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护士对临床决策中不确定性的认知:一项定性研究。

Nurses' perception of uncertainty in clinical decision-making: A qualitative study.

作者信息

Mousavi Shabestari Mitra, Jabbarzadeh Tabrizi Faranak, Roshangar Fariborz, Ghahramanian Akram, Zamanzadeh Vahid, Sarbakhsh Parvin, Agom David A

机构信息

Department of Medical Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.

Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Heliyon. 2024 Aug 14;10(16):e36228. doi: 10.1016/j.heliyon.2024.e36228. eCollection 2024 Aug 30.

Abstract

BACKGROUND

Uncertainty is a common challenge for nurses in clinical decision-making, which can compromise patient care quality and safety. To address this issue, it is essential to understand how nurses perceive and cope with uncertainty in their practice.

AIM

This study aimed to explore nurses' perceptions of uncertainty in clinical decision-making using a qualitative approach.

METHODS

This study was conducted with a qualitative approach and conventional content analysis in 2020. Participants consisted of 17 nurses from different wards of teaching hospitals in Northwestern Iran, recruited using the purposive sampling method. Data were collected through semi-structured interviews and analyzed simultaneously with data collection (June to December 2020). The data were analyzed using the content analysis approach suggested by Wildemuth. Data were managed with MAXQDA10 software. The analysis revealed four main themes and ten subthemes that described the nurses' experiences of uncertainty in clinical decision-making.

RESULTS

The main themes were: difficult choice, difficult situation, insufficient judgment, and emotional burden.

CONCLUSIONS

The study participants defined uncertainty in clinical decision-making as a difficult choice that occurs in difficult situations, which influenced their clinical judgment and emotional well-being. These findings provide valuable insights for developing interventions to help nurses manage uncertainty and improve their decision-making skills and safety.

摘要

背景

不确定性是护士临床决策中常见的挑战,这可能会损害患者护理质量和安全。为解决这一问题,了解护士在实践中如何感知和应对不确定性至关重要。

目的

本研究旨在采用定性方法探讨护士对临床决策中不确定性的认知。

方法

本研究于2020年采用定性方法和传统内容分析法进行。参与者包括来自伊朗西北部教学医院不同病房的17名护士,采用目的抽样法招募。通过半结构化访谈收集数据,并在数据收集过程中(2020年6月至12月)同时进行分析。使用Wildemuth建议的内容分析方法对数据进行分析。数据使用MAXQDA10软件进行管理。分析揭示了四个主要主题和十个子主题,描述了护士在临床决策中对不确定性的体验。

结果

主要主题为:艰难抉择、困境、判断不足和情感负担。

结论

研究参与者将临床决策中的不确定性定义为在困境中出现的艰难抉择,这影响了他们的临床判断和情绪健康。这些发现为制定干预措施提供了有价值的见解,以帮助护士应对不确定性,提高他们的决策技能和安全性。

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本文引用的文献

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Navigating Uncertainty in Clinical Practice: A Structured Approach.临床实践中的不确定性应对:一种结构化方法。
J Gen Intern Med. 2024 Apr;39(5):829-836. doi: 10.1007/s11606-023-08596-4. Epub 2024 Jan 29.
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Future Challenges of Nursing in Health System of Iran.伊朗卫生系统中护理的未来挑战。
Front Public Health. 2021 Jul 23;9:676160. doi: 10.3389/fpubh.2021.676160. eCollection 2021.

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