Analyzing How Discursive Practices Affect Physicians' Decision-Making Processes: A Phenomenological-Based Qualitative Study in Critical Care Contexts

Inquiry. 2017 Jan 1:54:46958017731962. doi: 10.1177/0046958017731962.

Abstract

An intensive care unit (ICU) is a demanding environment, defined by significant complexity, in which physicians must make decisions in situations characterized by high levels of uncertainty. This study used a phenomenological approach to investigate the decision-making (DM) processes among ICU physicians' team with the aim of understanding what happens when ICU physicians must reach a decision about the infectious status of a patient. The focus was put on the identification of how the discursive practices influence physicians' DM processes and on how different ICU environments make different discursive profiles emerge, particularly when a key issue is at the center of the physicians' discussion. A naturalistic approach used in this study is particularly suitable for investigating health care practices because it can best illuminate the essential meaning of the "lived experiences" of the participants. The findings revealed a common framework of elements that provide insight into DM processes in ICUs and how these are affected by discursive practices.

Keywords: decision making; discursive practice analysis; intensive care unit; phenomenological-based qualitative study; physicians; uncertainty.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Communication
  • Critical Care / organization & administration*
  • Decision Making*
  • Female
  • Humans
  • Intensive Care Units / organization & administration*
  • Male
  • Medicine
  • Patient Care Team / organization & administration
  • Physician-Patient Relations
  • Physicians / psychology*
  • Qualitative Research
  • Uncertainty