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PURPOSE. To propose a new NANDA diagnosis, self-neglect.
DATA SOURCES. Research studies and literature published from a variety of disciplines including nursing as well as primary research.
DATA SYNTHESES. This diagnosis can be used to describe a constellation of self-care problems of varying severity and impact on the health and well-being of people who self-neglect. Included are two subtypes of self-neglect based on the degree of intentionality. Clarification of self-neglect is long overdue because self-neglect presents conceptual, identification, and intervention problems for nurses, healthcare workers, and for medicolegal systems across settings and in many countries.
CONCLUSION. The proposed diagnosis, self-neglect, fills a gap in current standardized terminology. This diagnosis will contribute significantly to nurses leading the way in the explication of an interdisciplinary and international health concern.
PRACTICE AND POLICY IMPLICATIONS. Developing self-neglect as a recognized nursing label is vital to clinicians and policy makers within and across countries. Appreciating less serious/non-life-threatening presentations will give nurses a care perspective to improve the health and well-being of those in earlier stages of self-neglect. Definitions for this phenomenon will contribute to care planning and interventions, leading to consistency in practice and research.
Currently, there is no NANDA self-neglect nursing diagnosis for application to practice, policy formation, and research. Self-neglect presents conceptual, identification, and intervention problems for nurses, healthcare workers and for medicolegal systems in many countries. The term self-neglect itself may be seen by nurses as pejorative and judgmental but nevertheless it is the main term used in health, social, and legal services to characterize certain types of patients. In Australia and Europe self-neglect is primarily viewed as a medical psychiatric syndrome and is thought to be causally linked to an underlying mental illness (Lauder, Anderson, & Barclay, 2002). In the United States, elder self-neglect is conflated with elder abuse and elder neglect, and self-neglecters are often described in terms of "victimhood," where, for the most part, only the most vulnerable and frailest adults are being recognized as self-neglecting (O'Brien, Thibault, Turner, & Laird-Fick, 1999). Abuse, seen from a perspective of power and control, is a criminal matter, whereas selfneglect is a crisis in caregiving and a health and social concern (Fulmer, Paveza, & Guadagno, 2002).
Despite these differences, there is a large measure of international...