Purpose: Malnutrition rates are high in hospitals and in nursing homes and nurses are in a key position to impact this problem, but little experimental work has been done on what factors influence nurse judgments and decisions about patient nutrition. The purpose of this study was to examine 11 clinical and socio-demographic patient variables for their predictability in identifying similarities and differences in nurses’ approaches to assessing, screening and referring for nutritional problems.
Framework: A social judgment model, which explains how two or more people can reach differing conclusions with the same data, was used to frame the study.
Subjects: Third-year nursing students and post-RNs students (N=166) at 3 universities in the United States, Northern Ireland, and Scotland completed the study.
Method: This experimental design used factorial surveys. This method combines elements of a classic experimental design with survey research and allows researchers to examine variables that are impossible to disentangle in non-experimental designs. Subjects scored a unique set of 6 randomly generated vignettes in which 11 patient variables were examined for their effect on decisions.
Results: Analysis of data, using ordinary least squares regression, determined that over 20% of the variance in each of the 3 dependent variables were explained by 7 of the independent variables. By far the greatest explained variance came from the patient self-report of amount of food eaten in their last meals and, significantly less from objectives measures, i.e., weight and height, hemoglobin and state of hydration.
Conclusions: In this study nurses used primarily subjective information about food intake for decisions. This over reliance on subjective data warrants further investigation on nurses’ knowledge and use of nutrition information especially related to objective clinical data and on the prevalence of using nutrition screening tools.
Session #1198 - Decision Making
The 29th Annual MNRS Research Conference (April 1-4, 2005)