Publications by authors named "Emily Tsivitse"

3 Publications

  • Page 1 of 1

Decision fatigue among clinical nurses during the COVID-19 pandemic.

J Clin Nurs 2021 Jul 21. Epub 2021 Jul 21.

Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.

Aims And Objectives: The purpose of this study was to report the psychometric properties, including validity and reliability, of the decision fatigue scale (DFS).

Background: Decision fatigue may impair nurses' ability to make sound clinical decisions and negatively impact patient care. Given the negative impact of the COVID-19 pandemic on psychological well-being and the workplace environment, decision fatigue may be even more apparent among clinical nurses. Valid assessment of this condition among clinical nurses may inform supportive interventions to mitigate the negative sequelae associated with states of decision fatigue.

Design: This study was a secondary analysis of a parent study using a cross-sectional descriptive design.

Methods: A convenience sample of 160 staff nurses was recruited online from across the United States. Participants completed a demographic questionnaire and subjective measures of decision fatigue, nursing practice environment scale and traumatic stress. Exploratory factor analysis (EFA), correlation coefficients and internal consistency reliability coefficients were computed to examine the DFS's validity and reliability within this sample.

Results: The EFA yielded a single factor, 9-item version of the DFS. The DFS scores were strongly correlated with traumatic stress and moderately correlated with the nursing practice environment, and the scale displayed appropriate internal consistency.

Conclusions: This is the first known study to provide evidence of the DFS's validity and reliability in a sample of registered nurses working during the COVID-19 pandemic. The results of this study provide evidence of a reliable and valid assessment instrument for decision fatigue that can be used to measure the burden of decision-making among registered nurses.

Relevance To Clinical Practice: Given the relationship between traumatic stress and the nursing work environment, decision fatigue may be a modifiable target for interventions that can enhance the quality of decision-making among clinical nurses.
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http://dx.doi.org/10.1111/jocn.15939DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8447365PMC
July 2021

A psychometric evaluation of the Family Decision-Making Self-Efficacy Scale among surrogate decision-makers of the critically ill.

Palliat Support Care 2020 10;18(5):537-543

Case Western Reserve University, Cleveland, OH.

Objectives: The purpose of this study was to report the psychometric properties, in terms of validity and reliability, of the Unconscious Version of the Family Decision-Making Self-Efficacy Scale (FDMSE).

Methods: A convenience sample of 215 surrogate decision-makers for critically ill patients undergoing mechanical ventilation was recruited from four intensive care units at a tertiary hospital. Cross-sectional data were collected from participants between days 3 and 7 of a decisionally impaired patient's exposure to acute mechanical ventilation. Participants completed a self-report demographic form and subjective measures of family decision-making self-efficacy, preparation for decision-making, and decisional fatigue. Exploratory factor analyses, correlation coefficients, and internal consistency reliability estimates were computed to evaluate the FDMSE's validity and reliability in surrogate decision-makers of critically ill patients.

Results: The exploratory factor analyses revealed a two-factor, 11-item version of the FDMSE was the most parsimonious in this sample. Furthermore, modified 11-item FDMSE demonstrated discriminant validity with the measures of fatigue and preparation for decision-making and demonstrated acceptable internal consistency reliability estimates.

Significance Of Results: This is the first known study to provide evidence for a two-factor structure for a modified, 11-item FDMSE. These dimensions represent treatment and palliation-related domains of family decision-making self-efficacy. The modified FDMSE is a valid and reliable instrument that can be used to measure family decision-making self-efficacy among surrogate decision-makers of the critically ill.
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http://dx.doi.org/10.1017/S1478951519000907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205581PMC
October 2020

A preliminary psychometric evaluation of the eight-item cognitive load scale.

Appl Nurs Res 2018 04 31;40:99-105. Epub 2018 Jan 31.

Case Western Reserve University, Cleveland, OH, United States.

Aim: The aim of this article is to report the psychometric properties of the eight-item cognitive load scale.

Background: According to cognitive load theory, the formatting and delivery of healthcare education influences the degree to which patients and/or family members can engage their working memory systems for learning. However, despite its relevance, cognitive load has not yet been evaluated among surrogate decision makers exposed to electronic decision support for healthcare decisions. To date, no psychometric analyses of instruments evaluating cognitive load have been reported within healthcare settings.

Methods: A convenience sample of 62 surrogate decision makers for critically ill patients were exposed to one of two healthcare decision support interventions were recruited from four intensive care units at a tertiary medical center in Northeast Ohio. Participants were administered a battery of psychosocial instruments and the eight-item cognitive load scale (CLS).

Results: The CLS demonstrated a bidimensional factor structure with acceptable discriminant validity and internal consistency reliability (Cronbach's α = 0.75 and 0.89).

Conclusions: The CLS is a psychometrically sound instrument that may be used in the evaluation of decision support among surrogate decision makers of the critically ill. The authors recommend application of the cognitive load scale in the evaluation and development of healthcare education and interventions.
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http://dx.doi.org/10.1016/j.apnr.2018.01.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5873589PMC
April 2018
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