SEARCH · Search PubMed

Results for “Judgment”

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.

SourceResearch connectionFrom yearThrough year

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

At least 1,315 records · Page 73Linked to original sources

PubMedDate not supplied

Measuring moral judgment in nursing dilemmas.

Based on cognitive theory of moral development, this research investigated the difference between nurses' responses to general, hypothetical moral dilemmas and their responses to real-life nursing dilemmas. The purpose of the research was to: identify recurrent moral dilemmas experienced by staff nurses; develop an instrument (Nursing Dilemma Test [NDT]) to measure nurses' responses to nursing dilemmas and the importance given to moral issues and practical considerations; relate staff nurses' responses to nursing dilemmas in the NDT and responses to hypothetical moral dilemmas in the Defining Issues Test to two subject variables (level of nursing education and length of clinical nursing experience); and compare moral judgments, both hypothetical general and nursing specific, of five subject groups (N = 225): staff nurses with associate degrees (57) and baccalaureate degrees (85) in nursing, nurses with masters degrees in nursing (10), college junior prenurses (36), and graduate level nonnurses (37). Findings verified the significance of formal education and previous involvement with similar dilemmas in enhancing principled thinking and raised questions about the relative strength of practical considerations in the hospital milieu.

Adult↗

PubMed1995

The influence of victim's attire on adolescents' judgments of date rape.

A vignette depicting a date rape was presented to 352 male and female high school students. To investigate the effect of the victim's clothing on subjects' judgments of the date rape, the vignette was accompanied by either a photograph of the victim dressed provocatively, a photograph of the victim dressed conservatively, or no photograph. Subjects who viewed the photograph of the victim in provocative clothing were more likely than subjects who viewed the victim dressed conservatively or who saw no photograph of the victim to indicate that the victim was responsible for her assailant's behavior, that his behavior was justified, and were less likely to judge the act of unwanted sexual intercourse as rape.

Adolescent↗

PubMed1993

Judgments of personal responsibility for HIV infection: an attributional analysis.

This article examines the influence that attributions of personal responsibility for infection with the human immunodeficiency virus have on service and policy responses to the epidemic. A model of attributed responsibility is proposed that classifies social judgments of another person's behavior that take into account the extent to which the behavior caused the situation, the person knew or should have known the potential consequences of the behavior, the person intended to engage in the behavior, and factors over which the person had little or no control might have influenced the behavior. Research has shown that attributions of responsibility lead to increased anger, decreased empathy, and a diminished willingness to offer help to others in need. The author concludes that awareness of attributions of responsibility may help reduce their discriminatory effects at all levels of social work practice.

Anger↗

PubMed1993

Development of a disease activity score based on judgment in clinical practice by rheumatologists.

In a prospective study of up to 3 years' duration of 113 patients with early rheumatoid arthritis a disease activity score (DAS) was developed based on the clinical judgment of 6 rheumatologists. The patients were divided in groups with high and low disease activity according to explicit rules. By various statistical methods, including discriminant analysis and multiple regression analysis, a DAS could be defined. This DAS is a continuous measure consisting of the variables Ritchie articular index, number of swollen joints, erythrocyte sedimentation rate and general health measured on a visual analog scale.

Arthritis, Rheumatoid↗

PubMedDate not supplied

Charting critical thinking: nursing judgments and patient outcomes.

Critical thinking involves analyzing data and making judgments about patient conditions, progress, and nursing interventions. Critical thinking forms the basis for quality documentation. As nurses' expertise in critical thinking grows, nurses can record how the unique considerations for each patient guided individual care and resulted in positive outcomes. Emphasizing individual nursing care and patient outcomes from that care helps meet Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards and gives nurses credit for their expertise. Techniques of critical thinking supported by advanced critical care nurses can lead to improved documentation for entire nursing units.

Critical Care↗

PubMed1998

Children's thinking about traits: implications for judgments of the self and others.

