Knowledge Utilization Studies Program, Faculty of Nursing, University of Alberta, Alberta Canada.
Worldviews Evid Based Nurs. 2012 Aug;9(3):149-58. doi: 10.1111/j.1741-6787.2011.00237.x. Epub 2012 Jan 10.
There has been little research to date exploring nurses' uncertainty in their practice. Understanding nurses' uncertainty is important because it has potential implications for how care is delivered.
The purpose of this study is to develop a substantive theory to explain how staff nurses experience and respond to uncertainty in their practice.
Between 2006 and 2008, a grounded theory study was conducted that included in-depth semi-structured interviews. Fourteen staff nurses working in adult medical-surgical intensive care units at two teaching hospitals in Ontario, Canada, participated in the study.
The theory recognizing and responding to uncertainty characterizes the processes through which nurses' uncertainty manifested and how it was managed. Recognizing uncertainty involved the processes of assessing, reflecting, questioning, and/or being unable to predict aspects of the patient situation. Nurses' responses to uncertainty highlighted the cognitive-affective strategies used to manage uncertainty.
Study findings highlight the importance of acknowledging uncertainty and having collegial support to manage uncertainty. The theory adds to our understanding the processes involved in recognizing uncertainty, strategies and outcomes of managing uncertainty, and influencing factors.
Tailored nursing education programs should be developed to assist nurses in developing skills in articulating and managing their uncertainty. Further research is needed to extend, test and refine the theory of recognizing and responding to uncertainty to develop strategies for managing uncertainty.
This theory advances the nursing perspective of uncertainty in clinical practice. The theory is relevant to nurses who are faced with uncertainty and complex clinical decisions, to managers who support nurses in their clinical decision-making, and to researchers who investigate ways to improve decision-making and care delivery.
迄今为止，针对护士在实践中所面临的不确定性的研究甚少。理解护士的不确定性很重要，因为这可能对护理服务的提供方式产生影响。
本研究旨在构建一个实质性理论，用以解释在职护士如何体验并应对实践中的不确定性。
2006 年至 2008 年间，开展了一项扎根理论研究，包括深入的半结构化访谈。来自加拿大安大略省两家教学医院成人内科重症监护病房的 14 名在职护士参与了此项研究。
“识别和应对不确定性”理论描述了护士的不确定性表现出来的过程以及管理不确定性的方式。识别不确定性包括评估、反思、质疑和/或无法预测患者病情的各个方面。护士应对不确定性的策略突出了用于管理不确定性的认知-情感策略。
研究结果强调了承认不确定性和获得同事支持以管理不确定性的重要性。该理论增加了我们对识别不确定性、管理不确定性的策略和结果以及影响因素的理解。
应制定有针对性的护理教育计划，以帮助护士发展阐明和管理其不确定性的技能。需要进一步研究以扩展、检验和完善识别和应对不确定性的理论，从而制定管理不确定性的策略。
该理论拓展了护理实践中不确定性的视角。该理论与面临不确定性和复杂临床决策的护士、支持护士进行临床决策的管理人员以及研究如何改进决策和护理服务提供的研究人员相关。
