BACKGROUND: This paper reports a study about the effect of knowledge sources, such as handbooks, an assessment format and a predefined record structure for diagnostic documentation, as well as the influence of knowledge, disposition toward critical thinking and reasoning skills, on the accuracy of nursing diagnoses.Knowledge sources can support nurses in deriving diagnoses. A nurse's disposition toward critical thinking and reasoning skills is also thought to influence the accuracy of his or her nursing diagnoses.METHOD: A randomised factorial design was used in 2008-2009 to determine the effect of knowledge sources. We used the following instruments to assess the influence of ready knowledge, disposition, and reasoning skills on the accuracy of diagnoses: (1) a knowledge inventory, (2) the California Critical Thinking Disposition Inventory, and (3) the Health Science Reasoning Test. Nurses (n = 249) were randomly assigned to one of four factorial groups, and were instructed to derive diagnoses based on an assessment interview with a simulated patient/actor.RESULTS: The use of a predefined record structure resulted in a significantly higher accuracy of nursing diagnoses. A regression analysis reveals that almost half of the variance in the accuracy of diagnoses is explained by the use of a predefined record structure, a nurse's age and the reasoning skills of `deduction' and `analysis'.CONCLUSIONS: Improving nurses' dispositions toward critical thinking and reasoning skills, and the use of a predefined record structure, improves accuracy of nursing diagnoses.
A first episode of psychosis (FEP) is a stressful, often life-changing experience. Scarce information is available about personal preferences regarding their care needs during and after a FEP. Whereas a more thorough understanding of these preferences is essential to aid shared decision-making during treatment and improve treatment satisfaction. Methods: Face-to-face interviews with participants in remission of a FEP were setup, addressing personal preferences and needs for care during and after a FEP. The interviews were conducted by a female and a male researcher, the latter being an expert with lived experience. Results: Twenty individuals in remission of a FEP were interviewed, of which 16 had been hospitalized. The distinguished themes based on personal preferences were tranquility, peace and quietness, information, being understood, support from significant others, and practical guidance in rebuilding one's life. Our findings revealed that the need for information and the need to be heard were often not sufficiently met. For 16/20 participants, the tranquility of inpatient treatment of the FEP was pre-dominantly perceived as a welcome safe haven. The presence and support of family and close friends were mentioned as an important factor in the process of achieving remission.
MULTIFILE
Visually impaired people (VIP) can experience difficulties in navigating urban environments. They mostly depend on the environment’s infrastructure or technical solutions like smartphone apps for navigation. However apps typically use visual and audio feedback, which can be ineffective, distracting and dangerous. Haptic feedback in the form of vibrations can complement where visual and audio fall short, reducing the cognitive load.Existing research into wayfinding using haptic feedback to better support navigation for the visually impaired often relies on custom tactile actuators and the use of multiple vibration motors. Although these solutions can be effective, they are often impractical in every day life or are stigmatizing due to their unusual appearance.To address this issue we propose a more modular system that can be easily integrated in commercially available smartwatches. Based on existing research we present a tactile communication method utilizing the vibrotactile actuator of a smartwatch to provide VIP with wayfinding information that complements visual and audio feedback. Current smartwatches contain a single tactile actuator, but can still be used by focusing on navigation patterns. These patterns are based on research in personal orientation and mobility training with VIP. For example, a vibration pattern is used to represent a concept like ‘attention’, ‘left’ or ‘stairs’ directing the navigator’s attention towards audio or visual information or to the environment.In next phase of this research we will conduct several focus groups and co-creation sessions with VIP and orientation and mobility experts to further specify the requirements and test our proposed tactile method. In the future, this method could be integrated in existing navigation apps using commercially available devices to complement visual and audio information and provide VIP with additional wayfinding information via haptic feedback.
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