The relation between the way in which children interpret human behavior and their beliefs about the stability of human traits is investigated. In interviews with 202 7- and 8-year-olds across 2 studies, the belief that traits are stable predicted a greater tendency to make trait judgments, and an increased focus on outcomes and behaviors through which traits can be judged. In the academic domain, a belief in trait stability was associated with an emphasis on the evaluative meanings of performance outcomes, as opposed to mediating processes such as effort. In the sociomoral domain, the same belief was associated with an emphasis on the evaluative meanings of behaviors (e.g., whether the person is good or bad), as opposed to factors that mediate behavior, such as intention. Results suggest that beliefs about the stability of traits may serve an important role in thinking about and functioning within the academic and sociomoral domains.

Achievement↗

PubMed1998

The accuracy of patients' judgments of disease probability and test sensitivity and specificity.

BACKGROUND: We studied patients' understanding of the characteristics of diagnostic tests for six common conditions to determine what patients know about diagnostic uncertainties before they communicate with a doctor. We compared the accuracy of patients' estimates of disease probabilities and diagnostic test characteristics for diseases with which they did or did not have prior experience. METHODS: To measure patients' understanding of the uncertainty of diagnostic test results, questionnaires describing diseases were given to patients in clinic waiting rooms. For each of six diseases, a 2-page questionnaire presented a case history of the disease and its diagnostic test, and asked respondents to estimate the probability that the case patient has the suspected disease, the sensitivity of test, the specificity of test, and the probability that the patient has the disease if the test result is positive. It also asked whether the patient, a close friend, or family member had ever been thought to have this disease. RESULTS: One hundred eighty-four patients in the clinic waiting room responded for at least one disease. Although patients judged the disease probabilities to be higher after a positive diagnostic test, each of their four judgments was essentially the same for all diseases, including those with high and low prior probabilities, and with accurate and inaccurate tests. Past experience with the disease was associated with only a minimal increase in the accuracy of patient knowledge. CONCLUSIONS: Patients' ignorance of the uncertainties of diseases demonstrates the need for patient education when a disease is suspected. The lack of relation between knowledge and experience suggests that this need is not being effectively met. To convey the rates or probabilities, and to help the patients understand what the probabilities are based on, a physician should speak in terms that patients can easily understand.

Adolescent↗

PubMed1999

Role of a stimulus filling an action-outcome delay in human judgments of causal effectiveness.

Experiments examined the effect of a stimulus filling a response-outcome delay on human judgments of causal effectiveness. In Experiment 1, subjects rated the effectiveness of 2 concurrently available responses. One response led to the outcome with a 75% probability, the other never led to the outcome. Ratings were higher for the former compared to the latter key, and for immediate compared to delayed outcomes. A signal presented during the delay ameliorated this deficit. Experiments 2 and 3 examined conditioned reinforcement and perceptual catalysis accounts of this effect. In both experiments, 50% of responses on each of 2 keys led to an outcome. Ratings were high, relative to an unsignaled condition, when a stimulus filled the outcome delay, and when the same stimulus followed the response but did not precede the outcome. This result is not consistent with the operation of perceptual catalysis and was shown to be the result of secondary-reinforcement-like processes rather than outcome-confusion or generalization between responses (Experiments 3, 4).

Adolescent↗

PubMed2000

Accuracy of clinical judgment in neonatal jaundice.

