Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Reasoning”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 901 records · Page 50Linked to original sources
PubMedDate not supplied

Chinese adolescents' reasoning about democratic and authority-based decision making in peer, family, and school contexts.

This study explored the judgments and reasoning of Chinese adolescents (13-18 years of age) from 3 regions of mainland China (N = 574) regarding procedures for making decisions involving children in peer, family, and school contexts. Participants evaluated 2 democratic decision-making procedures (majority rule and consensus) and decision making by adult authorities for 2 decisions embedded in each social context. Judgments and reasoning about decision-making procedures varied by social context and by the decision under consideration, and evaluations of procedures became more differentiated with increasing age. The findings reveal that concepts of rights, individual autonomy, and democratic norms (majority rule) are salient aspects of Chinese adolescents' social reasoning and are used to evaluate critically existing social practices.

Adolescent↗
PubMed2004

Risk as analysis and risk as feelings: some thoughts about affect, reason, risk, and rationality.

Modern theories in cognitive psychology and neuroscience indicate that there are two fundamental ways in which human beings comprehend risk. The "analytic system" uses algorithms and normative rules, such as probability calculus, formal logic, and risk assessment. It is relatively slow, effortful, and requires conscious control. The "experiential system" is intuitive, fast, mostly automatic, and not very accessible to conscious awareness. The experiential system enabled human beings to survive during their long period of evolution and remains today the most natural and most common way to respond to risk. It relies on images and associations, linked by experience to emotion and affect (a feeling that something is good or bad). This system represents risk as a feeling that tells us whether it is safe to walk down this dark street or drink this strange-smelling water. Proponents of formal risk analysis tend to view affective responses to risk as irrational. Current wisdom disputes this view. The rational and the experiential systems operate in parallel and each seems to depend on the other for guidance. Studies have demonstrated that analytic reasoning cannot be effective unless it is guided by emotion and affect. Rational decision making requires proper integration of both modes of thought. Both systems have their advantages, biases, and limitations. Now that we are beginning to understand the complex interplay between emotion and reason that is essential to rational behavior, the challenge before us is to think creatively about what this means for managing risk. On the one hand, how do we apply reason to temper the strong emotions engendered by some risk events? On the other hand, how do we infuse needed "doses of feeling" into circumstances where lack of experience may otherwise leave us too "coldly rational"? This article addresses these important questions.

Affect↗
PubMed1988

Non-respondents in a post-myocardial infarction trial: characteristics and reasons for refusal.

We surveyed the 270 survivors of acute myocardial infarction who refused to participate in the Warfarin Re-Infarction Study (WARIS). Information on medical variables were derived from registration forms completed by hospital staff upon discharge, whereas data on a variety of health conditions and reasons for refusal were gathered by mailed questionnaires, 178 (66%) of which were returned. Some disparities were found when comparing non-respondents and participants, the former showing more potential bad risk factors. The diversities between participants and non-respondents are of yet unknown prognostic importance. However, the presence of such differences imply that information on characteristics of non-respondents in clinical trials is desirable in terms of generalizability of the trial results. Reasons stated for non-participation reflect poor motivation, low mobility and saturation with focusing on disease. A slight co-variation between social status and reasons for refusal was noted.

Clinical Trials as Topic↗
PubMed2004

Reasoning about emotional and neutral materials. Is logic affected by emotion?

In two experiments, we investigated whether people reason differently when they reason about emotional and neutral contents. We gave participants a conditional reasoning task ("If p, then q") and varied the emotionality of the items used as p and q. Participants were asked to draw inferences based on these statements. In Experiment 1, we compared statements including preexisting emotional and neutral words. In Experiment 2, we experimentally manipulated the emotionality of initially neutral words using classical conditioning. In both experiments, emotionality affected participants' responses. They were more likely to draw invalid inferences in response to emotional compared with neutral statements.

Affect↗
PubMed2005

Reasoning from unfamiliar premises: a study with unschooled adults.

A long tradition of research initiated by Luria in the 1930s has established that unschooled adults perform poorly on reasoning tasks. Particularly when the premises are unfamiliar, they adopt an inappropriate empirical bias. However, recent findings show that young children with little or no schooling reason competently if prompted to think of the unfamiliar premises as pertaining to a distant planet. We tested two groups of adults: illiterate, unschooled adults and adults with limited schooling. Both groups received problems that included either a premise with unknown content or a premise contradicting their everyday experience. When given a minimal prompt, both groups manifested the customary empirical bias. By contrast, when explicitly prompted to think of the unfamiliar premises as pertaining to a distant planet, they reasoned accurately and appropriately justified their conclusions in terms of the supplied premises.

