Investigation of the Relationship between Mental Fatigue and Clinical Decision-Making in Operating Room Nurses

Yıl 2023, , 237 - 244, 13.12.2023

Betül Güven , Özlem İbrahimoğlu

https://doi.org/10.48071/sbuhemsirelik.1330883

Öz

Introduction: Stressful and complex operating rooms can cause nurses to get tired mentally. The mental fatigue of nurses, who are expected to make the right clinical decisions in perioperative patient care, can directly affect patient safety.
Aim: This study was carried out to determine the relationship between mental fatigue and clinical decision making in operating room nurses.
Method: This descriptive correlational study was conducted with 168 operating room nurses working in public, private, and university hospitals in Turkey and accessed online. Data were collected with a Descriptive Characteristics
Form, the Mental Fatigue Scale, and the Clinical Decision Making in Nursing Scale. Descriptive statistics,
Mann-Whitney U and Kruskal-Wallis tests for intergroup comparisons, and Spearman correlation test for the investigation of the relationship between the scales were used to analysis data.
Results: Of the total number of nurses, 31.5% have professional experience of 1-5 years, 41.1% work in a public hospital and 94.0% work as a scrub/circulating nurse. The mean Mental Fatigue Scale score was 13.16 ± 6.81, and the mean Clinical Decision Making in Nursing Scale score was 138.87 ± 14.95. There was a statistically significant negative and weak correlation between the mean total Mental Fatigue Scale score and the mean total score of the Clinical Decision Making in Nursing Scale (r= -0.165; p<0.05).
Conclusion: It was concluded that the mental fatigue of the nurses negatively affected their decision-making. In this direction, implementation of practices that will reduce the mental fatigue will contribute to the improvement of patient care quality.

Anahtar Kelimeler

Clinical decision-making, mental fatigue, operating room nursing

Ameliyathane Hemşirelerinde Zihinsel Yorgunluk ile Klinik Karar Verme Arasındaki İlişkinin İncelenmesi

Öz

Giriş: Stresli ve karmaşık ameliyathane ortamları hemşirelerin zihinsel olarak yorulmasına neden olabilmektedir. Ameliyat öncesi, sırası ve sonrası hasta bakımında doğru klinik kararlar alması beklenen ameliyathane hemşirelerinin zihinsel yorgunluğu, hasta güvenliğini doğrudan etkileyebilir.
Amaç: Bu çalışma, ameliyathane hemşirelerinde zihinsel yorgunluk ile klinik karar verme arasındaki ilişkinin belirlenmesi amacıyla gerçekleştirildi.
Yöntem: Tanımlayıcı-ilişki arayıcı tipteki bu araştırma, Türkiye’de kamu, özel ve üniversite hastanelerinde çalışan ve çevrimiçi olarak ulaşılan 168 ameliyathane hemşiresi ile yapıldı. Veriler, Tanıtıcı Özellikler Formu, Zihinsel Yorgunluk Ölçeği ve Hemşirelikte Klinik Karar Verme Ölçeği ile toplandı. Verilerin değerlendirilmesinde tanımlayıcı istatistikler, gruplar arası karşılaştırmalarda Mann-Whitney U ve Kruskal-Wallis testleri ve ölçekler arasındaki ilişkinin değerlendirilmesinde
Spearman korelasyon testi kullanıldı.
Bulgular: Hemşirelerin %31,5’i 1-5 yıl arasında mesleki deneyime sahip olup, %41,1’i kamu hastanesinde ve
%94,0’ü scrub/sirküle hemşire pozisyonunda çalışmaktadır. Hemşirelerin Zihinsel Yorgunluk Ölçeği puan ortalamasının 13,16 ± 6,81, Hemşirelikte Klinik Karar Verme Ölçeği puan ortalaması ise 138,87 ± 14,95 saptandı. Zihinsel Yorgunluk Ölçeği ile Hemşirelikte Klinik Karar Verme Ölçeği toplam puan ortalaması arasında negatif yönde ve zayıf şiddette istatistiksel olarak anlamlı bir ilişki olduğu belirlendi (r = -0,165; p < 0,05).
Sonuç: Ameliyathane hemşirelerinin zihinsel yorgunluğunun klinik karar vermelerini olumsuz yönde etkilediği sonucuna ulaşıldı. Bu doğrultuda ameliyathane hemşirelerinin zihinsel yorgunluğunu azaltacak uygulamaların yapılması, hasta bakım kalitesinin iyileşmesine katkı sağlayacaktır.