CONTEXT: Recommendations for management of jaundice in newborns presume thatjaundice is a reliable clinical finding and that the pattern and intensity of jaundice reflects the degree of elevation of the serum bilirubin level. OBJECTIVES: To determine whether experienced observers agree in describing the extent of jaundice and to evaluate the reliability of visual assessment as an indication for the measurement of serum bilirubin levels. DESIGN: Comparison of independent judgments of the extent of jaundice between examiners and with actual serum bilirubin measurements. SETTING: Well-newborn nursery in an urban public hospital. PARTICIPANTS: A convenience sample of 122 healthy term newborns whose bilirubin concentration was measured in the course of standard newborn care. Observers were experienced pediatric nurse practitioners, pediatric house staff, and pediatric attending physicians. RESULTS: Agreement was moderately good for whether an infant's skin was darkly pigmented (K = 0.56). However, agreement between observers regarding the presence of jaundice at each specific body site was poor (0%-23% agreement beyond chance); correlation between estimated bilirubin concentrations was similarly poor (Pearson correlation coefficient, 0.37). Correlation between estimated and actual bilirubin values was slightly better (Pearson correlation coefficient, 0.43-0.54). CONCLUSIONS: Clinical examination with visual assessment for jaundice in newborns is neither reliable nor accurate. The decision to perform serum bilirubin testing should be based on additional factors.

Bilirubin↗

PubMed2005

HIPAA and patient care: the role for professional judgment.

Federal health privacy regulations, commonly known as the Health Insurance Portability and Accountability Act (HIPAA) regulations, came into effect in April 2003. Many clinicians and institutions have relied on consultants and risk managers to tell them how to implement these regulations. Much of the controversy and confusion over the HIPAA regulations concern so-called incidental disclosures. Some interpretations of the privacy regulations would limit essential communication and compromise good patient care. This article analyzes misconceptions regarding what the regulations say about incidental disclosures and discusses the reasons for such misunderstandings. Many misconceptions arise from gaps in the regulations. These gaps are appropriately filled by professional judgment informed by ethical guidelines. The communication should be necessary and effective for good patient care, and the risks of a breach of confidentiality should be proportional to the likely benefit for the patient's care. The alternative for communication should be impractical. We offer specific recommendations to help physicians think through what incidental disclosures in patient care are ethically permissible and what safeguards ought to be taken. Physicians should work with risk managers and practice administrators to develop policies that promote good communication in patient care, while taking appropriate steps to protect patient privacy.

Confidentiality↗

PubMed1997

Patients with chronic fatigue syndrome and accurate feeling-of-knowing judgments.

Many Chronic Fatigue Syndrome (CFS) patients complain of memory impairments which have been difficult to document empirically. Subjective complaints of memory impairment may be due to a deficit in metamemory judgment. CFS patients and matched controls were tested with a computerized Trivia Information Quiz that required them to rate their confidence about correctly recognizing an answer in a multiple choice format that they had been unable to remember in a fact-recall format. Even though CFS patients reported significantly greater amounts of fatigue, cognitive, and physical symptoms, the accuracy of their confidence levels and recognition responses were similar to controls. This finding suggests that a metamemory deficit is not the cause of the memory problems reported by CFS patients.

Adult↗

PubMed1999

International study of expert judgment on therapeutic use of benzodiazepines and other psychotherapeutic medications: VI. Trends in recommendations for the pharmacotherapy of anxiety disorders, 1992-1997.

