Intuition In Clinical Practice Research Articles

Barriers and Facilitators of Intuitive Decision-Making among Psychiatric Nurses: A Cross-sectional Study.

Due to the type and nature of hospitalized psychiatric patients, nurses encounter many ambiguous and complex clinical situations that require intuitive decision-making. The present study was conducted to determine the use of intuition and its barriers and facilitators among psychiatric nurses. This study adopts a descriptive cross-sectional design and employs 123 nurses using convenience sampling in 2022. Demographic characteristics, the use of intuition in clinical practice, and the barriers and facilitators of intuition in clinical practice questionnaires were used for data collection. The results of this study showed that the mean (SD) of intuitive decision-making among psychiatric nurses was 58 (13.07) out of a range from 25-125. The use of intuition had a statistically significant correlation with age and work experience in the psychiatry ward. The use of intuitive decision-making has a statistically significant difference in gender, work shift, and education level. The biggest barrier to the use of intuitive decision-making among psychiatric nurses was "The limitations of nursing role which restrict the use of intuition in the clinical setting". The most common facilitator in the use of intuition among psychiatric nurses was "having experience and clinical knowledge leads to the use of intuition in patient care". Given the low level of the use of intuition and the important role of intuitive decision-making in the quality of nursing care, nursing managers should provide some strategies for reducing the barriers to the use of intuition among nurses.

Experienced physician descriptions of intuition in clinical reasoning: a typology.

Background Diagnostic intuition is a rapid, non-analytic, unconscious mode of reasoning. A small body of evidence points to the ubiquity of intuition, and its usefulness in generating diagnostic hypotheses and ascertaining severity of illness. Little is known about how experienced physicians understand this phenomenon, and how they work with it in clinical practice. Methods Descriptions of how experienced physicians perceive their use of diagnostic intuition in clinical practice were elicited through interviews conducted with 30 physicians in emergency, internal and family medicine. Each participant was asked to share stories of diagnostic intuition, including times when intuition was both correct and incorrect. Multiple coders conducted descriptive analysis to analyze the salient aspects of these stories. Results Physicians provided descriptions of what diagnostic intuition is, when it occurs and what type of activity it prompts. From stories of correct intuition, a typology of four different types of intuition was identified: Sick/Not Sick, Something Not Right, Frame-shifting and Abduction. Most physician accounts of diagnostic intuition linked this phenomenon to non-analytic reasoning and emphasized the importance of experience in developing a trustworthy sense of intuition that can be used to effectively engage analytic reasoning to evaluate clinical evidence. Conclusions The participants recounted myriad stories of diagnostic intuition that alerted them to unusual diagnoses, previous diagnostic error or deleterious trajectories. While this qualitative study can offer no conclusions about the representativeness of these stories, it suggests that physicians perceive clinical intuition as beneficial for correcting and advancing diagnoses of both common and rare conditions.

Development and Psychometric Evaluation of an Instrument to Measure the Use of Intuition in Clinical Practice by Critical Care Nurses

The current study was conducted to develop and validate an instrument to measure the use of intuition in clinical practice by critical care nurses. Item generation and psychometric evaluation were developed. In the psychometric, content validity index and content validity ratio were calculated to establish initial instrument validity through the use of expert ratings, as well as, construct and criterion validity. The original items reduced to 25. Using principal components analysis and orthogonal varimax rotation, three factors had an eigenvalue >1, with 60.05% variance (Factor 1: 47.9%; Factor 2: 7.56%; and Factor 3: 5.05%). The tool had an acceptable correlation to criterion of the instrument (r = .769, p < .001), a Cronbach alpha consistency of 0.953, and a stability level of r = .945 and p < .001. In this study, a valid and reliable instrument was developed to measure intuition.

Relationship between the use of intuition in clinical practice and the clinical competence of critical care nurses.

