00276 Ineffective Health Self -Management

Domain 1: health promotion
Class 2: Health Management
Diagnostic Code: 00276
Nanda label: ineffective health self -management
Diagnostic focus: health self -management
approved 2020 • Evidence level 3.3

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « ineffective health self -management is defined as: unsatisfactory management of symptoms, treatment, physical, psychic and spiritual consequences and changes in the lifestyle inherent to live With a chronic condition.

Definite characteristics

  • Exacerbation of disease signs
  • Exacerbation of disease symptoms
  • Show sequelae of the disease
  • Express dissatisfaction with the quality of life
  • Failure to go to appointments with the health provider
  • Failure to include the therapeutic regime in daily life
  • Failure to take actions to reduce risk factors
  • Lack of attention to disease signs
  • Lack of attention to disease symptoms
  • ineffective decisions in daily life to achieve health objectives

Related factors

  • Cognitive dysfunction
  • Contradictory demands
  • Contradictory lifestyle preferences
  • Conflicts between cultural beliefs and health practices
  • Conflict between health behaviors and social norms
  • Conflict between spiritual beliefs and the therapeutic regime
  • Decreased perception of quality of life
  • Depressive symptoms
  • Difficulty accessing community resources
  • Difficulty in managing a complex therapeutic regime
  • Difficulty in handling in complex health systems
  • Difficulty in decision making
  • Inadequate implication in an action plan
  • Inadequate health literacy
  • Inappropriate knowledge about the treatment regime
  • Inappropriate number of indications for action
  • Inappropriate role models
  • Inadequate social support
  • People with limited experience in decision making
  • Limited ability to perform some aspects of treatment
  • Low self -efficacy
  • Negative feelings towards the therapeutic regime
  • Neurocomportal manifestations
  • No acceptance of a problem
  • Obstacle perception of the therapeutic regime
  • Perception of a social stigma associated with a problem
  • Inappropriate use of substances
  • Non -realistic perception of the severity of the situation
  • Non -realistic perception of susceptibility to sequels
  • Non -realistic perception of the benefits of treatment

Risk population

  • Children
  • People at economic disadvantage
  • People who experience adverse medication reactions
  • People with responsibilities as caregivers (as)
  • People with a history of ineffective personal health management
  • People with low educational level
  • Older adults

Associated problems

  • Asymptomatic disease
  • Disabilities of development
  • High acuity affection
  • Neurocognitive disorder
  • Polymedication
  • Significant comorbidity

Suggestions of use

  • This diagnosis should be used for patients who want to follow a therapeutic regime and who feel motivated to do so, but have difficulty achieve it. For example, this diagnosis is suitable for a patient who is trying to lose weight and has the necessary information, but who finds it difficult to follow a low -calorie diet because their businesses often demand eating out of home. The diagnosis is not appropriate for an obese patient who is not interested in making a diet or losing weight.

Suggested alternative diagnostics

  • Health risk behavior, a tendency to adopt
  • Failure (specify)
  • ineffective health maintenance
  • ineffective denial

NOC Results

  • Diabetes self -control: personal actions aimed at controlling diabetes mellitus and preventing the progression of the disease
  • Asthma self -control: personal actions to avoid or invest the inflammatory conditions that give rise to the appearance of bronchial oppressions of the respiratory tract
  • Self -care: Non -parenteral medication: Ability to administer oral or topical medicines to meet the therapeutic objectives independently, with or without help mechanisms
  • Self -care: parenteral medication: Ability to administer parental medications to meet the therapeutic objectives independently, with or without help mechanisms
  • Automanejo of heart disease: personal actions to handle heart disease and avoid its progress
  • Automanejo of multiple sclerosis: personal actions to handle multiple sclerosis and prevent the progression of the disease
  • Behavior to the cessation of smoking: personal actions to stop consuming tobacco
  • Behavior to cessation in alcohol abuse: personal actions to eliminate alcohol consumption that represents a health risk
  • Behavior to cessation in drug abuse: personal actions to eliminate drug use that represents a health risk
  • Compliance behavior: personal actions aimed at achieving levels
  • Optimal well -being, recovery and rehabilitation, recommended by a health professional
  • Compliance behavior: prescribed diet: personal actions to ingest food and liquids recommended by a health professional for a specific health condition
  • Compliance behavior: prescribed medication: personal actions to administer medications safely to meet the therapeutic objectives according to the recommendations of a health professional
  • Behavior to promote postpartum maternal health: personal actions aimed at improving the health of a mother during the period after the birth of a child
  • Behavior to promote prenatal health: personal actions aimed at promoting health in pregnancy and newborn
  • Therapeutic behavior: disease or injury: personal actions to mitigate or eliminate a pathology
  • Seizure control: personal actions to reduce the presence of convulsive episodes
  • Symptom control: personal actions to minimize adverse changes perceived in physical and emotional functioning
  • Beliefs on health: Control perception: Personal certainty that a health result can be influenced
  • Elimination of systemic toxins: dialysis: elimination of body toxins by means of peritoneal dialysis or hemodialysis
  • Blood glucose level: Degree to which plasma and urine glucose levels remain within normal limits
  • Participation in health care decisions: personal participation in the choice and evaluation of health care alternatives to achieve the desired result
  • Answer to medication: Therapeutic and adverse effects of prescribed medications RV .R