OBJECTIVE: To assemble expert clinical experience and judgment regarding the treatment of anxiety disorders in a systematic, quantitative manner, particularly with respect to changes during the preceding five years. METHOD: A panel of 73 internationally recognized experts in the pharmacotherapy of anxiety and depression was constituted by multistage peer nomination. Sixty-six completed a questionnaire in 1992, and 51 of those completed a follow-up questionnaire in 1997. This report focuses on the experts' responses to questions about therapeutic options relevant to seven vignettes describing typical cases of different anxiety disorders. RESULTS: The preferred initial treatment strategy in 1992 was a combination of medication with a psychological therapy for all vignettes except simple phobia, where a psychological procedure alone was favored. There was little change in 1997, primarily some decrease in the choice of psychological therapy and some increase in the choice of medication for social phobia. Experts recommending a medication in 1992 most often chose as first-line treatment a benzodiazepine anxiolytic (BZ) for panic disorder (PD), generalized anxiety disorder (GAD), simple phobia, and adjustment disorder. They recommended a beta-blocker most often for social phobia and a tricyclic anti-depressant (TCA) for agoraphobia and obsessive-compulsive disorder (OCD). Nearly a fourth chose a combination of medications, usually a TCA plus a BZ. In 1997, the expert panel's most frequent recommendation for agoraphobia, PD, and OCD changed to a specific serotonin reuptake inhibitor (SSRI); and they also recommended these compounds more often for GAD, social phobia, and simple phobia. Fewer experts chose BZs or TCAs. However, in 1997 many again chose a combination of medications, often a BZ plus a SSRI, so that, overall, there was only a small decline in recommendations for BZs. As second-line medications (1997 only), the experts recommended SSRIs most often for most vignettes, but a TCA for PD and GAD. Recommendations for a combination of medications rose substantially for most vignettes, usually a BZ plus an antidepressant. CONCLUSIONS: Combined cognitive-behavioral therapy plus medication was highly favored by the experts as the initial treatment strategy for anxiety disorders. During the preceding five years, SSRIs displaced older antidepressants as the experts' first-line choices for the pharmacotherapy of anxiety disorders. In case of an unsatisfactory response, the experts' second-line choices more often were an older antidepressant or a combination of an antidepressant plus a BZ. According to the experts' judgements, the BZs, especially combined with an antidepressant, remain mainstays of pharmacotherapy for anxiety disorders.

Anti-Anxiety Agents↗

PubMed1977

Judgment of emotion among chronic schizophrenics.

This study investigated accuracy of judgment as to posed facial expressions and nonverbal scenes of various emotions. Ss were 16 male and 16 female chronic schizophrenics and a normal control group of equal size and sex composition. The results revealed that normal Ss were significantly more accurate than schizophrenics in identifying emotions from both posed photographs of the face and nonverbal videotape scenes. S sex was not found to affect differentially the schizophrenic or normal Ss' response accuracy to both the photographs and videotapes. Further, it was observed that both groups' accuracy improved when given multiple-choice alternatives to select from as contrasted to their open-ended free responses; this was especially true for the schizophrenic group. Teaching patients to identify and practice expressing discrete emotions was suggested.

Adult↗

PubMed1981

Clinicians' judgments of female clients' causal attributions.

Presented clinical psychologists (N = 400) with statements of female client attributions for presenting problems with locus of causality varied. Clinicians' judgments of clients were investigated through their evaluations of the accuracy of these attributions. While clinician did not differ in estimate of accuracy based on whether attribution were internal or external, female clinicians were more likely than males to judge client attributions as accurate.

Adult↗

PubMed2005

Brain activation during semantic judgment of Chinese sentences: A functional MRI study.

A functional magnetic resonance imaging (fMRI) study was conducted to investigate whether the anatomic substrates of semantic memory may reflect categorical organization and to determine whether the left middle frontal gyrus (Brodmann area [BA] 9) plays a role in Chinese semantic judgment. Unlike previous studies using a word-retrieval task (e.g., word generation, naming, and word categorization), we used a typical task of semantic knowledge retrieval in cognitive psychology in which subjects were asked to determine whether a sentence describing an attribute of living things or nonliving things was true or not. The experimental conditions evoked extensive activation over several regions of the brain including a very strong activation in the left middle frontal region (BA9 and BA46). Our data show that there is no unique activation associated with living or nonliving things at the statistical threshold used in our study. The results imply that human semantic system is undifferentiated by category at the neural level. Our findings also corroborate and extend the claim that the left middle frontal gyrus plays an important role in reading Chinese at both the sentence and the word level.

Adolescent↗

PubMed2004

Quantifying clinical judgment in the assessment of adolescent psychopathology: Reliability, validity, and factor structure of the Child Behavior Checklist for clinician report.

