Work in the development of nursing diagnoses has been significant in establishing certain signs or cues necessary in patient assessment and care plan development. However, no set or cluster of cues has been specifically identified that describe the nursing diagnosis of altered body image. Because of the difficult nature of defining self and body image, this preliminary study was a beginning attempt to clarify this topic for nursing practice. This pattern of human responses does not lend itself easily to pure research forms. Therefore, a qualitative, descriptive methodology was utilized in order to identify a route for a future, quantitative research approach. An assessment tool is needed that will aid nurses in arriving at this nursing diagnosis. A nursing body image assessment tool (BBIAT) was developed and tested on 10 immobilized patients. These 10 patients were assessed by five Staff nurses and three expert nurses by utilizing the tool. An attempt to begin preliminary validation of the tool was done by the investigator, who was established as the standard of correctness, using another equivalent form involving oral, audiotaped patient interviews. Data from the staff and expert nurse sources were compared for inter-rater reliability. Tool evaluation revealed a useable format as well as strong agreement among all nurses on 6 out of 11 questions. Formal statistical reliability and validity testing of the tool is indicated as the next step in tool development. Further nursing research to clarify patient cues for the nursing diagnosis of alteration in body image is recommended. Possible nursing interventions pertinent to this diagnosis are also discussed.