Authors: Intansari Nurjannah, Sri Warsini and Jane Mills
Background. Several methods of diagnostic reasoning have been explained in the literature, but there has been no research to date comparing one method of diagnostic reasoning to another.
Aims. This study aimed to identify differences between the 4 steps method and the 6 steps method of diagnostic reasoning in terms of what the possible diagnoses based on scenario provided and in terms of ease of use, effectiveness, usefulness and the possibility of implementation in a clinical setting.
Method. Forty four participants, including nurse practitioners and academics participated in this study. All participants were attending a diagnostic reasoning workshop. Participants were taught the 4 steps method and the 6 steps method of formulating a nursing diagnosis. Using three scenarios participants identified possible diagnoses using each method, which were then compared. The participants were subsequently given a questionnaire with Likert scale. Statistical analysis with a Wilcoxon signed-rank test was performed using SPSS version 20.
Result. Results of this study showed that the 6 step method of diagnostic reasoning can identify more possible plausible diagnoses and differential diagnoses (DDx) than the 4 step method can. The 6 steps method of diagnostic reasoning also reduced the possibility of identifying inaccurate nursing diagnoses. The 6 steps method was considered easier to use, more effective, more useful and more likely to be implemented in a clinical setting than the 4 steps method (p<0.001). Keywords: method, diagnostic reasoning, nursing