Association of self perceived clinical decision making with perceived importance of caring behaviors among ICU nurses in the West Bank

Abstract

To examine the association between self-perceived clinical decision-making (CDM) and the perceived importance of caring behaviors among intensive care unit (ICU) nurses in the West Bank, Palestine. ICU nurses make rapid, high-stakes decisions while providing technically complex and person-centered care. How CDM relates to perceived importance of caring behaviors in resource-constrained ICU settings in the West Bank, Palestine, remains insufficiently understood. A convenience sample of 244 ICU nurses from ten public hospitals completed the Clinical Decision-Making in Nursing Scale (CDMNS) and the Caring Behaviors Assessment Tool-Nursing Version-Short Form (CBAN-SF). Internal consistency was acceptable in the current sample (Cronbach’s alpha = 0.88 for CDMNS and 0.90 for CBAN-SF). Hospital-level clustering was not modeled in the regression analysis; adjusted estimates were therefore interpreted as exploratory. The mean CDMNS total score was 142.5 (SD = 16.1). Among the four CDM domains, canvassing of objectives and values had the highest mean score (M = 38.4, SD = 4.7), and search for and unbiased assimilation of new information had the lowest (M = 33.5, SD = 6.9). The mean CBAN-SF perceived-importance score was 105.8 (SD = 14.2). CBAN-SF domain item means ranged from 3.8 to 4.0; humanism/faith-hope/sensitivity and expression of positive/negative feelings had the highest item means, whereas helping/trust and teaching/learning had the lowest. Higher self-perceived CDM scores, membership in the master’s-degree-or-higher group compared with the combined diploma/bachelor’s group, and longer ICU experience were associated with higher CBAN-SF perceived-importance scores. Because the study was cross-sectional and the outcome measured perceived importance rather than observed or enacted behavior, the findings indicate statistical association rather than causal or behavioral effects. Future multicenter research should account for hospital-level clustering, use theory-informed covariate selection, and incorporate observed, patient-reported, or other performance-based measures of caring.

The authors' abstract, as published at the source. Scientific Reports, 2026 · DOI ↗