Diagnostic frameworks and nursing diagnoses: a normative stance

Abstract

Diagnostic frameworks are essential to many scientific and technological activities and clinical practice. This study examines the main fundamental aspects of such frameworks. The three components required for all diagnoses are identified and examined, i.e. their normative dimension, temporal nature and structure, and teleological perspective. The normative dimension of a diagnosis is based on (1) epistemic values when associated with Hempel's inductive risk concerning the balance between false-positive and false-negative outcomes, leading to probabilistic judgements; and (2) non-epistemic values when related to ideas such as well-being, normality, illness, etc, as idealized norms or ideal points of reference. It should be noted that medical diagnoses match the three necessary components, while some essential diagnostic frameworks - the taxonomies of Gordon and NANDA - in nursing lack some components. The main lack is normative as the most popular frameworks in nursing diagnosis seem to be descriptions of observed reality rather than normative and value-based judgements in which both epistemic and non-epistemic values may coexist.