Bjørk Ida Torunn, Hamilton Glenys A
Department of Nursing Science, University of Oslo, Postboks 1153, Blindern, 0318 Oslo, Norway.
Nurs Res Pract. 2011;2011:524918. doi: 10.1155/2011/524918. Epub 2011 Sep 28.
This study analyzed nurses' perceptions of clinical decision making (CDM) in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies, t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.
本研究分析了护士在临床实践中对临床决策(CDM)的认知,并比较了与护士人口统计学和环境变量相关的决策差异。对挪威四家医院的2095名护士进行了横断面调查。使用基于认知连续体理论的24项护理决策工具,以探究护士在首次接诊择期手术患者时如何看待他们的临床决策。数据采用描述性频率、t检验、卡方检验和线性回归进行分析。护士的决策被分为分析-系统型、直觉-解释型和准理性型临床决策模型。大多数护士报告在临床决策过程中使用准理性模型,从而支持了认知通常包含分析和直觉属性这一原则。临床决策中直觉-解释型模型使用的增加与当前工作年限、继续教育、男性、较高年龄以及主要在外科科室工作有关。