Causal attributions in real life: Nurses' perceptions of causes for patient illness

Theresa Raphael-Grimm, University of Pennsylvania


The existence of the fundamental attribution error (FAE) has been well documented in the interpersonal attribution literature yet virtually all of this empirical support for the FAE has resulted from methodologies that have utilized hypothetical or laboratory situations. Additional empirical support for the FAE comes from Just World theory, a theory which also suffers from a dearth of real life evidence. This exploratory investigation attempted to examine the accuracy of both the FAE and Just World theory in a real life health care setting. An additional purpose was to identify factors that influence nurses' causal attributions about patients and patients' illnesses. The extent to which nurses are dispositionally biased about the non-pathophysiological causes for patient illness was examined and compared with nurses' belief in a just world. Theoretically, those who blamed patients for their illnesses were predicted to be strong believers in the premise that people generally get what they deserve. Literature review suggested that factors such as level of patient participation, nurses' perceptions of their own effectiveness, and extent of familiarity with the patient could affect nurses' judgements. These factors were incorporated into the design. Subjects completed three instruments. The first instrument addressed their intuitive hunches about causes of misfortune in two patients for whom they were currently providing care. One patient was familiar, the other was relatively unfamiliar. Subjects completed an adjective checklist on each of these patients, indicating the extent to which certain character traits, both positive and negative, described the patients. Subjects also completed a Just World Scale which measured the extent to which the subject believed that people generally get what they deserve. Results indicated that, in general, these nurses did not hold patients responsible for their illnesses. However, nurses did feel more positively towards patients with whom they were familiar and with whom they perceived their care to be more effective. Nurses were also more positive about patients who were active participants in their own care. While many nurses did emerge as just world believers, there was no relationship between belief in a just world and dispositional attributions for illness.

Subject Area

Nursing|Social psychology|Health

Recommended Citation

Raphael-Grimm, Theresa, "Causal attributions in real life: Nurses' perceptions of causes for patient illness" (1993). Dissertations available from ProQuest. AAI9413891.