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PubMedDate not supplied

Judgment: the nurse's key to knowledge.

Recently, nursing has turned more of its attention to judgment and has given it a high priority for study. A significant part of that study asks: What is judgment? How is it made? Why is it important? The ancient Greeks discovered reason and then created enduring art that demonstrates it. Three nurses are excerpted from this literature to evoke and explain how judgment is made. Euryclea, Cilissa, and Medea's nurse also illustrate the personal commitment in judgment. Human beings depend on the nurse's judgment. They depend on the nurse as knower. Nurses are obliged to move from doubt and opinion towards knowledge and certitude. Judgment is the nurse's key to that knowledge.

Drama↗
PubMed1979

Semantic judgment ability in adult aphasia.

Recent psycholinguistic literature suggests that language usage often involves the ability to make judgments or appraisals about various aspects of language. It was therefore the purpose of the present study to examine the semantic judgment or evaluation abilities of thirty persons with aphasia in comparison to these same behaviors in a group of thirty normal individuals. That is, this study examined subject ability to use knowledge to make comparisons or judgments in reference to specific criteria. Results support the existence of a judgment capacity and indicate that persons with aphasia are impaired in their ability to evaluate semantic material. Therefore, speech pathologists may wish to include semantic judgment tasks in their evaluation procedures and plan therapy directed toward the retrieval of judgment responses.

Aged↗
PubMedDate not supplied

The social context of critical care clinical judgment.

BACKGROUND: Clinical judgment in critical care is supported by a rich social network of care providers. The purpose of this study was to describe the social context in which the process of critical care clinical judgment occurs from the nurse's perspective. METHODS: An ethnographic study was conducted that included interviews with 10 nurses and participant observation in an open heart surgery unit with 59 nurses and two surgical teams during a 2-year period. RESULTS: Nurses and physicians were organized in hierarchies of nurse manager, resource nurse, charge nurse, and staff nurse or attending surgeon, fellow, chief resident, and resident. These parallel hierarchies allowed for checks on judgment both within and across professional lines. Rituals, such as nursing report, physician rounds, and flow sheet use, provided a context for a critique on judgment processes. Communication of judgment was frequently a casual, open conversation. At other times, differences in perspective could result in conflict. Communication between nurses and physicians has been associated with better patient outcomes. Critical care unit directors and managers can use an analysis of communication patterns to develop supports to clinical judgment.

Clinical Nursing Research↗
PubMed1994

A prospective comparison of paramedic judgment and the trauma triage rule in the prehospital setting.

STUDY OBJECTIVE: To study paramedic judgment and the Trauma Triage Rule in prehospital trauma triage. DESIGN: Prospective. SETTING: A county emergency medical services system. PARTICIPANTS: Six hundred fifty-three trauma patients. RESULTS: Over a 3-month period, 653 trauma patients were evaluated in the prehospital setting. Paramedic judgment and the Trauma Triage Rule (TTR), as described by Baxt, were evaluated for accuracy in identifying patients requiring trauma center care. The TTR achieved a sensitivity of 88% and a specificity of 86%. Paramedic judgment had a sensitivity of 91% and a specificity of 60%. Combining the TTR and paramedic judgment achieved a sensitivity of 100% and a specificity of 75%. CONCLUSION: The TTR and paramedic judgment are effective in identifying patients who require trauma center care in the prehospital setting. The TTR and paramedic judgment combined have the greatest predictive value in identifying seriously injured patients.

Adolescent↗
PubMed1993

Coping, defending, and the relations between moral judgment and moral behavior in prostitutes and other female juvenile delinquents.

Twenty female juvenile delinquents who acknowledged engaging in prostitution, 20 juvenile delinquents who denied doing so, and 20 same-age control subjects responded to Colby and Kohlberg's (1987) Moral Judgment Interview (MJI), a moral dilemma about prostitution, and Joffe and Naditch's (1977) test of coping and defending. Delinquents scored lower on moral maturity and coping and higher on defensiveness than nondelinquents. Post hoc analyses revealed that low-coping delinquents (but not high-coping delinquents or control subjects) made significantly lower level moral judgments on the prostitution dilemma than on the less personally relevant MJI dilemmas. Groups did not differ in their prescriptive judgments on the MJI, but prostitutes made weaker judgments against prostitution than the other delinquents. Prescriptive judgments were not related to moral maturity. The results elucidate the relation between moral judgment and moral behavior.

