Fuzzy logic and nursing

Embracing the wild profusion: A Foucauldian analysis of the impact of healthcare standardization on nursing knowledge and practice

Standardization has emerged as the dominant principle guiding the organization and provision of healthcare, with standards resultantly shaping how nurses conceptualize and deliver patient care. Standardization has been critiqued as homogenizing diverse patient experiences and diminishing nurses' skills and critical thinking; however, there has been limited examination of the philosophical implications of standardization for nursing knowledge and practice. In this manuscript, I draw on Foucault's philosophy of order and categorization to inform an analysis of the consequences of healthcare standardization for the profession of nursing. I utilize three exemplars to illustrate the impact of the primacy of standardized thinking and practices on nurses, patients and families: pain assessments using the 0-10 pain scale; patient triage emergency departments through the Canadian Triage and Acuity Scale; and determination of cause of death within the context of the current opioid crisis. Through each exemplar, I demonstrate that standardization reductively constrains nursing knowledge and the health and healthcare experiences of patients and populations. I argue that the centrality of standardization must be re-envisioned to embrace the complexity of health and more effectively and meaningfully frame nursing knowledge and practice within healthcare systems.

Yes, Virginia, Nursing Does Have Laws

In this article the author explores the possibility of the emergence of nursing laws as a natural consequence of the maturation and evolution of selected areas of nursing knowledge. To support this proposition, the evolution of social and scientific laws and their meanings are discussed. In addition, the roles that empirical validation and logical adequacy play in epistemological development, including the development of discipline-specific laws, are explored. Two areas of nursing knowledge in which laws may be emerging, as well as the foundation of these laws, are identified.

Nursing and fuzzy logic: an integrative review

This study conducted an integrative review investigating how fuzzy logic has been used in research with the participation of nurses. The article search was carried out in the CINAHL, EMBASE, SCOPUS, PubMed and Medline databases, with no limitation on time of publication. Articles written in Portuguese, English and Spanish with themes related to nursing and fuzzy logic with the authorship or participation of nurses were included. The final sample included 21 articles from eight countries. For the purpose of analysis, the articles were distributed into categories: theory, method and model. In nursing, fuzzy logic has significantly contributed to the understanding of subjects related to: imprecision or the need of an expert; as a research method; and in the development of models or decision support systems and hard technologies. The use of fuzzy logic in nursing has shown great potential and represents a vast field for research.

Model for differential nursing diagnosis of alterations in urinary elimination based on fuzzy logic

Nursing diagnoses associated with alterations of urinary elimination require different interventions. Nurses, who are not specialists, require support to diagnose and manage patients with disturbances of urine elimination. The aim of this study was to present a model based on fuzzy logic for differential diagnosis of alterations in urinary elimination, considering nursing diagnosis approved by the North American Nursing Diagnosis Association, 2001-2002. Fuzzy relations and the maximum-minimum composition approach were used to develop the system. The model performance was evaluated with 195 cases from the database of a previous study, resulting in 79.0% of total concordance and 19.5% of partial concordance, when compared with the panel of experts. Total discordance was observed in only three cases (1.5%). The agreement between model and experts was excellent (kappa = 0.98, P < .0001) or substantial (kappa = 0.69, P < .0001) when considering the overestimative accordance (accordance was considered when at least one diagnosis was equal) and the underestimative discordance (discordance was considered when at least one diagnosis was different), respectively. The model herein presented showed good performance and a simple theoretical structure, therefore demanding few computational resources.

Fuzzy logic in medicine and bioinformatics

The purpose of this paper is to present a general view of the current applications of fuzzy logic in medicine and bioinformatics. We particularly review the medical literature using fuzzy logic. We then recall the geometrical interpretation of fuzzy sets as points in a fuzzy hypercube and present two concrete illustrations in medicine (drug addictions) and in bioinformatics (comparison of genomes).

Error and objectivity: cognitive illusions and qualitative research

Psychological research has shown that cognitive illusions, of which visual illusions are just a special case, are systematic and pervasive, raising epistemological questions about how error in all forms of research can be identified and eliminated. The quantitative sciences make use of statistical techniques for this purpose, but it is not clear what the qualitative equivalent is, particularly in view of widespread scepticism about validity and objectivity. I argue that, in the light of cognitive psychology, the 'error question' cannot be dismissed as a positivist obsession, and that the concepts of truth and objectivity are unavoidable. However, they constitute only a 'minimal realism', which does not necessarily bring a commitment to 'absolute' truth, certainty, correspondence, causation, reductionism, or universal laws in its wake. The assumption that it does reflects a misreading of positivism and, ironically, precipitates a 'crisis of legitimation and representation', as described by constructivist authors.