Disturbed thought process

Domain 5. Perception-cognition
Class 4. Cognition
Diagnostic Code: 00279
Nanda label: Disturbed thought process
Diagnostic focus: Thought process

Introduction to Nursing Diagnosis Disturbed Thought Process

Nursing diagnoses serve as a pairing of diagnostic labels and related symptoms associated with patient care. When nurses encounter a patient with disturbances in their thought processes, such as a fear of catastrophic events, misperception of objects, or incoherent speech, a diagnosis of disturbed thought process must be identified and appropriately managed as part of the patient's overall treatment plan. Though nursing diagnosis has been used since the 1970s, the formalization of NANDA International (NANDA-I) brought structure to the system of diagnoses used to provide holistic care, through the identification and assessment of all contributing factors.

NANDA Nursing Diagnosis Definition for Disturbed Thought Process

The NANDA International system defines Disturbed Thought Process as “a state in which there is difficulty processing information correctly, difficulty using abstract thinking or planning, disjointed communication and difficulty interacting socially.” This broad definition is broken down into eight categories within NANDA-I's Taxonomy II, including poor reality orientation, impaired judgment, confusion, impoverished thinking, risk for altered thought processes, risk for other-directed violence, risk for suicide, and risk for delayed development. NANDA-I–approved nursing diagnoses are categorized in terms of the presence of a condition, risk factors that could lead to the presence of a condition, potential reactions of the body caused by a condition, and problems related to other conditions or physiological functions.

Defining Characteristics for Disturbed Thought Process

Subjective Characteristics: Reports of experiencing odd sensations, magical thinking, perceptual distortion, auditory hallucinations, suicidal thoughts, aggression towards self, anxiety, forms of nonverbal communication, inappropriate behavior and expression of feeling, unreality, confusion.

Objective Characteristics: Difficulty processing information correctly, difficulty using abstract thinking or planning, disjointed communication and difficulty interacting socially, decrease level of consciousness, delusional thinking, dangerous behavior, impairment in cognition, and episodes of self-harm.

Related Factors for Disturbed Thought Process

Explanation: Related factors are conditions or circumstances that are believed to play a role in the emergence of a particular diagnosis. For Disturbed Thought Process, related factors can include physiological imbalances, psychological distress, mental illness, absence of recall, brain injury, substance abuse, family history, use of medications, trauma, and low education or socioeconomic status.

At Risk Population for Disturbed Thought Process

Explanation: Certain populations are at greater risk for Disturbed Thought Process than others. Risk factors for this diagnosis include individuals who are older, have family living with mental illness, experience significant stress, live in poverty, suffer from trauma, and/or have comorbidities. These risk factors must also be taken into account when determining an effective treatment plan.

Associated Conditions for Disturbed Thought Process

Explanation: In addition to the presence of a particular diagnosis, nursing care must attend to related conditions or physiological functions. Mental health disorders such as depression, anxiety, and schizophrenia, as well as the use of drugs or alcohol, may result in changes in thoughts and behavior that can lead to a diagnosis of Disturbed Thought Process. Additionally, physical injury, prolonged states of confusion, high levels of stress, lack of sleep, and certain medical conditions may also be present.

Suggestions of Use for Disturbed Thought Process

Nursing care for patients with a diagnosis of Disturbed Thought Process helps promote patient safety and improved health outcomes. To begin, nurses should take an accurate medical history to assess for underlying causes and any co-existing conditions related to the diagnosis. Then, develop a plan of care that includes interventions to reduce stress and improve communication skills, while creating an environment that is conducive to recovery. In addition to medication and therapeutic interventions, nurses must recognize and address any potential side effects associated with treatment.

Suggested Alternative NANDA Nursing Diagnoses for Disturbed Thought Process

Explanation: Changes in cognition, reasoning, or behavior can result in the need for an alternative NANDA nursing diagnosis. In addition to Disturbed Thought Process, considerations for alternate diagnoses include Risk for Delayed Development, Anxiety, Ineffective coping, Pain, Risk for Self-Mutilation, and Disturbed Sensory Perception.

Usage Tips for Disturbed Thought Process

It is important for nurses to remain aware of the various types of nursing diagnoses, tools available for assessment strategies, evidence-based interventions and guidelines for interdisciplinary care when caring for patients with Disturbed Thought Process. A thorough understanding of nursing diagnoses is necessary for nurses to effectively asses, plan, implement and evaluate all aspects of a patient's care. Nurses should also maintain contact with the patient's primary care physician to ensure that all treatments, interventions, and assessments align with established plans.