Clinical competency has been the main focus of nurse educational systems. To further it, the concept of intuition was introduced into nursing in the 1970s. Benner's theory proposed that greater use of intuition was linked to higher clinical competence; however, there is still a paucity of data to verify this theory. Therefore, the current study was conducted to assess the relationship between the use of intuition in clinical practice and the clinical competence of critical care nurses. In this correlational study, 88 critical care nurses were recruited as convenience. The tools included a 'use of intuition in clinical practice' scale devised by the researcher, and a 'clinical competence' instrument. The gathered data were analyzed by SPSS version 20.0 software, using descriptive and inferential statistics. Of the 88 participants, 73.9% were women and 93.2% were at undergraduate level. The mean and standard deviation of participants' age and work experience was 32.29 ± 6.75 and 7.40 ± 5.68 years, respectively. The Pearson correlation test revealed no significant connection between the use of intuition in clinical practice and the clinical competence of critical care nurses (r = 0.091, P = 0.398), and produced similar results from the various demographic groups (P > 0.05). In this study, no significant correlation between the use of intuition and clinical competence in critical care nurses was found. This could be attributed to intuition as a nursing skill being almost excluded from the educational curriculum of nursing schools, and some background factors.

Intuition in Clinical Decision Making: Differences Among Practicing Nurses.

To examine the relationships and differences in the use of intuition among three categories of practicing nurses from various clinical units at a medical center in the Midwest. Descriptive, correlational, cross-sectional, prospective design. Three categories of nurses were based on the clinical unit: medical/surgical nurses ( n = 42), step-down/progressive care nurses ( n = 32), and critical care nurses ( n = 24). Participants were e-mailed the Rew Intuitive Judgment Scale (RIJS) via their employee e-mail to measure intuition in clinical practice. Participants were also asked to rate themselves according to Benner's (novice to expert) proficiency levels. Nurses practicing at higher self-reported proficiency levels, as defined by Benner, scored higher on the RIJS. More years of clinical experience were associated with higher self-reported levels of nursing proficiency and higher scores on the RIJS. There were no differences in intuition scores among the three categories of nurses. Nurses have many options, such as the nursing process, evidence-based clinical decision-making pathways, protocols, and intuition to aid them in the clinical decision-making process. Nurse educators and development professionals have a responsibility to recognize and embrace the multiple thought processes used by the nurse to better the nursing profession and positively affect patient outcomes.

The intuitive nurse in critical care practice: a phenomenological study

Intuition in clinical practice is the ability to experience the elements of a clinical situation as a whole, and to solve a problem or reach a decision with limited concrete information. Benner theorized that the expert nurse acts on intuition, but that he/she also deals with some ambiguities. However, there is a lack of studies about intuitive nursing in the critical care arena, where more critically ill patients are admitted. So, this study was conducted to explore the features of the intuitive nurse in critical care practice. In a descriptive-phenomenological study, twelve nurses employed in critical care units of the hospitals affiliated to Kermanshah University of Medical Sciences were recruited to the study, as purposive, a semi-structured interview was administered to them, then written down verbatim. The data was managed by MAXQDA 10 software (VERBI GmbH, Berlin, Germany) and analyzed as qualitative through the seven-stage approach of Colaizzi. Of the 12 nurses who participated in the study, seven (58.3%) were female and married, 88.3% (10 people) had a Bachelor of Nursing and the mean and standard deviations of the participants’ age, job experience and critical care experience were 36.66±7.01, 13.75±6.82 and 7.66±3.36 years, respectively. From the qualitative analysis of the data, we extracted three main themes, including &lt;em&gt;proficiency&lt;/em&gt;, &lt;em&gt;connection&lt;/em&gt; and &lt;em&gt;benevolence&lt;/em&gt;, and ten sub-themes. The intuitive nurses were substantially proficient in terms of knowledge, skill and experience, and relationships to patients. They desired to help the patients based on their consciences.

The perception of intuition in clinical practice by Iranian critical care nurses: a phenomenological study.

