Romanian nurses’ beliefs on nursing diagnosis. A survey study based on the theory of planned behavior

Abstract

Purpose: To identify clusters of beliefs about nursing diagnosis (ND) among Romanian hospital nurses and to ascertain variations in attitudes, intention to use, behavior associated with the use of ND, and sociodemographic characteristics. Methods: A cross-sectional online survey study was conducted on a convenience sample of 498 hospital nurses in Romania. The questionnaire comprises six scales measuring normative, behavioral, and control beliefs, intention to use, attitudes, and behavior toward ND. Results were reported through cluster analysis. Findings: Three clusters were identified: highly positive, average, and highly negative beliefs about ND. Romanian nurses have more homogeneous beliefs regarding ND than nurses from other countries. Comparisons among clusters showed significant differences in intention [H(2) = 111.59, p < 0.001], attitudes [H(2) = 145.27, p < 0.001], and reported behavior [H(2) = 43.84, p < 0.001]. The stronger the attitude toward ND, the intention to use it, and the behavior of using ND, the more favorable the beliefs and vice versa. Significant disparities among clusters were discovered regarding education in ND, whereas differences were not observed regarding years of experience, age, and gender. Conclusion: Nurses exhibited different belief patterns about ND. Those with more positive beliefs demonstrated a more favorable attitude, a higher intention, and a more frequent behavior in using ND. Training in ND facilitates positive beliefs about it. Implications for nursing practice: When designing interventions to promote ND in clinical practice, policymakers, administrators, and educators should consider addressing and potentially changing these beliefs. Modifying nurses’ attitudes could positively impact patient care quality during their hospital stay and post-discharge.