Nursing diagnoses: a study of cultural relevance

This study examines the adequacy/inadequacy of three nursing diagnoses with cultural etiologies: (1) impaired verbal communication related to cultural differences; (2) impaired social interaction related to sociocultural dissonance; and (3) noncompliance related to patient value system. The research tool was administered to the membership of the American Nurses Association Council on Cultural Diversity and the International Transcultural Nursing Society, with a response rate of N = 245 (42.2 per cent) from 43 states, the District of Columbia, and seven foreign countries. The tool listed the North American Nursing Diagnosis Association (NANDA) defining characteristics and cultural etiology for each diagnosis rated on a five-point Likert scale from "nearly always present" to "rarely present." The subjects also wrote and ranked other defining characteristics they used to make the diagnosis in clinical practice. Percentage distribution results indicate no defining characteristic meets the NANDA criteria for a major or minor defining characteristic. By collapsing categories, seven were acceptable only as minor defining characteristics. Respondents' 113 suggestions for additional characteristics were content analyzed. Themes for 12 categories were intuited and added to the lists. Based on respondents' suggestions, the definitions for each diagnosis were reworked, and new cultural-related factors were added. The cultural adequacy/inadequacy of elements within these three diagnoses was identified and provides the opportunity for greater selectivity in their clinical use. Additional suggestions from transcultural nursing experts form a data base for future research to expand the use of the currently limited components of NANDA diagnoses with culturally diverse patients.