Adaptation, Psychological↗
PubMed1988

Friends and strangers: acquaintanceship, agreement, and the accuracy of personality judgment.

We examined the effect of acquaintanceship on interjudge agreement in personality ratings. Approximately 150 undergraduates described their own personalities using the Q-sort. They were also described by two close acquaintances and by two "strangers" who knew them only via a single, spontaneous interaction viewed on videotape. The effect of acquaintanceship was powerful: Judgments by close acquaintances agreed with each other and with subjects' self-judgments much better than did judgments by strangers, even though strangers' judgments agreed with each other and with subjects' self-judgments beyond a chance level. This result implies that agreement among acquaintances' judgments must derive at least partly from experience with and observation of the person who is judged. The same traits that yielded better agreement among acquaintances also yielded better agreement among strangers and tended to be rated higher in subjective visibility, suggesting that people are intuitively knowledgeable about the traits they can judge with more and less agreement.

Adult↗
PubMed1997

Cross-cultural consensus in personality judgments.

Building on recent research demonstrating consensus and accuracy in interpersonal perception based on minimal information, the present studies examined American and Chinese participants' within- and cross-cultural judgments. In Study 1, the authors used the zero-acquaintance paradigm in the People's Republic of China and found consensus on all personality dimensions. In Study 2, Chinese and American participants judged each other on the basis of photographs, and consensus was found among Americans' judgments of Chinese and Chinese participants' judgments of Americans. Further, by correlating target effects based on within-culture zero-acquaintance judgments and cross-cultural photographic judgments, the authors found agreement in the judgments of individuals by members of their own culture and the other culture for both Chinese and Americans.

China↗
PubMed1997

Simultaneous assimilation and contrast effects in judgments of self and others.

Judgments of self and referent others tend to be positively related, as evident in the false consensus effect, but others may also be contrasted from the self, as noted in the false uniqueness literature. In 3 studies that examined the domains of attitudes and traits, evidence of both assimilative and contrastive associations between self- and other-judgements were noted, depending on the form of judgment (objective vs. subjective) and the relevant judgment scale anchor (self vs. others). When self-judgments were made first, objective appraisals of reference groups were contrasted from subjective self-appraisals (after controlling for individual differences in participants' behavioral reports). When judgments of others were made first, objective self-ratings were contrasted from subjective other-judgments. Implications for the false consensus literature and the shifting standards model (M. Biernat, M. Manis, & T. E. Nelson, 1991) are discussed.

Adult↗
PubMed2003

The role of intent and harm in judgments of prejudice and discrimination.

Four experiments examined how an actor's intent and the harm experienced by a target influence judgments of prejudice and discrimination. The presence of intent increased the likelihood that participants judged an actor as prejudiced and the actor's behavior as discriminatory. When intent was uncertain, harm influenced judgments of the behavior, which in turn influenced judgments of the actor, and participants were more cautious in their judgments about an actor than an actor's behavior. Harm also played a stronger role in targets' than observers' judgments. Understanding the role of intent and harm on perceptions of prejudice can help explain variations in targets' versus observers', and possibly targets' versus actors', judgments of discrimination and prejudice.

Adult↗
PubMed2003

On the subjective quality of social justice: the role of affect as information in the psychology of justice judgments.

This article argues that it is not uncommon for people forming justice judgments to lack information that is most relevant in the particular situation. In information-uncertain conditions, people may therefore construct justice judgments by relying on how they feel about the events they have encountered, and justice judgments may hence be strongly influenced by affect information. Findings show that in information-uncertain conditions, the affective states that people had been in prior and unrelated to the justice event indeed strongly influenced their justice judgments. These findings thus reveal that in situations of information uncertainty, people's judgments of justice can be very subjective, susceptible to affective states that have no logical relationship with the justice judgments they are constructing. Implications for the social psychology of justice and the literature on social cognition and affect are discussed.

Adult↗
PubMed1975

Comparison of social judgments of creativity and intelligence.

