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 919 records · Page 51Linked to original sources
PubMed2005

A clinician's approach to clinical ethical reasoning.

We offer a systematic strategy that situates clinical ethical reasoning within the paradigm of clinical reasoning. The trajectory of this strategy parallels clinical reasoning: a plain statement of the initial problem, careful gathering of data, a differential diagnostic assessment, and articulation and confirmation of a justified plan. This approach pays special attention to the goals of medical care, because so much depends on whether or not physician and patient share the same goals. This approach also addresses the heterogeneity of clinical problems that at first appear ethical and acknowledges the ethical pluralism that pervades clinical ethics.

Aged↗
PubMed1996

Nurses' reasoning in the assessment of family violence.

This is a report of the reasoning related to family violence by health professionals but specifically by 241 surveyed and 9 interviewed nurses. Using survey and interviewing techniques, this study explored factors that influence clinicians' choice to intervene in family violence and compared the differences in reasoning of health professionals. Findings from both the survey and interviews are discussed. It is recommended that content about family violence be integrated in curricula and that different approaches to clinical reasoning emphasized.

Choice Behavior↗
PubMed1986

Reasons for taking radiographs in general dental practice.

This survey investigated the reasons why general dental practitioners take radiographs. 179 (54%) dentists responded and provided information for 2359 patients who were radiographed during a specified week. Of those patients aged less than 15 yr, 62% were radiographed primarily for orthodontic purposes and 22% for caries. In older age groups, caries was the predominant reason for taking radiographs but endodontic assessment assumed increasing importance with age and accounted for 37% of radiographs in patients aged more than 45 yr. Only 8% of patients were radiographed for periodontal reasons. These findings are discussed with respect to the changing pattern of disease and treatment provided in general dental practice.

Adolescent↗
PubMedDate not supplied

Research on diagnostic reasoning in nursing.

NANDA has traditionally complemented its work on the development and clinical testing of nursing diagnoses with concurrent interest in nurses' diagnostic reasoning processes. This literature review describes studies in diagnostic reasoning, including research based on the information processing model, research examining the role of intuition, and research using grounded theory to study the diagnosis of specific patient conditions. The review presents a synthesis of the research to date, and common themes in these diverse studies are identified. This review emphasizes research in nursing, although pertinent findings from cognitive psychology and medicine are included. Suggestions for future work in diagnostic reasoning are offered.

Clinical Competence↗
PubMedDate not supplied

Metacognitive skills in diagnostic reasoning: making the implicit explicit.

The metacognitive skills of monitoring, analyzing, predicting, planning, evaluating, regulating, and revising frame the nursing process and support clinical reasoning. Nurse educators who encourage metacognitive skill acquisition are likely to accelerate student comprehension, understanding, and mastery of nursing diagnosis, nursing process, and clinical reasoning. The models presented in this article have implications for teaching and learning clinical/diagnostic reasoning.

Cognition↗
PubMed2005

A study of midlife women's reasons for changing healthcare providers.

PURPOSE: The purpose of this study was to examine the reasons midlife women report for changing healthcare providers and to determine if there were any differences in reasons given for the change based on gender or ethnicity. DATA SOURCES: This was an analysis of data collected from a healthy community-based sample of midlife women as part of a longitudinal 5-year study of changes in health outcomes during transition to menopause. Women were queried about their experience in changing healthcare providers. CONCLUSIONS: Over 42% indicated that they had changed health providers because of dissatisfaction with care. The component accounting for the majority of the variance was related to communication issues. There were no significant differences across ethnic groups in decision to change providers or in reasons for their dissatisfaction with care. However, their reports of experiencing racism in the healthcare system were troubling. IMPLICATIONS FOR PRACTICE: The ability of the provider to communicate with women may have implications in women's choices in health care later in life.

Adult↗
PubMed1997

Normal and abnormal reasoning in people with delusions.

