The relationships of nurses' critical thinking ability and patients' self-disclosure to accuracy in nursing assessment of depression in elderly medical patients

Abstract

This study investigated the relationships of nurses' critical thinking ability and patients' self-disclosure to accuracy in nursing assessment of depression in elderly medical patients. The sample consisted of 120 female nurse-patient dyads. Critical thinking ability was measured by the Watson-Glaser Critical Thinking Appraisal Test (Watson-Glaser, 1980). Accuracy in nursing assessment was measured by the magnitude of the prediction error (absolute value), using the nurse's score in the Depression Status Inventory (DSI) (Zung, 1972) to predict the patient's score in the Depression Self-Rating Scale (SDS) (Zung, 1973). The DSI was used by the nurses to assess the severity of depression, while the patients used the SDS. A modification of Zung's instrument (DSI, 1972) was used to measure the patient self-disclosure. Education was reported to influence the ways in which nurses process information (Broderick & Ammentorp, 1979; Del Bueno, 1983; Tanner, Padrick, Westfall, & Putzier, 1987; Verhonick, Nicholas, Glor, & McCarthy, 1968). Education was statistically controlled in this study. The hypotheses were as follows: (1) There is a positive relationship between the nurses' critical thinking ability to accuracy in nursing assessment of depression, independent of nurses' education; (2) there is a positive relationship between patient self-disclosure to accuracy in nursing assessment of depression, independent of nurses' education; and (3) nurses' critical thinking ability and patient self-disclosure interact in relation to accuracy in nursing assessment of depression. Multiple regression analysis was used to analyze the data. All significance tests were conducted at.05 level. Hypothesis 1 was supported. Critical thinking had a regression coefficient of $-$.15 which was statistically significant ($p$ =.004) after partialling out nurses' education. Hypotheses 2 and 3 were not supported. The importance of accurate nursing assessment is well documented in the nursing literature. The findings in this study underscore the importance of nurses' critical thinking ability in relation to accuracy in nursing assessment of depression among the elderly medical patients.