International Journal of Nursing Knowledge

PURPOSE. To assess psychiatric nurses' views of the importance of itemized content represented on an Inventory of Voice Experiences (IVE) for ongoing assessment of atypical auditory sense perception in people who hear voices.

METHODS. Over 6 months, 317 experienced psychiatric nurses rated 58 assessment cues for hallucinated voice experiences. Cronbach's alpha, Cohen's kappa, and Bartko's intraclass correlation coefficients were used to measure concordance of the nurses' judgments against two hypothetical standards derived for purposes of the study.

FINDINGS. There was moderate support for both the internal consistency of the nurses' judgments concerning the importance of itemized content represented on the WE and overall equivalence of the content. There was modest-to-moderate concordance of the nurses' original and subsequent judgments but a lack of concordance of the nurses' judgments with equally weighted judgments of the principal investigator even though the judgments of the investigator were based on extant literature and published reports of voice hearers.

CONCLUSIONS. Results may reflect the effects of repeated testing, but it also is possible that some nurses did not have enough knowledge or professional experience to quantify judgments about the importance of hallucinated voice descriptions tied to the items on the WE. The findings are being used to refine the IVE.

PRACTICE IMPLICATIONS. Findings provide nurses with opportunities for discerning specific characteristics, antecedents, and consequences of voice hearing along with their implications for health and well-being. Discernment of this information will facilitate identification of more specific and meaningful options for helping voice hearers manage their voices.

Search terms: Auditory hallucinations, schizophrenia

Interpretations of patient data are complex and diverse, contributing to a risk of low accuracy nursing diagnoses. This risk is confirmed in research findings that accuracy of nurses' diagnoses varied widely from high to low. Highly accurate diagnoses are essential, however, to guide nursing interventions for the achievement of positive health outcomes. Development of critical thinking abilities is likely to improve accuracy of nurses' diagnoses. New views of critical thinking serve as a basis for critical thinking in nursing. Seven cognitive skills and ten habits of mind are identified as dimensions of critical thinking for use in the diagnostic process. Application of the cognitive skills of critical thinking illustrates the importance of using critical thinking for accuracy of nurses' diagnoses. Ten strategies are proposed for self-development of critical thinking abilities.