부산대학교 도서관

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1741-6787.2008.00138.x Byline: Lisa Cranley (1), Diane M. Doran (1), Ann E. Tourangeau (1), Andre Kushniruk (1), Lynn Nagle (1) Keywords: nurses; uncertainty; decision-making; information seeking; literature review Abstract: ABSTRACT Aim: This paper is a report of the results of a review of the literature conducted with the goal of determining how nurses' clinical uncertainty has been conceptualized in the nursing literature. Background: Although existing research has advanced the body of knowledge regarding the concept of uncertainty in decision-making, this has been largely from physicians' viewpoints and from patients' perspectives (patients' uncertainty). Understanding how nurses' experience and act on uncertainty remains relatively unreported. Method: A search of Medline, CINAHL, and PubMed databases was conducted to retrieve literature published from 1990 to 2007. The question guiding the literature review was: How has nurses' clinical uncertainty been conceptualized in nursing literature? Findings: Little exploration has been done of nurses' experience of uncertainty in practice. Many investigators have not theorized about the uncertainty in their studies, but have described nurses' uncertainty in the context of clinical decision-making. The findings from these studies indicated that unfamiliarity with the aspects of patient care is a source of uncertainty, and nurses tended to rely on heuristics or on the expertise of colleagues as sources of information for practice decisions. Expressing uncertainties as information needs might help guide information seeking and reduce uncertainty. However, studies indicated that nurses have difficulty recognizing or expressing uncertainties, and as a result, information needs are not recognized and information seeking is not initiated. Conclusions: A more comprehensive understanding of nurses' uncertainty could lead to the development and implementation of strategies to support nurses in their clinical decision-making and practice. Descriptions are needed about how nurses experience and respond to uncertainty in their practice, and the influence of uncertainty on their information needs and information seeking. Author Affiliation: (1)Lisa Cranley,RN, MN, Doctoral Candidate;Diane M. Doran,RN, PhD, FCAHS, Lawrence S. Bloomberg Limited Term Professor in Patient Safety;Ann E. Tourangeau,RN, PhD, Associate Professor; all at Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada;Andre Kushniruk,BSc, BA, MSc, PhD, Associate Professor and Director, School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada;Lynn Nagle,RN, PhD, Assistant Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada, and President, Nagle & Associates, Inc., Toronto, Ontario, Canada. Article History: Accepted 28 July 2008 Article note: Address correspondence to Lisa Cranley, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 130-155 College Street, Toronto, Ontario M5T 1P8, Canada; lisa.cranley@utoronto.ca