Strategies for enhancing nurses' clinical judgment in care for patients with chronic diseases: A grounded theory study in Iran

BACKGROUND: A varying background in situations of chronic diseases affects the selection of strategies in clinical judgments. This study explained the strategies used to enhance the clinical judgment in chronic diseases situations. METHODS: This article was the part of a grounded theory study. Obtained data from open and semi-structured interviews were analyzed simultaneously with data collection and according to the Corbin and Strauss approach. The first experienced nurse was selected with purposive sampling and 25 other participants were selected on the basis of the theoretical sampling from different wards of the clinical and educational care centers of Sanandaj, Iran from 2011 to 2013. RESULTS: As shown in results, the core variable “situation-based efforts for enhancing clinical judgment” represented the main process used by participants in the promotion of clinical judgment in situations of chronic disease. The main categories included a "comprehensive collaboration", "inclusive education", "matching of clinical judgment skills", "maintaining patient's and nurses' autonomy" in a clinical judgment. CONCLUSION: Participants were trying to use strategies appropriate to different situations for clinical judgment in terms of chronic diseases conditions. Applying these processes with regard to the present context, can enhance the clinical judgment in chronic diseases situations.