Correlates of Cognitive Load in Surrogate Decision Makers of the Critically III.
Grant A Pignatiello, Ronald L Hickman
PMID 30366508WHAT IT FOUND
ICU surrogate decision makers reported greater mental burden from the information itself when they had more decision fatigue or anxiety, and age was linked to greater burden; expressive suppression and the decision aid received were linked to greater burden from how it was presented.
Key findings
01Decision fatigue, age, and anxiety were significant predictors of intrinsic cognitive load, while expressive suppression and cognitive reappraisal were not.
02Expressive suppression, age, and the decision aid received were significant predictors of extraneous cognitive load, while decision fatigue and cognitive reappraisal were not.
03Cognitive reappraisal was not a significant predictor of either intrinsic or extraneous cognitive load.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Data were collected at one time point, so the study cannot show that decision fatigue, anxiety, expressive suppression, age, or the decision aid caused higher cognitive load. The sample was convenience recruited at one tertiary medical center and was mostly White and female, so findings may not apply to more diverse surrogate decision makers. The regression models explained only 26% of the variance in cognitive load, leaving much unexplained. Expressive suppression and cognitive reappraisal were measured as general traits, not as what the surrogate did during the decision aid. This was a secondary analysis, and the authors participated in data collection for the parent trial. Only participants who received a decision aid were analyzed, so the study did not compare either aid with usual care here.
Declared interests
The paper is listed as supported by extramural NIH funding; no author conflict declaration is provided in the supplied text.
The easy way to misread this
Do not conclude that choosing a passive video over an interactive avatar, or reducing decision fatigue, anxiety, or expressive suppression, will lower cognitive load. These were associations measured at one time point in a secondary analysis, and the models explained only 26% of the variance.