Adolescent↗
PubMed2006

Initial phase of chronic medication use; patients' reasons for discontinuation.

AIM: The aim of this study was to gain more insight into patients' reasons for discontinuing chronic medication. METHODS: Electronic medication overviews recorded by a pharmacy were analysed with respect to patients' return behaviour during 3 months following their first prescription. Patients who did not return in time were interviewed by telephone to find out their reasons for either returning too late or not returning at all to the pharmacy to collect their repeat medication. RESULTS: Of 232 first-time chronic medication prescriptions, 132 were not collected at all (46.1%) or too late (11%). These prescriptions involved 121 patients, 113 (93.4%) of whom participated in the telephone interview. Twenty patients returned too late to collect their repeat prescriptions, largely because they had forgotten to take their medication according to schedule (n=13). Ninety-three patients did not return to the pharmacy at all because of side-effects (24.5%), inefficacy (16.4%), medication not intended for chronic use (15.3%) and absence of need for continued use (14.3%). CONCLUSIONS: About 50% of patients who have been prescribed chronic medication for the first time stop using their drugs within a matter of months. Perceived drug side-effects, drug ineffectiveness and personal considerations related to use and a lack of need of treatment were the main reasons for discontinuing chronic drug therapy. This kind of noncompliance may result in an increased health risk as well as constituting a waste of a large amount of money. Adequate patient counselling and shared decision-making between doctors and patients are needed to prevent the unnecessary cessation of chronic drug therapy.

Adult↗
PubMed1995

Some surprising similarities in the clinical reasoning of 'expert' and 'novice' orthopaedic nurses: report of a study using verbal protocols and protocol analyses.

This paper reports on an Australian study of 'expert' and 'novice' orthopaedic nursing practitioners' clinical reasoning. Concurrent and retrospective verbal reports of patient assessment and care planning in real 'everyday' practice situations were collected from nine pairs of 'expert' and 'novice' orthopaedic nurses. Verbal protocol analyses revealed that the experts used the same level of concepts as novices, that their clinical reasoning was as physically orientated as that of novices, and that the implicit constructions of nursing in the reasonings of both experts and novices were consistent with a 'medical model' of health care. The research design, limitations and findings are discussed.

Adult↗
PubMed2005

Modelling novice clinical reasoning for a computerized decision support system.

AIM: The aim of this paper is to introduce the theoretical framework that directs the project. BACKGROUND: The Novice Computer Decision Support (N-CODES) Project is developing a point-of-care system to assist novice acute care nurses while making clinical judgements. Unlike prior approaches, N-CODES is guided by a theoretical understanding of nurses' decision-making processes, including the manner by which novices develop this skill. FRAMEWORK: Assumptions within information processing theory guided the clinical decision-making framework. The framework is composed of a clinical decision-making model and a second embedded model depicting the clinical reasoning development of novice nurses. MODELS: The model is developed within a pluralistic perspective synthesizing theoretical and empirical knowledge on clinical decision-making and the development of novice reasoning skills. A visual representation of experienced nurse decision-making is presented. A central element is the nurse's use of pre-encounter data and working knowledge. A second model integrates empirical data on the developing clinical reasoning of the novice. This knowledge is loosely scattered through 25 years of literature. The intersection of these models provides a novel perspective on the way novices begin to identify working knowledge patterns and develop a sense of saliency. CONCLUSIONS: Previous attempts to build comprehensive clinical decision support systems have disregarded important theoretical considerations hindering the success of these projects. Grounding a Decision Support System in a theoretical model of novice nurse decision-making will strengthen the utility and acceptance of the Decision Support System. Additionally, a conceptualization of novice nurse development is an asset to nurse educators, managers and scientists interested in improving clinical decision-making.

Clinical Competence↗
PubMed2004

Concordance with community mental health appointments: service users' reasons for discontinuation.

