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首页> 外文期刊>Journal of continuing education in nursing >Mixed-methods approach to understanding nurses' clinical reasoning in recognizing delirium in hospitalized older adults
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Mixed-methods approach to understanding nurses' clinical reasoning in recognizing delirium in hospitalized older adults

机译：混合方法理解护士在住院老年人del妄中的临床推理

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摘要

A mixed-methods study was conducted to enhance understanding of nurses' clinical reasoning in recognizing delirium in the hospitalized older adult. Paired nurse and researcher ratings of the confusion assessment method in 103 medical-surgical patients were analyzed to determine the rate of agreement in detecting delirium and to identify a purposive sample of nurses to be interviewed about the patients with delirium who were under their care. Nurses' clinical reasoning in recognizing and underrecognizing delirium was investigated using semistructured interviews. The incidence of delirium was 13%, with poor agreement (95% CI [0.05, 0.64], p < 0.05) between the researchers and the nurses in detecting delirium. Sixteen nurses were interviewed and transcripts were analyzed with grounded theory. Confusion was the primary causal factor for recognizing symptoms of delirium. The findings explicated a framework that forms the basis for generating testable assumptions to improve nurses' recognition of delirium.
机译：进行了一项混合方法研究，以加深对住院老年人识别del妄的护士临床推理的理解。对103名外科手术患者的混淆评估方法的配对护士和研究人员评级进行了分析，以确定detecting妄检测的符合率，并确定要接受采访的a妄护理样本。使用半结构式访谈调查了护士在and妄认识和认识不足方面的临床推理。 ir妄的发生率为13％，研究人员与护士在检测del妄方面的一致性较差（95％CI [0.05，0.64]，p <0.05）。采访了16名护士，并以扎根理论对笔录进行了分析。混乱是识别del妄症状的主要原因。研究结果阐明了一个框架，该框架构成了产生可检验的假设以提高护士对del妄的认识的基础。

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