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Situated clinical reasoning: Distinguishing acute confusion from dementia in hospitalized older adults
Author(s) -
McCarthy Marianne
Publication year - 2003
Publication title -
research in nursing and health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.836
H-Index - 85
eISSN - 1098-240X
pISSN - 0160-6891
DOI - 10.1002/nur.10079
Subject(s) - confusion , dementia , situated , acute care , psychology , medicine , population , nursing , gerontology , health care , disease , artificial intelligence , computer science , psychoanalysis , economics , economic growth , environmental health , pathology
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. © 2003 Wiley Periodicals, Inc. Res Nurs Health 26:90–101, 2003