Journal
RESEARCH IN NURSING & HEALTH
Volume 26, Issue 2, Pages 90-101Publisher
WILEY
DOI: 10.1002/nur.10079
Keywords
clinical reasoning; delirium; acute confusion; aged; grounded theory; dimensional analysis
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In this study a dimensional analysis approach was used to explore the clinical reasoning of nurses who care for hospitalized older adults to identify factors that might explain their failure to detect acute confusion and to distinguish it from dementia in this patient population. Data analysis yielded a grounded theory of situated clinical reasoning, which proposes that the ability of nurses to identify acute confusion varies widely. This variation can be attributed to the differences in nurses' philosophical perspectives on aging. According to this theory, three distinct Perspectives are unwittingly embraced by nurses who care for older patients. These perspectives influence how nurses characterize aging and the aged and condition the ways in which they judge and ultimately deal with older adults in clinical situations. (C) 2003 Wiley Periodicals, Inc.
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