NURSES' CLINICAL JUDGMENTS ABOUT DIABETIC PATIENTS: AN INVESTIGATION OF COMPETING MODELS OF CLINICAL JUDGMENT (HEALTH COMPLIANCE).
Contributors: State University of New York at Albany.
Published: 1984
Number of pages: 141
Subjects: Psychology, Clinical.
Description: Nurses make important clinical judgments about patients which influence the quality of health care. Previous research related to patient compliance and quality of health care has described relationships between patient characteristics, compliance, and behaviors of nurses. This descriptive research supports the use of a clinical judgment process in which final evaluations are based soley on observational data about the patient. Cognitive theorists, on the other hand, suggest that the clinical judgment process involves intervening stages in the cognitive processing of information by the nurse that may mediate between patient data and clinical judgments.

In the present study the clinical judgment process was conceptualized as a form of information processing and four competing theoretical models of clinical judgment were examined as a means of investigating the relationship between patient data, nurses' status and causal inferences, and clinical predictions related to diabetic patients who differed in their compliance with the medical regimen. Subjects were presented with case histories containing three pieces of patient data (age, level of compliance with a diabetic regimen, and severity of illness) and asked to make an inference about the patient's level of functioning, to make a causal attribution about the patient's behavior, and to make a clinical prediction and a clinical evaluation about each hypothetical patient. Path analytic procedures were used in testing the efficacy of the theoretical models in accounting for variance in the clinical judgment process.

Results of the study suggested that when making a prediction about diabetic patients' future behavior, nurses used a non-mediated linear model of clinical judgment in which the patients' age was the greatest predictor and status and causal inferences had no direct influence on predictions. When evaluating diabetic patients, nurses used a stagewise cognitive mediated model of clinical judgment in which causal attributions had a direct impact on evaluation.
Notes: Source: Dissertation Abstracts International, Volume: 45-01, Section: B, page: 0345.

Thesis (PH.D.)--STATE UNIVERSITY OF NEW YORK AT ALBANY, 1984.

School code: 0668.