Anahtar Kelimeler

Ameliyathane hemşireliği, klinik karar verme, zihin yorgunluğu

Kaynakça

• Akalın, B., ve Modanlıoğlu, A. (2020). “Ameliyathane hemşiresi olmak”: Nitel bir çalışma. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 23(1), 100-108.
• Akansel, N., Akansel, M., & Yanık, H. (2019). Association of organisational stress with fatigue in operating room nurses. Internation Journal Of Caring Sciences, 12(2), 627-638.
• Alshammari, B., AlEnazy, A., Alshammari, F., Madkhali, N., & Al-Masaeed, M.(2022). Investigation of the level and factors ınfluencing emergency department nurses fatigue: A case study of the Saudi Arabian context. Healthcare (Basel, Switzerland), 10(7), 1294. doi:10.3390/healthcare10071294
• An, R., Li, C., Ai, S., Wu, Y., Luo, X., Li, X., … He, C. (2022). Effect of shift work on fatigue, reaction time and accuracy of nurses in the Department of Neurology: A cross-sectional observational study. Journal of Nursing Management, 30(6), 2074–2083. doi:10.1111/jonm.13665
• Arzani, A., Lotfi, M., & Abedi, A.R. (2016). Experiences and clinical decision-making of operating room nurses based on Benner’s Theory. Journal of Babol University of Medical Sciences,18(4), 35-40.
• Ay, E., Karakurt, N., ve Kavuran, E. (2022). Hemşirelerin sosyotropik otonomik kişilik özellikleri ile klinik karar vermeleri arasındaki ilişkinin incelenmesi. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 5(1), 41-48. doi:10.38108/ouhcd.893821
• Bakhshi, E., Mazloumi, A., & Hoseini, S.M. (2019). Relationship between mental fatigue and mental workload among nurses. Zahedan Journal of Research in Medical Sciences, 21(1), e83082. doi:10.5812/zjrms.83082
• Barker, L. M., & Nussbaum, M. A. (2011). Fatigue, performance and the work environment: a survey of registered nurses. Journal of Advanced Nursing, 67(6), 1370–1382. doi:10.1111/j.1365-2648.2010.05597.x
• Battié, R. N., Rall, H., Khorsand, L., & Hill, J. (2017). Addressing perioperative staff member fatigue. AORN Journal, 105(3), 285–291. doi:10.1016/j. aorn.2017.01.003
• Bazazan, A., Dianat, I., Mombeini, Z., Aynehchi, A., & Asghari Jafarabadi, M.(2019). Fatigue as a mediator of the relationship between quality of life and mental health problems in hospital nurses. Accident Analysis & Prevention, 126, 31–36. doi:10.1016/j.aap.2018.01.042
• Bijani, M., Abedi, S., Karimi, S., & Tehranineshat, B. (2021). Major challenges and barriers in clinical decision-making as perceived by emergency medical services personnel: A qualitative content analysis. BMC Emergency Medicine, 21(1), 11. doi:10.1186/s12873-021-00408-4
• Billones, R., Liwang, J. K., Butler, K., Graves, L., & Saligan, L. N. (2021). Dissecting the fatigue experience: A scoping review of fatigue definitions, dimensions, and measures in non-oncologic medical conditions. Brain, Behavior, & Immunity - Health, 15, 100266. doi:10.1016/j.bbih.2021.100266
• Boksem, M. A., & Tops, M. (2008). Mental fatigue: costs and benefits. Brain Research Reviews, 59(1), 125–139. doi:10.1016/j.brainresrev.2008.07.001
• Chen, S. L., Hsu, H. Y., Chang, C. F., & Lin, E. C. (2016). An exploration of the correlates of nurse practitioners’ clinical decision-making abilities. Journal of Clinical Nursing, 25(7-8), 1016–1024. doi:10.1111/jocn.13136
• Çerçi, S., Uyurdağ, N., ve Reyhanoğlu, N. (2022). Sorumlu hemşirelerin sorun çözme ve klinik karar verme becerilerinin bazı değişkenlere göre değerlendirilmesi. Sağlık ve Hemşirelik Yönetimi Dergisi, 9(3), 427-437. doi:10.54304/SHYD.2022.53254
• Durmaz Edeer, A., & Sarıkaya, A. (2015). Adaptation of clinical decision making in nursing scale to undergraduate students of nursing: the study of reliability and validity. International Journal of Psychology and Educational Studies, 2(3),1-9. doi:10.17220/ijpes.2015.03.001