People who experience delusions have been found to request less information prior to making a decision than control participants on tasks that are unrelated to the theme of the delusion (Huq, Garety & Hemsley, 1988). Two studies investigated whether people with delusions have an absolute deficit in reasoning or a more specific data-gathering bias. In Expt 1, 12 people with delusions, 12 people with depression and 12 normal controls were shown the results of spinning a supposedly biased coin. The evidence provided varied in the number of heads to tails. In normal controls a high ratio of head to tails produces a high estimate that the coin is biased. In this experiment, where the evidence gathered was predetermined by the experimenter, all groups of participants were shown to reason in a similar way. Experiment 2 tested whether a difference would exist between the groups in conditions where participants were free to determine the amount of evidence seen, in contrast to when all of them viewed the same evidence. Two jars of beads in opposite but equal ratios (e.g. 85:15, 15:85) were shown to 15 people with delusions, 15 with depression and 15 normal controls. On the basis of beads being drawn one at a time, it was the participants' task to determine which jar they came from. When free to decide when they wished, people with delusions decided on the basis of less evidence than the other groups. However, as in Expt 1, the group with delusions did not differ when made to view the same amount of beads as other participants. Therefore, people with delusions have a data-gathering bias rather than a difficulty in employing the data in reasoning. This "jump to conclusions' bias generalized to a less discriminable ratio of beads (60:40), and was not a consequence of impulsiveness or memory deficit.

Adolescent↗
PubMed1998

Reasoning biases in delusion-prone individuals.

OBJECTIVES: The objective was to test whether individuals high in delusional ideation exhibit a reasoning bias on tasks involving hypothesis testing and probability judgments. On the basis of previous findings (e.g. Garety, Hemsley & Wessely, 1991), it was predicted that individuals high in delusional ideation would exhibit a 'jump-to-conclusions' style of reasoning and would be less sensitive to the effects of random variation, in comparison to individuals low in delusional ideation. DESIGN: A non-randomized matched groups design was employed enabling the performance of the delusion prone individuals to be compared to that of a control group. METHOD: Forty individuals, selected from the normal population, were divided into groups high and low in delusional ideation, according to their scores on the Peters et al. Delusions Inventory (Peters, Day & Garety, 1996), and were compared on two tasks involving probability judgment and two tasks involving hypothesis testing. RESULTS: Although no significant differences were found on tasks involving hypothesis testing and the aggregation of probabilistic information, it was found that individuals high in delusional ideation had a 'jump-to-conclusions' style of data gathering and were less sensitive to the effects of random variation, in comparison to individuals low in delusional ideation. CONCLUSIONS: In conclusion, although individuals high in delusional ideation were not found to have a general reasoning bias, some evidence of a more specific bias was found. It is thought that these aberrations may play some role in delusion formation in schizophrenia and paranoia.

Adult↗
PubMed1993

Influence of working memory on adult age differences in matrix reasoning.

The four studies reported in this article, involving a total of 401 adults ranging between 18 and 80 years of age, were designed to investigate how working memory might mediate adult age differences in matrix reasoning tasks such as the Raven's Progressive Matrices Test. Evidence of this medication is available in the finding that statistical control of an index of working memory reduces the age-related variance in matrix reasoning performance by approximately 70 per cent. Because the age differences were nearly constant across items of varying difficulty, it was concluded that the factors responsible for variation in item difficulty were distinct from those responsible for the age differences. However, young adults were found to be more accurate than older adults at recognizing information presented earlier in the matrix reasoning trial, thereby supporting the interpretation that working memory exerts its influence by contributing to the preservation of information during subsequent processing.

Adolescent↗
PubMed1984

Moral reasoning and delinquent behaviour among students.

In a sample of students, relationships between delinquency and moral reasoning scores--on Rest's (1975) DIT--were consistent with the view that these scores reflect political orientation rather than developmental differences. More serious delinquency was positively correlated with principled reasoning for females (P less than 0.05), and negatively with Stage 4 reasoning for males (P less than 0.02).

Adult↗
PubMed1979

Reasons for requesting radiographs in an accident department.

A prospective study of 500 patients was performed to determine the reasons for requesting radiographs in an accident and emergency department. Most examinations were requested either to confirm a clinically suspected abnormality or because of difficulty in excluding a significant bone injury on clinical grounds alone. Several requests were also made to reassure the patient. Medicolegal reasons were relatively few, and those made purely because the doctor feared litigation probably accounted for only 5% of requests. Undue emphasis on the medicolegal aspects of accident and emergency radiography in the United Kingdom is unhelpful in that it directs attention away from the real reasons for x-ray referral. Although a reduction in the number of x-ray examinations is desirable on the grounds of expense and radiation exposure it is likely to be obtained only by improving experience and acumen in the clinical assessment of injuries.

Clinical Competence↗
PubMed1995

Screening for colorectal cancer: reasons for refusal of faecal occult blood testing in a general practice in England.

