate follow-up care and support.
Suggested Alternative NANDA Nursing Diagnoses
Some alternative NANDA nursing diagnoses for decisional conflict include anxiety, impaired verbal communication, impaired comfort, and delayed growth and development.
Usage Tips
When working with individuals who are experiencing decisional conflict, it is important to recognize that choices can be made on an individual basis. People may select a choice based on personal values and beliefs, as well as their own perceptions of the consequences of making a given choice. It is therefore important to provide support and guidance to help individuals find clarity in their decision-making process.
NOC Outcomes
The following list comprises the intended outcomes of nursing actions for an individual with decisional conflict:
- Decision Balance: Ability to review ideas and identify advantages and disadvantages to possible decision options.
- Decision Making: Ability to make choices based on available alternatives.
- Problem Solving: Ability to identify a constructively framed solution to a problem.
- Coping: Ability to meet challenges presented by ways of managing stressors.
Evaluation Objectives and Criteria
For individuals with decisional conflict, the following evaluation objectives and criteria should be used to determine progress and adaptation:
- Verbalize increased clarity of the decisional problem.
- Identify alternative solutions to the decisional problem.
- Verbalize and implement an evidence-based decision.
- Display improved functioning after making a decision.
NIC Interventions
The following NIC interventions could be used by nurses to help with decisional conflict:
- Counseling: Provide psychosocial interventions to assist with individual’s decision-making process.
- Care Planning: Develop a plan of care to address the individual’s decisional conflict.
- Health Teaching: Educate the individual on the decision-making process, benefits, and risks of decisions.
- Risk Management: Implement strategies to minimize risk associated with decisional conflict.
- Support Systems Management: Utilize support systems to assist with coping, resources, and decision-making.
Nursing Activities
Nurses can provide supportive care to those with decisional conflict through a variety of activities, such as:
- Providing personal assistance and support to the individual.
- Helping explore available options and providing feedback in making decisions.
- Assisting in identifying resources and care plans.
- Encouraging healthy coping strategies.
- Monitoring decisional conflict episodes and observing reaction to treatment.
Conclusion
Decisional conflict is a difficult diagnosis to manage, but with appropriate interventions, support, and education, many individuals are able to overcome this challenge. Nurses should recognize the need for adequate assessment, intervention, and follow-up care when working with individuals with decisional conflict.
5 FAQs
- What is Decisional Conflict?
Decisional conflict is a type of nursing diagnosis that occurs when a nurse has to make a difficult decision or any kind of choice, and finds himself or herself unable to decide which option would be best. - What are some defining characteristics of decisional conflict?
Defining characteristics of decisional conflict include expressing concerns regarding the decision-making process, confusion when trying to determine what is important, anxiety, frustration, guilt, ambivalence, unclear criteria or strategy for choosing between options, decreased level of functioning and indecision when making plans of care - What are some related factors to consider with decisional conflict?
Related factors to consider with decisional conflict include lack of knowledge or expertise in the situation being assessed, psychosocial issues such as fear of failure/success, expectation of negative outcomes, uncertainty of consequences, and unexpected events that change the available options. - What are some suggestions for use with a person experiencing decisional conflict?
When working with individuals who are experiencing decisional conflict, it is important to thoroughly assess the situation and provide adequate education and support to the individual to help him or her navigate this difficult process. It is also important to be aware of the impact of decisional conflict on an individual’s mental and physical functioning, and to provide appropriate follow-up care and support. - What are the intended outcomes of nursing actions for an individual with decisional conflict?
The intended outcomes of nursing actions for an individual with decisional conflict include decision balance, decision making, problem solving, and coping.