Evaluation of the Decisional Fatigue Scale Among Surrogate Decision Makers of the Critically Ill.
Ronald L Hickman, Grant A Pignatiello, Sadia Tahir
PMID 28805132WHAT IT FOUND
The 9-item Decision Fatigue Scale is a reliable tool for measuring stress in ICU surrogate decision makers.
It correlates with anxiety and decision conflict, helping clinicians identify when families are too exhausted to make clear choices.
Key findings
01A 9-item version of the Decision Fatigue Scale showed strong internal consistency and stability over eight weeks.
02The scale demonstrated discriminant validity, showing distinct relationships with anxiety, depression, and decisional conflict.
03Participants reported low levels of decision fatigue, potentially due to recall bias from the one-week reflection period.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was relatively small and lacked diversity, limiting generalizability. The scale showed a floor effect, with participants reporting very low fatigue, possibly because asking them to recall feelings from the past week introduced bias. The study did not compare the DFS to any existing measures of decision fatigue.
The easy way to misread this
Do not assume this scale is ready for immediate clinical use. The authors note a floor effect and recall bias, recommending a shorter reflection period (e.g., 24 hours) before applying it to capture real-time decision fatigue.