STUDY OBJECTIVE: To ascertain reasons for non-compliance with faecal occult blood tests in colorectal cancer screening programmes. DESIGN: A standard interview by a trained nurse of a random sample of those who declined screening. SETTING: The Leicestershire town of Market Harborough, where most of the 25,000 population are served by a single general practice of 10 partners. PARTICIPANTS: Altogether 4185 residents aged 51 to 70 years were invited to receive a free faecal occult blood test (Haemoccult). Eighty one subjects from a sample of 351 who wrote declining the offer were interviewed. MAIN RESULTS: Non-compliers were divided into those who did not request a test kit and those who returned an unused kit. In the former group the commonest reasons given were intercurrent illness (39%), fear of further tests and surgery (24%), and feeling well (22%). For those who returned unused kits the commonest reasons were the unpleasantness of the stool collection procedure (65%), feeling well (30%), intercurrent illness (23%), and fear of further tests and surgery (20%). In both groups the main concern of those who did not comply were fear of further diagnostic tests and surgery rather than concern at the lack of effective treatment for cancer. CONCLUSIONS: To increase compliance, education and publicity must explain the concept of asymptomatic illness and allay people's fear of hospital investigation and treatment. The benefits of screening should be particularly emphasised to those who return kits so they may overcome their reservations.

Aged↗
PubMed1996

Ethical reasoning in mixed nurse-physician groups.

OBJECTIVES: To study the ethical reasoning of nurses and physicians, and to assess whether or not modified focus groups are a valuable tool for this purpose. DESIGN: Discussion of cases in modified focus groups, each consisting of three physicians and three nurses. The discussion was taped and analysed by content analysis. SETTING: Five departments of internal medicine at Danish hospitals. SAMPLE: Seven discussion groups. MAIN MEASUREMENTS: Ethical content of statements, style of statements, time used by each participant. RESULTS: Danish physicians and nurses do not differ in the kind of ethical reasoning they use, but physicians use more of the discussion time than nurses, they use a more assertive style of argumentation, and the solutions chosen are usually first put forward by physicians. CONCLUSION: The results and informal comparisons with similar data from long qualitative interviews indicate that groups of this kind are a useful tool for gathering data on ethical reasoning.

Aged↗
PubMed1990

Reasoning.

Strict theories of reasoning are schoolmarmish in their insistence on rules and structure, but this gives them an advantage when inference is relatively well behaved. In the case of reasoning with deductively valid arguments, Strict theories give a convincing account of the universality of certain inference forms and the productivity of reasoning in comprehension and production. However, Strict views are rather frail, since they have to appeal to nonreasoning processes (memory limitations, comprehension failure, conversational factors) when inferencing breaks down. They seem less suited to inductive and analogical arguments, though they may be helpful in restricted situations where the inference is routine or the domain well understood. By contrast, Loose theories are inarticulate and nerdy. They dispense with formal rules in favor of continuous functions defined over beliefs, and the inferences they describe are modulations of these functions. In some sense, they are more robust than Strict theories, since they apply not only to inductively strong arguments but also to deductively valid ones as a limiting case. In fact, we have seen that they can provide insight into subjects' responses to purportedly deductive problems that are too unruly for Strict theories to handle. They are also extremely literal-minded in refusing to recognize permanent generalizations. Their only generalities are temporary products of their updating schemes. Because of these features, Loose theories have trouble producing new beliefs, explaining or justifying their own inferences, and keeping straight the difference between correlational and causal evidence. As I've described them here, Strict and Loose views are postures, not scientific theories. It's hard to see how either point of view could be exclusively true, but equally hard to combine their insights successfully.

Cognition↗
PubMed2005

[Alcohol consumption in Toledo schoolchildren: reasons and alternatives].

