Nurses’ personal and environmental factors in approaches to nursing diagnoses: A cluster analysis

Aim This study aimed to identify distinct nurse clusters based on personal and environmental factors influencing their approaches to nursing diagnosis (NDs). Methods A cross‐sectional study was conducted with 444 nurses from two hospitals in Italy. Data were collected using validated tools: the Behavioral Beliefs Scale (BBS), Normative Beliefs Scale (NBS), Control Beliefs Scale (CBS), positions on nursing diagnosis, Intention Scale (INT), Behavior Scale, Practice Environment Scale of the Nursing Work Index, and Nurse Clinical Reasoning Scale. A cluster analysis was performed. Results The study analyzed 444 nurses, predominantly female (85.36%) with a mean age of 40.11 and 20.92 years of experience in nursing. Factor analysis confirmed the unidimensional structures for the BBS, NBS, and CBS scales, with excellent fit and reliability. Three clusters emerged: “positive beliefs” (37.4%), “neutral beliefs” (48.6%), and “negative beliefs” (14%). Nurses in the positive cluster exhibited stronger clinical reasoning skills and more favorable perceptions of the work environment. Significant differences were noted across clusters regarding practice environment subscales and behavioral beliefs. Conclusions Both personal and environmental factors significantly impact nurses’ engagement with NDs. Tailored strategies to improve clinical reasoning and enhance work environments are essential to fostering positive attitudes and effective use of NDs. Implications for nursing practice By classifying nurses based on their beliefs regarding nursing diagnoses, administrators and educators can more effectively tailor interventions to improve the application of nursing diagnoses in practical environments.