The aim of this study was to assess the reliability and validity of the Child Behavior Checklist (CBCL) as completed by doctoral-level clinicians in the treatment of adolescents. We asked 294 randomly selected, experienced psychiatrists and psychologists to describe a patient aged 14 to 18 in treatment for personality pathology. Clinicians completed the CBCL (parent-report version) and measures of adaptive functioning, personality pathology, and family and developmental history, which served as criterion variables to test the validity of the CBCL as completed by clinicians. Most CBCL scales demonstrated acceptable reliability. Validity estimates were impressive, and the data revealed clinically meaningful associations between specific CBCL scale scores and developmental and family history variables. Confirmatory factor analysis showed that the factorial structure of the clinician-report CBCL resembled that of the parent-report CBCL, with the exception of a substantially lower correlation between higher order internalizing and externalizing factors. The data suggest that clinical judgment can be both reliable and valid when quantified using psychometrically sound instruments.

Adolescent↗

PubMed2000

Attentional bias toward low-intensity stimuli: an explanation for the intensity dissociation between reaction time and temporal order judgment?

If two stimuli need different times to be processed, this difference should in principle be reflected both by response times (RT) and by judgments of their temporal order (TOJ). However, several dissociations have been reported between RT and TOJ, e.g., RT is more affected than TOJ when stimulus intensity decreases. One account for these dissociations is to assume differences in the allocation of attention induced by the two tasks. To test this hypothesis, different distributions of attention were induced in the present study between two stimulus positions (above and below fixation). Only bright stimuli appeared in one position and either bright or dim stimuli in the other. In the two RT experiments, participants had to respond to every stimulus appearing in one of the two positions. Reaction times to bright stimuli were faster when they appeared in the position where dim stimuli were likely to occur. This finding suggests that the allocation of attention was adapted to the asymmetrical arrangement of stimuli, not suggested by explicit instruction. In the two TOJ experiments, the temporal order of stimuli appearing in the two positions had to be judged. Although bright stimuli appearing at the bright-and-dim location were judged to be earlier, this effect was small and insignificant. Further, the intensity dissociation between RT and TOJ was insensitive to random vs blockwise presentations of intensities, therefore was not modified by attentional preferences. Thus, asymmetrical arrangement of stimuli has an impact on the allocation of attention, but only in the RT task. Therefore dissociations between TOJ and response times cannot be accounted for by an attentional bias in the TOJ task but probably by different use of temporal information in the two tasks.

Adult↗

PubMed2001

The neural basis of vertical and horizontal line bisection judgments: an fMRI study of normal volunteers.

Bisection of horizontal lines is used as a clinical test of spatial cognition in patients with left visuospatial neglect after right hemisphere lesions. Bisection of vertical lines has also been employed, albeit less frequently. Interestingly, normal subjects often bisect horizontal lines too far left and vertical lines too high. We used fMRI to investigate whether vertical/horizontal stimulus orientation interacts with the neural mechanisms associated with line bisection judgments (the Landmark task). For control of orientation per se, subjects performed a visual detection task with the same stimuli. Statistical analysis of evoked BOLD responses employed SPM99. The Landmark task increased neural activity (P < 0.05, corrected) in the superior and inferior parietal lobes bilaterally, though predominantly on the right; early visual processing areas bilaterally; and cerebellar vermis, left cerebellar hemisphere, anterior cingulate, and prefrontal cortex bilaterally. Vertical lines (relative to horizontal lines and vice versa) increased neural activity in early visual processing areas, consistent with differential retinotopic stimulation. In addition, vertical lines activated right parietooccipital and superior posterior parietal cortex bilaterally. No significant interactions between the neural mechanisms associated with task and stimuli were observed. Increased neural activation in parietal and parietooccipital cortex associated with vertical lines may reflect increased attentional demands associated with this stimulus orientation. The right hemispheric dominance observed in posterior parietal during the Landmark task irrespective of stimulus orientation is consistent with lesion studies. Our results suggest that the behavioral patterns observed in normal subjects and neurological patients result from different stimulus effects rather than differential task demands.

Adult↗