Evaluation objectives and criteria

  • Demonstrates compliance behavior, as manifested by the following indicators (specify from 1 to 5: never, sometimes, sometimes, often or usually):
  • Perform the treatment regime as prescribed
  • Watch the response to treatment
  • Perform selfvigilance if it is told how to do it
  • Performs the activities of everyday life as prescribed
  • Other examples

    • Change or modify the health regime as indicated by the health professional
    • Report the control of symptoms
    • Watch the risk factors of personal behavior

    NIC Interventions

    • Support in decision making: Provision of information and support to a patient who is making a decision regarding his health
    • Support for personal change: reinforcement of self -directed change, initiated by the patient to achieve personal importance objectives
    • Support for smoking cessation: helps another person to stop smoking
    • Nutrition advice: use of an interactive aid process that focuses on the need to modify the diet
    • Psychological advice: use of an interactive process of help focused on the needs, problems or feelings of the patient and their loved ones, to improve or strengthen the coping, solution of problems and interpersonal relationships
    • Help in self -care: Help another to carry out the activities of daily life
    • postpartum care: surveillance and management of the patient that has recently given birth
    • Prenatal care: patient control and management during pregnancy to avoid complications and favor a healthy result for both the mother and the baby
    • Teaching: prescribed activity/exercise: preparation of a patient to achieve or maintain a prescribed level of activity
    • Teaching: prescribed diet: Preparation of a patient to correctly follow a prescribed diet
    • Teaching: Psychomotor skill: Preparation of a patient to carry out a psychomotor skill
    • Teaching: Individual: Planning, application and evaluation of an educational program designed to address the specific needs of a patient
    • Teaching: prescribed medication: preparation of a patient to correctly take the prescribed medications and monitor their effects
    • Teaching: Procedure or treatment: Preparation of a patient to understand and prepare mentally to receive a prescribed procedure or treatment
    • Teaching: disease process: patient assistance to understand information related to a specific disease process
    • Facilitation of personal responsibility: impulse to the patient to assume greater responsibility of their own behavior
    • Laboratory data interpretation: Critical analysis of patient laboratory data to help make medical decisions
    • Medication management: facilitation of the safe and effective use of drugs with and without recipe
    • Asthma management: identification, treatment and prevention of reactions caused by inflammation or constriction of respiratory tract
    • Environment management: Security: Control and manipulation of the physical environment to favor security
    • Improvement of self -awareness: Help a patient to explore and understand their thoughts, feelings, motivations and behaviors
    • Improvement of self -efficacy: Strengthening of the individual’s confidence in their ability to exhibit healthy behavior
    • Orientation on the health system: facilitation to a patient of the location and use of adequate health services
    • Laboratory tests in bed: obtaining laboratory tests in bed or in the place where the patient is treated
    • Cognitive restructuring: I challenge a patient to modify their distorted thinking patterns and see yourself and the world in a more realistic way
    • Peritoneal dialysis therapy: administration and control of dialysis solution at the entrance and output of the peritoneal cavity
    • Hemodialysis therapy: Management of the extracorporal duct of the patient’s blood through a dialyzer
    • Treatment of substance consumption: patient care and care and family members, who suffer from physical and psychosocial problems related to alcohol or drug use

    Nursing Activities


    • Assess the level of understanding of the patient regarding the disease, complications and recommended treatments, to determine its knowledge deficit
    • Interview the patient and his family to determine the problem areas by integrating the treatment regime into their lifestyle
    • (NIC) Support for personal change:
      • Evaluate the patient’s reasons to want to change
      • Evaluate the current knowledge and the patient’s skill level with respect to the desired change
      • Evaluate the patient’s social and physical environment for the level of support of the desired behaviors

    Patient and family education

    • Identify essential treatments
    • Offer information about the specific community resources for patient health goals (for example, support groups)
    • Help the patient identify situational obstacles for compliance with the therapeutic regime
    • Provide information about the disease, complications and recommended treatments
    • (NIC) Support for personal change: teach the patient to move from continuous reinforcement to intermittent reinforcement

    Collaboration activities

    • Collaborate with other health providers to determine how to modify the therapeutic regime without jeopardizing the patient’s health


    • Help the patient develop realistic plans to comply with the therapeutic regime. The plan should include the following:
      • Identification of modifications or adaptations in daily life activities
      • Identification of support systems to achieve therapeutic goals
      • Identification of the actions that the patient and his family are willing to make (changes in the diet, modification of the exercise, changes in sleep patterns, schedules of medication and treatment, modification of sexual activity, changes in their roles)
    • Provide particular instruction and support to motivate the patient to comply with the treatment
    • (NIC) Support for personal change:
      • Help the patient identify a specific goal for change
      • Help the patient identify specific behaviors to change to achieve the desired objective
      • Examine with the patient possible obstacles to behavior change
      • Identify with the patient the most effective strategies for behavior change
      • Motivate the patient to identify reinforcers and important and adequate rewards
      • Promote the patient to trust more in self -refund than in the rewards of family members or nursing professional
      • Help the patient identify the circumstances or situations in which behavior appears (signs, triggers)
      • Explain to the patient the importance of highway to achieve a change in behavior

    At home

    • Previous activities can be used or adapted for use at home
    • Help the patient or family find a way to integrate the therapeutic regime into their daily life activities