A survey of accuracy of nurses' clinical judgement of cutaneous graft-versus-host disease in Japan

Nurs Open. 2021 Mar;8(2):646-655. doi: 10.1002/nop2.669. Epub 2020 Nov 2.


Aim: We examined accuracy of nurses' clinical judgement of graft-versus-host-disease (GVHD) symptoms and related factors using Common Terminology Criteria for Adverse Events (CTCAE) for patients who developed chronic cutaneous GVHD after haematopoietic stem cell transplants.

Design: Cross-sectional design using nationwide survey.

Methods: A questionnaire survey based on Tanner's clinical judgement model to assess patients with chronic cutaneous GVHD using CTCAE was used. Free-text descriptions and statistical analyses of relationship between correct responses and demographic data were performed.

Results: The rate of correct responses for main symptoms of skin GVHD was < 50%; there was no statistical significance between correct responses and demographic data, knowledge about GVHD and collaborative practice with physicians. The accuracy of cutaneous GVHD clinical judgements was not directly related to nurses' background. Educational opportunities that reinforce nurses' abilities to reflect on knowledge and experiences to interpret patient symptoms are essential for improving accuracy of clinical judgement.

Keywords: care; clinical judgement; haematopoietic stem cell transplantation; nursing assessment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Clinical Competence
  • Clinical Reasoning*
  • Cross-Sectional Studies
  • Female
  • Graft vs Host Disease* / diagnosis
  • Humans
  • Japan
  • Male
  • Nurses*
  • Surveys and Questionnaires