BackgroundIntuition as a way of learning in nursing is applied to decision making and judgment in complicated clinical situations. Several studies have been conducted on intuition in clinical settings, but comprehension of this concept is unclear. Moreover, there is a lack of information about intuition in critical care nurses caring for more seriously ill patients. This study aimed to explore Iranian critical care nurses’ understanding of intuition in clinical practice.MethodsIn a descriptive–phenomenological study, 12 nurses employed in critical care units of the hospitals affiliated to Kermanshah University of Medical Sciences were purposively recruited to the study. A semistructured interview was administered, and then written verbatim. The data were managed by MAXQDA 10 software, and qualitative analysis was undertaken using the seven-stage approach of Colaizzi.ResultsOf the 12 nurses who participated in the study, 7 (58.3%) were female and married, and 10 (88.3%) held a bachelor’s degree in nursing. The mean and standard deviations of participants’ age, job experience, and critical care experience were 36.66±7.01, 13.75±6.82, and 7.66±3.36 years, respectively. Four main themes and eleven sub-themes were elicited from the qualitative analysis; the main themes including “Understanding intuition as a feeling”, “Understanding intuition as a thought”, “Understanding intuition as receiving signs”, and “Understanding intuition as an alarm”. Because they have trust in their own intuition, the nurses made further assessments and paid more attention to patients. They were also better prepared after receiving intuition alarms to perform the appropriate responses, and acting upon the alarms reduced the nurses’ physical and psychological signs.ConclusionThe findings showed how intuition was understood by the critical care nurses; therefore, these results can be considered to form a theoretical basis for designing other studies. Because of the significant role of intuition in enhancing the nursing care of critically ill patients, it is suggested that more qualitative, quantitative, and trials studies be performed to reinforce intuition in nursing; moreover, to incorporate intuition into nursing curriculums, it should be debated in academic settings.

Use of intuition by critical care nurses: a phenomenological study

BackgroundIntuition is defined as an irrational unconscious type of knowing. This concept was incorporated into nursing discipline for 3 decades, but nowadays its application is uncertain and ignored by educational institutions. Therefore, this study aimed to explore critical care nurses’ understanding of the use of intuition in clinical practice.Materials and methodsIn a descriptive phenomenological study, 12 nurses employed in critical care units of the hospitals affiliated with Kermanshah University of Medical Sciences, were recruited to a study using purposive, semistructured interviews, which were then written down verbatim. The data were managed by MaxQDA 10 software and analyzed as qualitative, with Colaizzi’s seven-stage approach.ResultsOf the 12 nurses who participated in the study, seven (58.3%) were female and married, 88.3% (ten) had a Bachelor of Nursing (BSc) degree, and the means ± SD of age, job experience, and critical care experience were 36.66±7.01, 13.75±6.82, and 7.66±3.36 years, respectively. We extracted three main themes, namely “patient conditions”, “nurse readiness”, and “outcome”, and seven subthemes – including “clinical signs”, “patient behaviors”, “prognosis”, “being sensitive”, “desire to act”, “prediction”, and “satisfaction” – integral to understanding the use of intuition in clinical practice by critical care nurses.ConclusionThe findings showed that some nurses were attracted by the patients’ conditions and were more intuitive about them, and following their intuition prepared the nurses to under-take more appropriate measures. The positive results that the majority of the nurses experienced convinced them to follow their intuitions more often.

Is intuition embodied? A phenomenological study of clinical intuition in somatic psychotherapy practice

Intuition in psychotherapy practice is often confused with terms such as emotional insight, body language, gut feeling and psychic ability. These terms generalise a common experience, yet do not adequately describe the lived experience of intuitive phenomena. This phenomenological study explored intuition in clinical practice from an embodied perspective based on two questions: (i) How, if at all, is intuition embodied? (ii) What is the role of non-verbal expressions while describing clinical intuitive phenomena? Purposive sampling was used to recruit somatic psychotherapists who claimed to experience intuition during clinical practice. An original methodology was created by synthesising a body-focused interview with descriptive analysis. Findings (i) challenged the current parameters of embodiment by expanding upon the experience of intuition beyond ‘gut feelings’, and (ii) suggested that gestures reveal implicit information regarding the ways in which intuition arrives into consciousness. Further studies are needed to investigate clinical phenomena from an embodied perspective, which could augment the value of somatic psychology practice and clarify the role of embodiment in traditional clinical practice for adjacent fields of psychology.

Intuition in clinical practice: The pleasure and the pain

This is a narrative account, drawn from a study by the first author exploring the role of intuition in clinical psychology as self-understood by eight clinical psychologists (Tovey, 2008). We aim to reflect the original analysis by presenting a series of data extracts and our comments – and to encourage comments from others.