• Eriksson, J., Lindgren, B. M., & Lindahl, E. (2020). Newly trained operating room nurses’ experiences of nursing care in the operating room. Scandinavian Journal of Caring Sciences, 34(4), 1074–1082. doi:10.1111/scs.12817
• Golvani, J., Roos, L., & Henricson, M. (2021). Operating room nurses’ experiences of limited access to daylight in the workplace - a qualitative interview study. BMC Nursing, 20(1), 227. doi:10.1186/s12912-021-00751-8
• Gök, F., & Koçbilek, Z.D. (2022). Examination of fatigue levels and factors affecting fatigue in operating room nurses. Perioperative Care and Operating Room Management, 26,100243. doi:10.1016/j.pcorm.2022.100243
• Güven, B., İbrahimoğlu, Ö., & Mersin, S. (2023). The Turkish adaptation of Mental Fatigue Scale: a validity and reliability study. Journal of Education and Research in Nursing, 20(2), 121-126. doi:10.14744/jern.2021.21197
• Han, K., Trinkoff, A.M., & Geiger-Brown, J. (2014). Factors associated with work-related fatigue and recovery in hospital nurses working 12-hour shifts. Workplace Health & Safety, 62(10), 409–414. doi:10.3928/21650799-20140826-01
• Hazzard, B., Johnson, K., Dordunoo, D., Klein, T., Russell, B., & Walkowiak, P.(2013). Work- and nonwork-related factors associated with PACU nurses’ fatigue. Journal of Perianesthesia Nursing, 28(4), 201–209. doi:10.1016/j. jopan.2012.06.010
• Herlambang, M.B., Cnossen, F., & Taatgen, N.A. (2021). The effects of intrinsic motivation on mental fatigue. PloS One, 16(1), e0243754. doi:10.1371/ journal.pone.0243754
• Jalilian, H., Shouroki, F.K., Azmoon, H., Rostamabadi, A., & Choobineh, A. (2019). Relationship between job stress and fatigue based on job demand-control-support model in hospital nurses. International Journal of Preventive Medicine, 10, 56. doi:10.4103/ijpvm.IJPVM_178_17
• Jang, H.J., Kim, O., Kim, S., Kim, M.S., Choi, J.A., Kim, B., … Jung, H. (2021). Factors affecting physical and mental fatigue among female hospital nurses: the Korea nurses’ health study. Healthcare (Basel, Switzerland), 9(2), 201.doi:10.3390/healthcare9020201
• Jenkins, H. (1983). Perceptions of decision making among baccalaureate nursing students as measured by the clinical decision making in nursing scale. (Doktora Tezi) The University of Maryland, Amerika Birleşik Devletleri.
• Jia, H., Lin, C.J., & Wang, E.M. (2022). Effects of mental fatigue on risk preference and feedback processing in risk decision-making. Scientific reports, 12(1), 10695. doi:10.1038/s41598-022-14682-0
• Johansson, B., Starmark, A., Berglund, P., Rödholm, M., & Rönnbäck, L. (2010). A self-assessment questionnaire for mental fatigue and related symptoms after neurological disorders and injuries. Brain Injury, 24(1), 2–12. doi:10.3109/02699050903452961
• Keskin, A.Y. (2020). Hemşirelik öğrencilerinin klinik karar verme algıları ve klinik karar vermelerini etkileyen faktörlerin incelenmesi. Ankara Sağlık Bilimleri Dergisi, 9(2),102-111. doi:10.46971/ausbid.751280
• Lee, D.S., Abdullah, K.L., Subramanian, P., Bachmann, R.T., & Ong, S.L. (2017). An integrated review of the correlation between critical thinking ability and clinical decision-making in nursing. Journal of Clinical Nursing, 26(23-24),4065-4079. doi:10.1111/jocn.13901
• Mirzaee, S., Zamanian, Z., & Zade, J.H. (2015). Effects of work shifts and mental workload on chronic fatigue among female nurses in ıntensive care units. Journal of Health Sciences & Surveillance System, 3(3), 113-18.
