Situated clinical reasoning: Distinguishing acute confusion from dementia in hospitalized older adults

Marianne McCarthy

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)90-101
Number of pages12
JournalResearch in Nursing and Health
Volume26
Issue number2
DOIs
StatePublished - Apr 1 2003

Keywords

  • Acute confusion
  • Aged
  • Clinical reasoning
  • Delirium
  • Dimensional analysis
  • Grounded theory

ASJC Scopus subject areas

  • Nursing(all)

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