School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Canberra, Australia.
Clare Holland House, North Canberra Hospital, Bruce, Canberra, Australia.
J Clin Nurs. 2023 Dec;32(23-24):7979-7995. doi: 10.1111/jocn.16893. Epub 2023 Oct 15.
To explore how the Cognitive Continuum Theory has been used in qualitative nursing research and to what extent it has been integrated in the research process using the Qualitative Network for Theory Use and Methodology (QUANTUM).
Theory, research and nursing are intrinsically linked, as are decision-making and nursing practice. With increasing pressure on nurses to improve patient outcomes, systematic knowledge regarding decision-making is critical and urgent.
A meta-aggregative systematic review.
DATABASES: CINAHL, Medline, PsycINFO, Embase and PubMed were searched from inception until May 2022 for peer-reviewed research published in English. Seven studies were included and assessed for methodological quality using the Joanna Briggs Institute checklist for qualitative research. A meta-aggregative synthesis was conducted using Joanna Briggs methodology. The QUANTUM typology was used to evaluate the visibility of the Cognitive Continuum Theory in the research process.
The review identified five synthesised findings, namely: 1. the decision-making capacity of the individual nurse, 2. nurses' level of experience, 3. availability of decision support tools, 4. the availability of resources and 5. access to senior staff and peers. Only two of seven studies rigorously applied the theory. The included studies were mainly descriptive-exploratory in nature.
The transferability of the Cognitive Continuum Theory was demonstrated; however, evolution or critique was absent. A gap in the provision of a patient-centric approach to decision-making was identified. Education, support and research is needed to assist decision-making. A new Person-Centred Nursing Model of the Cognitive Continuum Theory has been proposed to guide future research in clinical decision-making.
Nurses make numerous decisions every day that directly impact patient care, therefore development and testing of new theories, modification and revision of older theories to reflect advances in knowledge and technology in contemporary health care are essential.
探索认知连续体理论在定性护理研究中的应用，以及使用定性理论应用与方法学网络（QUANTUM）在研究过程中对其进行整合的程度。
理论、研究和护理本质上是相互关联的，决策和护理实践也是如此。随着对护士提高患者治疗效果的要求不断增加，系统地了解决策过程至关重要且刻不容缓。
元聚合系统评价。
数据库：从创建到 2022 年 5 月，在 CINAHL、Medline、PsycINFO、Embase 和 PubMed 上搜索同行评审的英文出版的研究论文。纳入并使用 Joanna Briggs 研究所定性研究清单评估 7 项研究的方法学质量。使用 Joanna Briggs 方法进行元聚合综合。使用 QUANTUM 分类法评估认知连续体理论在研究过程中的可见度。
该综述确定了 5 个综合发现，即：1. 个体护士的决策能力；2. 护士的经验水平；3. 决策支持工具的可用性；4. 资源的可用性；5. 获得高级工作人员和同行的机会。在 7 项研究中，只有 2 项严格应用了该理论。纳入的研究主要是描述性-探索性的。
证明了认知连续体理论的可转移性；然而，却缺乏其进化或批判。确定了在提供以患者为中心的决策方法方面存在差距。需要教育、支持和研究来协助决策。提出了一种新的以人（Person）为中心的认知连续体理论护理模型，以指导未来的临床决策研究。
护士每天都会做出许多直接影响患者护理的决策，因此，开发和测试新理论，以及修改和修订旧理论以反映当代医疗保健中知识和技术的进步，是至关重要的。
