The question of whether anxiety constitutes a nursing diagnosis often causes confusion. While “diagnosis” usually refers to identifying a medical disease, nursing uses a distinct, standardized language to describe patient needs and responses. This framework guides nursing care by focusing on the individual’s experience rather than the underlying pathology. This approach allows nurses to articulate a clinical judgment that directs interventions within their scope of expertise.
The Role of Standardized Nursing Diagnoses
Nursing diagnoses serve as clinical judgments about an individual, family, or community’s response to actual or potential health problems or life processes. This definition makes it clear that the focus is on the human response to a situation, which is different from a medical diagnosis of a disease. The primary system for this standardized terminology is maintained by NANDA International (NANDA-I), which provides a universally recognized classification system. The purpose of NANDA-I is to ensure that nurses worldwide use a consistent language to describe patient conditions that are treatable through nursing interventions. Using standardized terminology promotes effective communication among healthcare professionals and enhances the quality of care planning.
Anxiety as a Recognized Nursing Diagnosis
Yes, “Anxiety” is a formal, recognized nursing diagnosis within the NANDA-I classification system. It is categorized under Domain 9, “Coping/Stress Tolerance,” and falls within Class 2, “Coping Responses.” The NANDA-I definition describes Anxiety as a vague, uneasy feeling of discomfort or dread, often accompanied by an autonomic response, where the source is non-specific or unknown. It is considered an alerting sign that warns of impending danger, prompting the individual to deal with the perceived threat. A nurse diagnoses the patient’s emotional and physiological response to a stressor, such as an unfamiliar hospital environment or a serious health prognosis.
Key Components of the Anxiety Diagnosis
To validate the diagnosis of Anxiety, a nurse collects two types of clinical data: defining characteristics and related factors. Defining characteristics are the observable signs and subjective symptoms that confirm the presence of the problem. Subjective characteristics include the patient expressing worry, distress, dread, or insecurity. Objective signs include increased heart rate, elevated blood pressure, tremors, or restlessness. Related factors are the conditions or circumstances that contribute to the anxiety, such as a situational crisis, an unfamiliar situation, a threat to self-concept, or conflict over life goals. A complete nursing diagnosis might be stated as “Anxiety related to unfamiliar situation and impending surgery, as evidenced by verbalized nervousness and increased heart rate.”
Actual vs. Risk Diagnosis
It is important to distinguish between the actual problem of “Anxiety” and the potential problem, “Risk for Anxiety.” The actual diagnosis is used when the defining characteristics are currently present and observable. The risk diagnosis is used when a patient is vulnerable to developing anxiety due to the presence of risk factors, even if symptoms are not yet evident.
Distinguishing Nursing Diagnosis from Medical Diagnosis
The fundamental difference between a nursing diagnosis and a medical diagnosis lies in their focus and scope of intervention. A medical diagnosis, such as Generalized Anxiety Disorder, identifies a disease or pathology, and its treatment centers on curing or managing the illness. This diagnosis is made by a physician and guides medical treatment, such as prescribing medication. Conversely, the nursing diagnosis of Anxiety focuses entirely on the patient’s response to their health condition or life process, which is manageable by the nurse.
For example, a patient may have the medical diagnosis of Coronary Artery Disease, but the nurse identifies the nursing diagnosis as “Anxiety related to fear of death and uncertainty about the future.” The nurse’s intervention focuses on reducing the patient’s fear through education, active listening, and relaxation techniques, actions within the nurse’s autonomous scope of practice. The medical diagnosis remains constant, while the nursing diagnosis changes as the patient’s response and coping ability fluctuate.