OBJECTIVE: To know the consumption of alcohol in Toledo schoolchildren, to find out the reasons which cause them to drink and the alternatives proposed. DESIGN: Descriptive, transverse study. LOCATION: 2 zones in the Toledo health area. PARTICIPANTS: A total of 625 adolescents between 13 and 18 years, in the third and fourth years of Obligatory Secondary Education and first year in High School (Bachillerato) of 2 secondary education institutions in Torrijos and 1 in Toledo capital. MAIN MEASUREMENTS: Using an ad hoc designed anonymous questionnaire, with 32 items, the following data was collected: age, sex, alcohol consumption (personal, family, and friends), how much (standard drink units), knowledge and sources of information on alcohol, taking of other drugs, reasons for consuming, and the alternatives. RESULTS: 47.27% of those questioned were male. The mean age was 15.4 +/- (-)1.3 years. 93.4% had tried alcohol (95% CI, 91.1-95.2). 52.0% had been drunk at some time, which was more frequent in rural areas than in the city. 58.1% considered alcohol as a drug. Among the reasons mentioned for drinking, the main ones were "enjoyment" (46.3%), "to forget problems" (30.7%), and "curiosity" (24.6%). The alternatives to drinking which were proposed were related to computers and sport. CONCLUSIONS: The consumption of alcohol is a common habit among adolescents and its pattern differs between urban and rural areas, where it is much earlier and more intense in the latter. It forms part of their lifestyle, they use it as a means of enjoyment and a large percentage consider that alcohol is a drug. Against "street binge drinking," their proposals are computer activities and sport.

Adolescent↗
PubMedDate not supplied

Helping parents to grieve after second trimester termination of pregnancy for fetopathic reasons.

The main interest in our study was to find out if advice given to facilitate mourning after perinatal child loss (looking at the dead child, picture, burial) could be used to help parents terminating pregnancies for fetopathic reasons. To evaluate the acceptance and to compare the outcome in grief reactions we interviewed women undergoing termination of pregnancy for fetopathic reasons 1-2 days after the loss of the child and they answered a mailed questionnaire 8 weeks later. For comparison we assessed data from women with spontaneous child losses within the 12th to 24th week of pregnancy in a similar way. No difference in the extent of creating memories between the two groups of child losses could be assessed (44% of women after termination and 55% after spontaneous loss looked at their dead child). Making the dead baby a tangible person led to stronger grief reactions immediately after the loss without significant difference due to the kind of loss. But 8 weeks later women after spontaneous child losses reported significantly more mourning than those after termination. It could be shown that women do mourn after termination of pregnancy, that creating memories leads to more intense grief reactions shortly after the loss and that grief diminishes over time. The advice given to facilitate mourning after perinatal child loss can be transferred to parents dealing with termination of pregnancy for fetopathic reasons although coping seems to be more complicated in the latter situation.

Abortion, Induced↗
PubMed2006

A connectionist computational model for epistemic and temporal reasoning.

The importance of the efforts to bridge the gap between the connectionist and symbolic paradigms of artificial intelligence has been widely recognized. The merging of theory (background knowledge) and data learning (learning from examples) into neural-symbolic systems has indicated that such a learning system is more effective than purely symbolic or purely connectionist systems. Until recently, however, neural-symbolic systems were not able to fully represent, reason, and learn expressive languages other than classical propositional and fragments of first-order logic. In this article, we show that nonclassical logics, in particular propositional temporal logic and combinations of temporal and epistemic (modal) reasoning, can be effectively computed by artificial neural networks. We present the language of a connectionist temporal logic of knowledge (CTLK). We then present a temporal algorithm that translates CTLK theories into ensembles of neural networks and prove that the translation is correct. Finally, we apply CTLK to the muddy children puzzle, which has been widely used as a test-bed for distributed knowledge representation. We provide a complete solution to the puzzle with the use of simple neural networks, capable of reasoning about knowledge evolution in time and of knowledge acquisition through learning.

Algorithms↗
PubMed1994

Reasons for condom utilization among high-risk adolescent girls.

Two hundred forty-eight adolescent girls responded to a list of 30 statements describing reasons for using and not using condoms. For 24 of the statements, most adolescents (> 70%) gave the same response regarding why they did or did not use condoms. Therefore, only the six remaining statements were used in further analyses. The relationship between the six statements and psychosexual history, condom use, and sexually transmitted disease (STD) history was examined. Those adolescent girls who had been sexually active longer were more likely to report lack of enjoyment as a reason that they did not use condoms (P < .03), and those adolescents who had been sexually active less time were more likely to report personal (P < .005) and partner (P < .0006) enjoyment of sex with condoms as a reason for using condoms. Longer relationships before intercourse were associated with having condoms available (P < .01) and partner insistence on their use (P < .02). Partner insistence on condom use was related to fewer episodes of sexually transmitted diseases (P = .03). These findings indicate the importance of relationship and partner variables in adolescent girls' perceptions of condom use.

Adolescent↗