Hege Mari Johnsen1, Åshild Slettebø2, Mariann Fossum2. 1. Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway. Electronic address: hege.mari.johnsen@uia.no. 2. Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
Abstract
BACKGROUND: The home healthcare context can be unpredictable and complex, and requires registered nurses with a high level of clinical reasoning skills and professional autonomy. Thus, additional knowledge about registered nurses' clinical reasoning performance during patient home care is required. OBJECTIVES: The aim of this study is to describe the cognitive processes and thinking strategies used by recently graduated registered nurses while caring for patients in home healthcare clinical practice. DESIGN: An exploratory qualitative think-aloud design with protocol analysis was used. SETTINGS: Home healthcare visits to patients with stroke, diabetes, and chronic obstructive pulmonary disease in seven healthcare districts in southern Norway. PARTICIPANTS: A purposeful sample of eight registered nurses with one year of experience. METHODS: Each nurse was interviewed using the concurrent think-aloud technique in three different patient home healthcare clinical practice visits. A total of 24 home healthcare visits occurred. Follow-up interviews were conducted with each participant. The think-aloud sessions were transcribed and analysed using three-step protocol analysis. RESULTS: Recently graduated registered nurses focused on both general nursing concepts and concepts specific to the domains required and tasks provided in home healthcare services as well as for different patient groups. Additionally, participants used several assertion types, cognitive processes, and thinking strategies. CONCLUSIONS: Our results showed that recently graduated registered nurses used both simple and complex cognitive processes involving both inductive and deductive reasoning. However, their reasoning was more reactive than proactive. The results may contribute to nursing practice in terms of developing effective nursing education programmes.
BACKGROUND: The home healthcare context can be unpredictable and complex, and requires registered nurses with a high level of clinical reasoning skills and professional autonomy. Thus, additional knowledge about registered nurses' clinical reasoning performance during patient home care is required. OBJECTIVES: The aim of this study is to describe the cognitive processes and thinking strategies used by recently graduated registered nurses while caring for patients in home healthcare clinical practice. DESIGN: An exploratory qualitative think-aloud design with protocol analysis was used. SETTINGS: Home healthcare visits to patients with stroke, diabetes, and chronic obstructive pulmonary disease in seven healthcare districts in southern Norway. PARTICIPANTS: A purposeful sample of eight registered nurses with one year of experience. METHODS: Each nurse was interviewed using the concurrent think-aloud technique in three different patient home healthcare clinical practice visits. A total of 24 home healthcare visits occurred. Follow-up interviews were conducted with each participant. The think-aloud sessions were transcribed and analysed using three-step protocol analysis. RESULTS: Recently graduated registered nurses focused on both general nursing concepts and concepts specific to the domains required and tasks provided in home healthcare services as well as for different patient groups. Additionally, participants used several assertion types, cognitive processes, and thinking strategies. CONCLUSIONS: Our results showed that recently graduated registered nurses used both simple and complex cognitive processes involving both inductive and deductive reasoning. However, their reasoning was more reactive than proactive. The results may contribute to nursing practice in terms of developing effective nursing education programmes.
Authors: Michael McGillion; Jennifer Yost; Andrew Turner; Duane Bender; Ted Scott; Sandra Carroll; Paul Ritvo; Elizabeth Peter; Andre Lamy; Gill Furze; Kirsten Krull; Valerie Dunlop; Amber Good; Nazari Dvirnik; Debbie Bedini; Frank Naus; Shirley Pettit; Shaunattonie Henry; Christine Probst; Joseph Mills; Elaine Gossage; Irene Travale; Janine Duquette; Christy Taberner; Sanjeev Bhavnani; James S Khan; David Cowan; Eric Romeril; John Lee; Tracey Colella; Manon Choinière; Jason Busse; Joel Katz; J Charles Victor; Jeffrey Hoch; Wanrudee Isaranuwatchai; Sharon Kaasalainen; Salima Ladak; Sheila O'Keefe-McCarthy; Monica Parry; Daniel I Sessler; Michael Stacey; Bonnie Stevens; Robyn Stremler; Lehana Thabane; Judy Watt-Watson; Richard Whitlock; Joy C MacDermid; Marit Leegaard; Robert McKelvie; Michael Hillmer; Lynn Cooper; Gavin Arthur; Krista Sider; Susan Oliver; Karen Boyajian; Mark Farrow; Chris Lawton; Darryl Gamble; Jake Walsh; Mark Field; Sandra LeFort; Wendy Clyne; Maria Ricupero; Laurie Poole; Karsten Russell-Wood; Michael Weber; Jolene McNeil; Robyn Alpert; Sarah Sharpe; Sue Bhella; David Mohajer; Sem Ponnambalam; Naeem Lakhani; Rabia Khan; Peter Liu; P J Devereaux Journal: JMIR Res Protoc Date: 2016-08-01