• Mo, X., Qin, Q., Wu, F., Li, H., Tang, Y., Cheng, Q., & Wen, Y. (2021). Effects of breathing meditation training on sustained attention level, mindfulness attention awareness level, and mental state of operating room nurses. American Journal of Health Behavior, 45(6), 993–1001. doi:10.5993/AJHB.45.6.4
• Morelock, S. (2016). Sustained vigilance and errors in critical care. Nursing Critical Care,11(6),38–47. doi:10.1097/01.CCN.0000503414.59852.16
• Motamedzade, M., Abbasinia, M., Parvari, R., Oliaie, M., Karimi, S., & Mohammadi, P. (2017). Mental workload and its association with fatigue in operating room personnel of Hamadan hospitals, Iran, 2016. Journal of Occupational Health and Epidemiology, 6(2), 98-105. doi:10.29252/johe.6.2.98
• Nahid, N., Behzad, I., & Reza, K.H. (2021). Operating room nurses’ lived experiences of occupational hazards: a phenomenological study. Perioperative Care and Operating Room Management, 25,100211. doi:10.1016/j.pcorm.2021.100211
• Özden, D., Özveren, H., ve Gülnar, E. (2018). Hemşirelik öğrencilerinin klinik karar verme düzeyleri ve etkileyen faktörler. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi,11(1), 41-47.
• Özvurmaz, S., & Mandıracıoğlu, A. (2018). Work-related fatigue and related factors among nurses working at the Adnan Menderes University Hospital. Medical Science and Discovery, 5(8), 284-289.
• Rodrigues, A. L., Torres, F.B.G., Gomes, D.C., Carvalho, D.R., Santos, E.A.P., & Cubas, M.R. (2020). Workflow and decision making of operating room nurses: integrative review. Revista Gaucha de Enfermagem, 41, e20190387. doi:10.1590/1983-1447.2020.20190387
• Rose, D.M., Seidler, A., Nübling, M., Latza, U., Brähler, E., Klein, E.M., … Beutel, M.E. (2017). Associations of fatigue to work-related stress, mental and physical health in an employed community sample. BMC Psychiatry, 17(1), 167. doi:10.1186/s12888-017-1237-y
• Sagherian, K., Clinton, M.E., Abu-Saad Huijer, H., & Geiger-Brown, J. (2017). Fatigue, work schedules, and perceived performance in bedside care nurses. Workplace Health & Safety, 65(7), 304–312. doi:10.1177/2165079916665398
• Scott, L.D., Arslanian-Engoren, C., & Engoren, M.C. (2014). Association of sleep and fatigue with decision regret among critical care nurses. American Journal of Critical-Care Nurses, 23(1), 13–23. doi:10.4037/ajcc2014191
• Sillero, A., & Zabalegui, A. (2018). Organizational factors and burnout of perioperative nurses. Clinical Practice and Epidemiology in Mental Health, 14, 132–142. doi:10.2174/1745017901814010132
• Teymoori, E., Zareiyan, A., Babajani-Vafsi, S., & Laripour, R. (2022). Viewpoint of operating room nurses about factors associated with the occupational burnout: A qualitative study. Frontiers in Psychology, 13, 947189. doi:10.3389/ fpsyg.2022.947189
• Uğurlu, Z., Karahan, A., Ünlü, H., Abbasoğlu, A., Özhan Elbaş, N., Avcı Işık, S., & Tepe, A. (2015). The effects of workload and working conditions on operating room nurses and technicians. Workplace Health & Safety, 63(9), 399–407. doi:10.1177/2165079915592281
• Wang, D., Xie, X., Tian, H., Wu, T., Liu, C., Huang, K., … Zhang, L. (2022). Mental fatigue and negative emotion among nurses during the COVID-19 pandemic. Current Psychology, 41(11), 8123–8131. doi:10.1007/s12144-022-03468-2
• Zhang, Q., Sun, M.A., Sun, Q., Mei, H., Rao, H., & Liu, J. (2023). Mental fatigue is associated with subjective cognitive decline among older adults. Brain Sciences, 13(3), 376. doi:10.3390/brainsci13030376
• Zhan, Y.X., Zhao, S.Y., Yuan, J., Liu, H., Liu, Y.F., Gui, L.L., … Li, S.Y. (2020). Prevalence and influencing factors on fatigue of first-line nurses combating with COVID-19 in China: A descriptive cross-sectional study. Current Medical Science, 40(4), 625–635. doi:10.1007/s11596-020-2226-9