Social judgment of creativity and intelligence was investigated by having subjects give trait ratings for stimulus profiles of actual art students based on abilities information alone, based on personality information alone, based on biographical information alone, and finally, based on the total set of all three types of cue information. Regression equations differed depending upon whether intelligence or creativity judgments were being predicted. For all types of information, there was a significant amount of variation unique to creativity judgments which could not be accounted for by intelligence judgments, and vice versa. However, the proposition of variation unique to each type of trait judgment was smallest when subjects had only abilities information available and was approximately four times larger when judgments were based on the total set of three types of cue information. Implications of this finding for the study of creativity are discussed.

Aptitude↗
PubMed2002

Haptic pictures: fit judgments predict identification, recognition memory, and confidence.

DAngiulli et al (1998 Scandinavian Journal of Psychology 39 187-190) found blind and sighted (blindfolded) children identified common objects in raised-outline drawings explored haptically, and corrected themselves without feedback. The self-correction suggests that participants can assess the extent to which the referents they suggest as possible identifications fit the haptic pictures. Indeed, when we asked subjects to identify haptic pictures, and to judge how well the referents they mentioned fitted the pictures, their fit judgments predicted the accuracy of their suggestions. Also, when one group of subjects offered the suggestions and another group assessed the fit of the suggestions to the pictures, the fit judgments predicted the accuracy of the suggestions. Further, good fit predicted successful recognition memory. In addition, both high and low fit judgments were made confidently, so the range of confidence judgments was smaller than the range of fit judgments. Finally, visual judgments of fit by one group predicted the level of success of the suggestions from another (haptic) group. In sum, subjects assess their suggested identifications appropriately, most likely on the basis of object shape criteria, outlined surface edges, and use of a vantage point.

Blindness↗
PubMed1993

The structural consistency of moral judgments about AIDS.

This study compared the structure (i.e., stage) of moral judgments to dilemmas involving AIDS to the structure of moral judgment on Kohlberg's test to determine whether attitudes and opinions about AIDS affect level of moral judgment. Subjects included 40 men, who responded to (a) two standard dilemmas from Colby and Kohlberg's (1987) test of moral judgment, (b) two of Kohlberg's dilemmas ammended to involve AIDS, (c) a set of AIDS dilemmas derived from incidents reported in the media, (d) a set of questions tapping attitudes toward people with AIDS, and (e) Rubin and Peplau's (1975) just-world scale. Moral judgment was structurally consistent across the three sets of dilemmas, and only weakly related to attitudes towards AIDS and belief in a just world. Moral choices did not covary with moral stage. These results are consistent with Kohlberg's contention that moral judgment is organized in "structures of the whole."

AIDS Serodiagnosis↗
PubMed2000

Religiosity and agency and communion: their relationship to religious judgmentalism.

The present study is an introduction to the construct of religious judgmentalism, defined as a willingness to make religious or moral judgments of others based on a limited period of observation; the study offers a prediction about which individuals will engage in such judgmental behavior. It was predicted that agency motives would significantly predict religious judgmentalism in a religious population but that communion motives and intrinsic religiosity would moderate this effect. Overall, the findings supported these predictions. Agency motives were positively correlated with religious judgmentalism. Intrinsic religiosity predicted a general unwillingness to make religious evaluations of others. Both intrinsic religiosity and communion motives did moderate the effects of high agency motives. Specifically, increases in communion motive and intrinsic religiosity, at high levels of agency motives, significantly predicted lower scores for religious judgmentalism. These findings were conceptualized as preliminary evidence for the position that interpersonal motives, rather than religiousness or religious motivation, predict social intolerance and criticism in religious individuals.

Adult↗
PubMed2001

The stability of older adults' judgments of fates better and worse than death.

Decisions about specific life-sustaining medical treatments have been found to be only moderately stable over time. This study examined whether more general judgments, such as whether a particular health condition is better or worse than death, would exhibit greater stability. Fifty adults (aged 65 yrs and older) made judgments about the perceived quality of life (QOL) possible in a number of hypothetical states of impaired health and their desire to live or die (LOD) in each state. Judgments were made twice from 5 to 16 months apart (M = 10.7 mo). Both QOL and LOD judgments demonstrated only moderate stability regardless of the method of analysis used. Judgments about states characterized by severe impairment became more moderate over time with a substantial minority of participants viewing the states as worse than death at the initial interview viewing them as better than death at follow-up. Participants who did not have a living will, did not have children, had a lower perceived QOL at the follow-up interview, and had a longer time between interviews had more unstable judgments. The implications of these findings for the use of instructional advance directives are discussed.