Nursing experience and preference for intuition in decision making

This article examines the relationship between domain-specific and domain-general intuition among practicing nurses and student nurses to determine the role of intuition in nurses' decision making. Measures of nursing intuition have not been compared with one another or to measures of general preference for intuition in the psychological literature. Prior research has shown that experienced nurses rely on intuition in clinical judgement, but the various aspects of intuition associated with experience have not been fully explored. A correlational design was used to examine the factor structures and interrelationships of self-reported measures of intuition, as well as their relationship to experience. A web-based survey was given to 175 practicing nurses and student nurses in the fall of 2007 using measures of intuition from the nursing and psychological literatures. Quantitative analyses employed descriptive and inferential statistics. Measures of preference for intuition were combined, resulting in the identification of two independent aspects of nursing intuition uniquely related to general intuition and nursing experience. Results revealed that preference for intuition in nursing was not solely due to general preference for intuition and that use of nursing intuition increased with experience. These results strengthen the knowledge base of decision making in clinical practice by examining differences in preference for use of intuition among nurses. Further interdisciplinary collaboration is recommended. Understanding the use of intuition in clinical judgement will promote professional practice and favourable patient outcomes. If experience simply leads to increased self-confidence and preference for the use of intuition, this may not actually be related to accuracy in judgement. However, if experience provides valuable information on associations between patient symptoms and outcomes, then the use of intuition in clinical practice should be encouraged.

Intuition in emergency nursing: A phenomenological study

The evidence of experience of intuitive knowing in the clinical setting has to this point only been informal and anecdotal. Reported experiences thus need to be either validated or refuted so that its place in emergency nursing can be determined. The history, nature and component themes captured within the intuitive practice of emergency nursing are described. This study was informed by the philosophy and method of phenomenology. Participants were 14 experienced emergency nurses. Through their narrative accounts and recall of events their experience of knowing was captured. Through a Van Manen process and a Gadamerian analysis, six themes associated with the ways in which the participants experienced intuition in clinical practice, were identified. This paper reveals the six emerging themes as knowledge, experience, connection, feeling, syncretism and trust.

Measuring the use of intuition by registered nurses in clinical practice

To administer the Smith Intuition Instrument to a sample of registered nurses to clarify its factors and test convergent validity. The Smith Intuition Instrument (27 items), a subscale of the Miller Intuitiveness Instrument (18 items), and demographic questions, were posted to 1,000 registered nurses in January 2006. With a response rate of 79% (n=79), the findings are preliminary. Principal component factor analysis with orthogonal varimax rotation resulted in four factors accounting for 70.8% of variance: spiritual connections (373%), reassuring feelings (14.6%), physical sensations (12.5%) and bad feelings (6.2%). Eigenvalues ranged from 1.1 to 6.7 and factor loadings ranged from 0.705 to 0.887 An 18-item instrument emerged with a Cronbach's alpha of 0.896 and a range of 0.806 to 0.892 for each factor. Pearson's correlation between the two intuition measures was 0.520. Psychometric evaluation demonstrated construct validity, convergent validity and reliability, and clarified the factors. The Smith Intuition Instrument is a valid and reliable tool for measuring nurses' use of intuition in clinical practice.

Intuition in nursing practice: sharing graduate students' exemplars with undergraduate students.

Failure to acknowledge ways of knowing in nursing education curricula other than linear reasoning hinders the development of the full extent of mental abilities brought to learning situations by nursing students. Nurse educators are challenged to develop creative methods to facilitate nursing students' intuitive thinking. In this article, a teaching strategy is described in which graduate students' exemplars of intuition in clinical practice are shared with undergraduate nursing students. Implications of using this teaching approach to demystify the intuitive process and address its legitimacy are discussed.

Intuition in Psychiatric‐Mental Health Nursing

A descriptive study was done to explore how psychiatric-mental health nurses define and act on intuition in clinical practice with children and adolescents, and to identify supports for and barriers to taking such action. Interviews of 16 nurses were tape-recorded, transcribed, and analyzed for manifest and latent content. Findings support previous studies about intuition in nursing practice and have implications for psychiatric-mental health nurses working with high-risk populations of children and adolescents.