BACKGROUND: Quality issues are being given renewed emphasis through clinical governance and a drive to ensure service users' views underpin health service development. AIMS: To establish service users' reasons for discontinuation of community based mental health appointments in one National Health Service Trust. METHOD: A two-phase survey of all non-completers over a year. Phase one using a structured postal questionnaire. Phase two using structured interviews with respondents to phase one by post, telephone and face to face. RESULTS: A total of 243 discharges because of non-completion were identified by local services over the 12 months of the study and followed up by initial questionnaire. This represents 8.19% of all discharges (2967) within the same period. Forty-four users were engaged and followed up within phase two of the survey. Data were subject to both quantitative and qualitative analysis. CONCLUSIONS: Analysis of responses suggests that the main reasons for non-completion are because of dissatisfaction although the reasons are varied and the interplay between variables is complex. Whilst this user group are not apparently suffering from 'severe mental illness', there is clear, expressed need for a service. RELEVANCE TO CLINICAL PRACTICE: Whoever provides such a service should be responsive to expressed need and a non-medical approach seems to be favoured. If these needs are appropriately met then users are more likely to be engaged and satisfaction is likely to be improved. Although this in itself does not necessarily mean improved clinical outcomes, users are more likely to stay in touch until an agreed discharge. Practical problems of applied health service research are discussed and recommendations are made for a review of referral systems, service delivery and organization with suggestions for further research.

Adult↗
PubMed2005

Reasons for non-treatment of hepatitis C in veterans in care.

We prospectively studied 354 patients with hepatitis C virus (HCV) infection who were referred to a hepatology specialty clinic to find the reasons for non-treatment of HCV. The median age was 48 years (range 27-77 years), 98.5% were male and 71% were white. Seventy per cent of the patients were not treated. The most common reasons for non-treatment were non-adherence to follow-up visit (24%), normal liver enzymes (14%), concurrent medical problems (11%), alcohol and drug use (9%), psychiatric problems (7%), advanced liver disease (7%), referral for transplant evaluation (6.4%) and patient refusal, transfer of care to another facility and non-detectable HCV RNA levels (5% each). The reason was not recorded for 5% of the patients and was treatment deferred in 2.4% while waiting for pegylated interferon approval. Non-treatment was more likely in patients with less than 12 years of education and a history of incarceration. Patients who were lost to follow-up and refused treatment were more likely to have current alcohol and drug use and a history of incarceration.

Adult↗
PubMed1992

Evaluation of teaching medical ethics by an assessment of moral reasoning.

This study assessed the hypothesis that the formal teaching of medical ethics promotes a significant increase in the growth and development of moral reasoning in medical students. Results indicated a statistically significant increase (P less than or equal to 0.0005) in the level of moral reasoning of students exposed to a medical ethics course compared to the control group that was not exposed to the medical ethics course. When the posttest scores were adjusted by subtracting the pretest scores, the differences were even more significant (P less than or equal to 0.0002). This study confirmed similar findings of another study using a different instrument of assessment. Brief discussion is given of the fundamental premise that the appropriate function of teaching medical ethics in our modern pluralistic society is to improve students' moral reasoning about value issues regardless of what their particular set of moral values happens to be.

Education, Medical, Undergraduate↗
PubMed1995

Changes in moral reasoning and the teaching of medical ethics.

Courses in medical ethics are becoming an integral part of many medical school curricula in Europe. At the medical school of the University of Copenhagen, a course on philosophy of medicine has been compulsory for all medical students since 1988. The effect of such courses on the ethical awareness and reasoning of medical students is not well understood and we have therefore found it of interest to study the effects of the Copenhagen course. For the study, we used a Danish version of the Defining Issues Test (DIT) which measures development in moral reasoning (Rest J R, 1979 Development in Judging Moral Issues. University of Minnesota Press, Minneapolis). The study was conducted as a pre- and post-test study without a control group, and the subjects were all medical students attending the course in the autumn of 1993. The results show that moral reasoning scores measured by the DIT increase significantly, and we argue that this increase can only be explained as an effect of the course.

Adult↗
PubMed2000

Reasons for improper simple hysterectomy in patients with invasive cervical cancer in the northern region of Thailand.

OBJECTIVE: To determine the reasons for improper simple hysterectomy in the presence of invasive cervical cancer. METHODS: The medical records of 70 patients who had undergone simple hysterectomy in the presence of invasive cervical cancer and were referred to Chiang Mai University Hospital between January 1991 and December 1998 were reviewed. RESULTS: Approximately half of the patients presented with abnormal vaginal bleeding. Failure to perform a Papanicolaou smear before the operation accounted for 35.4%. Normal pelvic examination in which no gross invasive tumor was observed accounted for 59%. The most common indications for inappropriate operation was cervical dysplasia. The reasons for inappropriate simple hysterectomy included lack of preoperative cervical cytology (22.8%), incomplete evaluation of cervical dysplasia or microinvasion on biopsy (21.4%), false-negative cervical cytology (18.6%), failure to perform an endocervical curettage following conization (8.6%), emergency hysterectomy (8.6%), failure to perform indicated conization (5.6%), errors in colposcopic examination (4.3%), incomplete evaluation of an abnormal cervical cytology (1.4%), failure to perform endocervical currettage following loop conization (1.4%), failure to review slide (1.4%), failure to check the pathology report (1.4%), failure to biopsy a gross cervical lesion, and skipped lesion in upper part of the endocervix (1.4%). One case of invasive disease was missed for unknown reason. CONCLUSION: Most cases of inappropriate hysterectomy resulted from deviation from guideline for cervical cancer detection. Preoperative Papanicolaou smear and strict adherence to the well-established diagnostic protocol for patients with an abnormal smear are advised to prevent such occurrence.