Advance Directives↗
PubMed1989

Intertester reliability of clinical judgments of medial knee ligament integrity.

The purpose of this study was to determine the intertester reliability of judgments based on tibiofemoral joint abduction (TFJA) tests of the medial collateral ligament (MCL). The TFJA tests were performed by three physical therapists on 50 patients with unilateral knee problems. The therapists used the techniques they normally use in clinical practice and tested TFJA with the knee in both 0 and 30 degrees of flexion. Three variables were evaluated: the amount of TFJA, pain elicited during the test, and the type of end-feel. When the test was performed with the subjects' knees in 0 degrees of flexion, the weighted Kappa value for judgments of motion was .06, the Kappa value for judgments of whether pain was elicited was .40, and the Kappa value for end-feel was .00. For the 30-degree test position, the weighted Kappa value for judgments of the amount of TFJA was .16, and the Kappa values for judgments of pain and end-feel were .33 and .38, respectively. The results suggest that judgments based on TFJA tests may not be reliable when taken in a clinical setting by physical therapists.

Adolescent↗
PubMed1992

Controlled trial using computerized feedback to improve physicians' diagnostic judgments.

The goal of this study was to test an innovative method to improve physicians' diagnostic judgments by integrating the use of a computer program (employing cognitive feedback to teach a clinical rule that predicts the probability of streptococcal pharyngitis), a traditional lecture, and periodic disease-prevalence reports. In a controlled trial using pre- and postintervention measures involving 885 patients, the authors compared the effects of the integrated method on the diagnostic judgments of seven experienced physicians at a university health service (from 1982 to 1985) with the effects of the lecture alone on the judgments of seven experienced physicians at a different university health service (1986 to 1987). The integrated method significantly improved the quality of the physicians' judgments as measured by calibration curves and Brier scores, and increased the level of agreement between the physicians' judgments and those made by the clinical prediction rule. The lecture alone produced less improvement in the quality of the physicians' judgments, and decreased the level of agreement with the rule. The authors conclude that this method, based on cognitive psychology, is a promising educational tool.

Computer-Assisted Instruction↗
PubMed1997

Subjective judgments of speech clarity measured by paired comparisons and category rating.

OBJECTIVE: The purpose of this study was to compare listeners' subjective judgments of speech clarity via paired comparisons and category rating using stimulus conditions that varied in the relative spacing between stimulus items, producing either a wide or narrow range of performance. DESIGN: Subjective judgments of speech clarity were measured via paired comparisons and category rating in 12 normal-hearing (Experiment 1) and eight hearing-impaired adults (Experiment 2). Sentences processed by six band-pass filters that increased monotonically in Articulation Index (AI) estimates constituted the stimuli to be judged. Using subsets of three filters from the group of six, subjective judgments were additionally obtained for stimulus conditions in which the performance ranges were wide (large differences in AI) and narrow (small differences in AI). RESULTS: Speech clarity judgments obtained by paired comparisons and category rating were highly related to the AI estimates both for normal-hearing and hearing-impaired subjects. When the performance range was wide, both methods provided similar judgments for the normal-hearing subjects. For the hearing-impaired subjects, paired comparisons were more sensitive than category rating. When the performance range was narrow, paired comparisons were more sensitive than category rating in differentiating between filters for both groups of subjects. This difference was less obvious for the normal-hearing subjects when paired comparison data were converted to a scale comparable to the category ratings. Large between-subject variability was evident for the hearing-impaired subjects on the psychophysical scaling procedures, most notably for category rating. CONCLUSIONS: When judging the clarity among stimulus items where performance varied over a wide range, both category rating and paired comparisons provided comparable judgments for normal-hearing listeners. For conditions in which perceptual differences between stimulus items were restricted either by the choice of conditions or by the effects of sensorineural hearing loss, the method of paired comparisons was the more sensitive procedure.

Adult↗