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Letter to the Editor
Methodological bases, taxonomy and critical thinking
Bases metodológicas, taxonomía y pensamiento crítico
A.R. Alconero-Camareroa,
Corresponding author
alconear@unican.es

Corresponding author.
, M.I. Ibáñez-Rementeríab
a Ciencias de la Salud, Departamento de enfermería, Facultad de Enfermería Casa de Salud Valdecilla, Universidad de Cantabria, Santander, Cantabria, Spain
b Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
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I do not believe that doctors will identify diagnoses without considering the exact and specific cause of these problems&#44; since they will have to act on it to solve the problem&#46; Causes are not a matter of indifference&#59; it is important to pinpoint exactly the right one&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Returning to the case at hand&#44; methodologically we could opt for a focused assessment &#40;FA&#41; in the areas that have to be monitored more closely due to the disease&#8217;s impact&#44; avoiding irrelevant assessment&#46; Important data on his hypothyroidism and how it affects his clinical condition are omitted&#44; as well as information on the patient&#39;s conception and management of the disease&#46; We find it strange that&#44; as a professional colleague diagnosed 20 years ago with MD&#44; he does not understand his disease process and does not know how to live with it&#44; since he does incompatible physical exercises&#44; which is something he should be aware of to avoid complications&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">According to Carpenito-Moyet<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> none of the nursing diagnoses &#40;ND&#41; presented in the case<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> are such&#46; The ND cannot be related to medical problems since the nurse has no autonomy to solve them without the corresponding authorisation of a physician to apply the prescribed treatments and techniques &#40;what level of autonomy does a nurse have to palliate pain of this nature or how can they solve acute renal failure if not with the help of fluid therapy and drugs prescribed by another professional&#63;&#41; Therefore&#44; based on scientific evidence&#44; these are all collaborative or interdependent problems&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">There are several explanations for this&#58; one&#44; the NANDA taxonomy<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> contains certain labels for diagnostic concepts that can lead to imprecise use&#44; without an FA that can differentiate it from a symptom&#44; medical problem or medical treatment&#46; Two&#44; nurses in advanced clinical practice in other countries where the taxonomy is implemented have different competencies to diagnose and treat health problems to those of other nurses in our country&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and therefore not all diagnoses are feasible for any nurse in any context&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A possible ND in the patient with this chronic disease is in <span class="elsevierStyleItalic">Readiness for advanced health management &#40;ineffective management of own health &#40;</span>00162<span class="elsevierStyleItalic">&#41;</span><a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#59; despite being a nurse&#44; it is not at all clear what level of control he has over his disease&#44; since nothing has been recorded in this respect&#46; In addition&#44; certain needs will have to be met due to his acute situation&#44; in which we sense that the doctor will have prescribed rest and he will have no autonomy in this&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">On reflection&#44; the methodological bases come first and then all the existing classifications or taxonomies&#44; but all of this must be linked to critical thinking and guided by knowledge and&#44; of course&#44; by common sense&#46; An ND is a clinical judgement&#44; i&#46;e&#46;&#44; a complex mental process that goes beyond simply stating a disorder that we observe in the patient&#47;client&#46;</p></span>"
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