Adult↗
PubMed1995

Genetic therapy, identity and the person-regarding reasons.

It has been argued that there can be no person-regarding reasons for practising genetic therapy, since it affects identity and causes to exist an individual who would not otherwise have existed. And there can be no such reasons for causing somebody to exist because existing cannot be better for an individual than never existing. In the present paper, both of these claims are denied. It is contended, first, that in practically all significant cases genetic therapy will not affect the identity of beings of our kind. This is so irrespective of whether, essentially, we are beings with minds or beings of a certain biological species, the human one. Second, it is contended that, even if genetic therapy were to affect our identity, there could be person-regarding reasons for conducting it, for existence can be better than non-existence for the individual.

Beginning of Human Life↗
PubMed1986

Sex differences in moral reasoning: response to Walker's (1984) conclusion that there are none.

Data from the Family Socialization and Developmental Competence Project are used to probe Walker's conclusion that there are no sex differences in moral reasoning. Ordinal and nominal nonparametric statistics result in a complex but theoretically meaningful network of relationships among sex, educational level, and Kohlberg stage score level, with the presence and direction of sex differences in stage score level dependent on educational level. The effects on stage score level of educational level and working status are also shown to differ for men and women. Reasons are considered for not accepting Walker's dismissal of studies that use (a) a pre-1983 scoring manual, or (b) fail to control for education. The problems presented to Kohlberg's theory by the significant relationship between educational and stage score levels in the general population are discussed, particularly as these apply to the postconventional level of moral reasoning.

Adult↗
PubMed1989

Adolescents' and parents' reasoning about actual family conflict.

This study employed a distinct domain perspective on social-cognitive development to assess reasoning about issues of family conflict. Subjects were 102 fifth through twelfth graders from 2-parent families and their parents. Individually interviewed family members described actual family conflicts and, for each, justified their position on the dispute and reasoned about them from the other's perspective. Parents generated fewer conflicts than did children. Preadolescent to late adolescent families generally agreed that conflicts occurred over the mundane, everyday details of family life, but they did not agree on their interpretation. Adolescents understood but rejected their parents' conventional interpretations of conflicts, reasoning instead in terms of personal choice. Boys' understanding of their parents' conventional perspectives increased significantly with age, whereas girls' understanding was significantly lower in early adolescence, as compared to pre- or late adolescence. The results are discussed in terms of adolescent individuation and parent-child conflict during adolescence.

Adolescent↗
PubMed2006

Prescribing spectacles: reasons for failure of spectacle lens acceptance.

The objective of this descriptive study was to determine the frequency with which patients return for re-examination due to a failure of spectacle lens acceptance and to quantify the reasons for the failure. A random sample of patient records was reviewed to determine the rate of spectacle lens prescription. Spectacles reassessment records, completed after dispensing problems were dealt with were reviewed to determine the primary reason for the failure. Spectacles were prescribed for 58% of the 44 341 patients seen over 6 years. Of the 25 718 prescriptions written, 400 patients (1.6%) returned for reassessment. The most common problem was incorrect refractive error measurement (59%), followed by inability of the patient to adapt to an accurate refractive correction (10.3%), inadequate patient education regarding lens design (9.5%), pathology (9.3%), appliance problem (5.8%), transcription errors (1.6%) and other (4.5%). The frequency of failure to adapt to spectacle prescriptions is quite low and the most common reason for this failure is inaccuracy in the measurement of the refractive error.

Accommodation, Ocular↗
PubMed1990

Comparability of reasons for cesarean sections in patient records and mothers' interviews.

Reasons for cesarean sections from three different data sources were compared. One hundred mothers were interviewed, their patient records were read, and the discharge diagnoses were noted. In about 70% of cases at least two of the data sources gave similar reasons for cesarean section, but when all three sources were compared, in only one-third was information similar. These figures cast doubt on the utility of recorded indications in studying reasons for cesarean sections.

Adult↗