NOC Outcomes for Disturbed Thought Process

Explanation: NOC stands for Nursing Outcomes Classification, and is a comprehensive, standardized taxonomy of patient outcomes developed by NANDA-I. The following is a list of possible NOC outcomes related to Disturbed Thought Process: Cognitive Function, Mood Status, Sleep Pattern, Coping, Interpersonal Relationships, Anxiety Level, Safety Awareness, Risk Recognition, and Fear Control.

Evaluation Objectives and Criteria for Disturbed Thought Process

Evaluation objectives and criteria provide a snapshot of the desired outcomes of the care plan. When dealing with Disturbed Thought Process specifically, evaluation objectives include improved orientation to time and place, improved meaning and logical thought process, decreased distorted perception of reality, enhanced problem solving abilities, improved communication, improved mood and emotional stability, improved safety awareness, adherence to treatment goals, and reduced risk behaviors.

NIC Interventions for Disturbed Thought Process

Explanation: NIC stands for Nursing Interventions Classification, and is a comprehensive standardized taxonomy of nursing interventions developed by NANDA-I. The following is a list of possible NIC interventions related to Disturbed Thought Process: Cognitive Stimulation, Cognitive Retraining, Memory Enhancement, Psychotherapy, Reinforcement Therapy, Psycho-education, Relaxation Therapy, Hallucinations Management, and Safety Enhancement.

Nursing Activities for Disturbed Thought Process

Nurses provide a wide array of care and services when it comes to caring for patients with disturbed thought processes. In addition to evaluating and addressing the presenting sign and symptoms, activities include providing psychotherapeutic intervention, implementing supportive care measures, collaboration with interdisciplinary teams, monitoring for changes in condition and effectiveness of interventions, administering medications as prescribed, and providing patient and family education. Nurses additionally encourage the development of self-expression and communication, as well as provide support to the patient's family.

Conclusion

When treating patients with Disturbed Thought Process, nurses must be able to recognize the signs and symptoms, identify the NANDA nursing diagnosis definition, related factors, at risk population, associated conditions, suggested alternative NANDAs, usage tips, NOC outcomes and NIC interventions, and create an appropriate nursing plan of care and set of evaluations. In addition, they must implement interventions that are mindful of the patient's individual needs, preferences, and capability in order to create a culture of safety, strengthen treatments, maintain privacy and autonomy, and ensure quality of life.

FAQs

1. What is Disturbed Thought Process?

   Disturbed Thought Process is a state in which there is difficulty processing information correctly, difficulty using abstract thinking or planning, disjointed communication and difficulty interacting socially.

2. What are the defining characteristics of Disturbed Thought Process?

   Subjective characteristics of Disturbed Thought Process include reports of experiencing odd sensations, magical thinking, perceptual distortion, auditory hallucinations, suicidal thoughts, aggression towards self, anxiety, forms of nonverbal communication, inappropriate behavior and expression of feeling, unreality, confusion. Objective characteristics can include difficulty processing information correctly, difficulty using abstract thinking or planning, disjointed communication and difficulty interacting socially, decrease level of consciousness, delusional thinking, dangerous behavior, impairment in cognition, and episodes of self-harm.

3. What kinds of interventions are appropriate for Disturbed Thought Process?

   Interventions for Disturbed Thought Process should reduce stress and improve communication skills, while providing an environment conducive to recovery. These interventions can include cognitive stimulation, cognitive retraining, memory enhancement, psychotherapy, reinforcement therapy, psycho-education, relaxation therapy, hallucinations management, and safety enhancement.

4. Which populations are at risk for Disturbed Thought Process?

   Populations at risk for Disturbed Thought Process include individuals who are older, have family living with mental illness, experience significant stress, live in poverty, suffer from trauma, and/or have comorbidities.

5. What is the importance of assessment in Disturbed Thought Process?

   Assessment plays a crucial role in providing holistic care for patients with Disturbed Thought Process. During assessment, nurses should explore the individual's underlying medical history, physiological function and related conditions that may be present. Additionally, nurses should assess for any co-existing conditions and risk factors, evaluate the effectiveness of interventions implemented, and consult the patient's primary physician when necessary.

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