Original ArticlesDeveloping an instrument to measure and describe clinical decision making in different nursing fields*
Section snippets
Decision-making theories
Most of the research in nursing science is based on either analytical decision-making theory (Aspinall, 1979; Baumann & Bourbonnais, 1982; Grier, 1976; Lauri, 1981) or information-processing theory (Corcoran, 1986; Hannah, Reimer, Mill, & Letourneau, 1987; Holzemer, 1986; Lauri, 1992; Tanner et al., 1987). In analytic decision-making theory, human decision-making proceeds in accordance with a certain systematic process, and the decision can be reached by analysis of the situation.
Instrument
The instrument of this study was developed on the basis of analytical, information-processing, and intuitive decision-making theories as well as Hammond's Cognitive Continuum Theory (1996a), the Dreyfus' theory about the change of cognition from analysis to intuition (1986), and earlier studies on nursing decision-making (Lauri & Salanterä, 1994a, Lauri & Salanterä, 1994b, Lauri & Salanterä, 1995, Lauri & Salanterä, 1998). Based on an extensive research literature, the structure of the
Validity of the instrument
The psychometric properties of the instrument were assessed in the pilot study by a convenience sample (n = 200) consisting of 100 nurses from one Finnish central university hospital, and 100 nurses who worked in preventive health care in three Finnish community health centers. The rotated factor analysis was calculated for all 56 items to evaluate the content of the items. It was conducted with a maximum likelihood solution, and the factors were orthogonally rotated with Varimax rotation
Discussion
The instrument development reported in this study is based on extensive analyses of the literature on human decision making as well as earlier nursing research into decision-making processes. The content validity of the instrument may be described as good because the factor analyses yielded similar factors for different data sets. This indicates that nurses from different countries and working in different areas of nursing respond similarly to the instrument items. The instrument's
References (61)
- et al.
Categorisation of patient's medical condition—an analysis of nursing judgement
International Journal of Nursing Studies
(1995) - et al.
Domain-specific knowledge and task characteristics in decision-making
Organizational Behavior and Human Decision Processes
(1995) A research tool for measuring perceptions of clinical decision-making
Journal of Professional Nursing
(1985)- et al.
Decision making of nurses practicing in intensive care in Canada, Finland, Northern Ireland, Switzerland and the United States
Heart & Lung
(1998) - et al.
Decision-making of psychiatric nurses in Finland, Northern Ireland, and the United States
Journal of Professional Nursing
(1999) - et al.
The role of decision analysis in informed consent: Choosing between intuition and systematicity
Social Science Medicine
(1997) - et al.
Decision-making and pediatric pain: A review
Journal of Advanced Nursing
(1997) A cognitive theory of judgement and decisions
Use of a decision tree to improve accuracy of diagnosis
Nursing Research
(1979)- et al.
Nursing decision-making in critical care areas
Journal of Advanced Nursing,
(1982)
The limits of decision-making analysis for rapid decision making in ICU nursing
Image: Journal of Nursing Scholarship
From novice to expert: Power and excellence in nursing practice
How expert nurses use intuition
American Journal of Nursing
Expertise in nursing practice: Caring, ethics and clinical judgement
Critical care nurses' decision-making activities in natural clinical setting
Journal of Clinical Nursing
The relationship between clinical decision-making skills in nursing and general critical thinking abilities of senior nursing students in four types of nursing programs
Critical Thinking
Diagnostic reasoning and treatment decision-making in nursing
Diagnostic reasoning and treatment decision-making in nursing
Quality of decision-making by registered nurses
Journal of Nursing Staff Development
Nurses' perceptions of their problem-solving ability
Journal of Advanced Nursing
Judgement analysis. Theory, methods and applications
Task complexity and nursing expertise as factors in decision making
Nursing Research
What computers can't do: The limits of artificial intelligence
Mind over machine
Intuition and rational decision-making in professional thinking: A false dichotomy
Journal of Advanced Nursing
Medical problem solving
Evaluation & The Health Professions
Use of the Watson-Glaser critical thinking appraisal with BSN students
Nursing Health Care Perspective
Graduate nurses: Critical thinkers or better decision makers?
Journal of Advanced Nursing
The development and testing of the nursing performance simulation instrument
Decision-making about patient care
Nursing Research
Cited by (0)
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Address correspondence and reprint requests to Dr. Sirkka Lauri: Department of Nursing Science, 20014 University of Turku, Finland. E-mail: [email protected]