Please use this identifier to cite or link to this item:
http://hdl.handle.net/1893/36881
Appears in Collections: | Psychology Journal Articles |
Peer Review Status: | Refereed |
Title: | Lengthy shifts and decision fatigue in out-of-hours primary care: a qualitative study |
Author(s): | Maier, Mona Lawrie, Louisa Powell, Daniel Murchie, Peter Allan, Julia |
Contact Email: | julia.allan@stir.ac.uk |
Keywords: | clinical decision-making decision fatigue general practitioners interview medical decision-making nurses |
Issue Date: | Mar-2025 |
Date Deposited: | 25-Feb-2025 |
Citation: | Maier M, Lawrie L, Powell D, Murchie P & Allan J (2025) Lengthy shifts and decision fatigue in out-of-hours primary care: a qualitative study. |
Abstract: | Rationale: Demands on healthcare workers are high: services are stretched, shifts are long, and healthcare professionals regularly work lengthy periods without a break. Spending time continuously ‘on task’ changes decision-making in predictable ways, as described by the ‘decision fatigue’ phenomenon where decision-makers progressively shift towards making less cognitively effortful decisions as the time worked without a break increases. This phenomenon has been observed repeatedly in large quantitative observational studies, however, individual healthcare workers’ experiences have not been explored. Aims: This qualitative study aimed to explore general practitioners’ (GPs) and advanced nurse practitioners’ (ANPs) experiences of working for lengthy periods in an out-of-hours primary care service in the UK. This included exploration of self-perceived changes in decision-making throughout a work shift, and mitigating strategies used to avoid changes in decision-making over time. Design: Semi-structured interviews were conducted online. An inductive thematic analysis was carried out to identify salient issues articulated by participants. Setting and participants: The interview sample (n=10) comprised ANPs (n=5) and GPs (n=5) who regularly worked within the out-of-hours primary care service across a regional National Health Service (NHS) health board. Results: Healthcare professionals (GPs and ANPs) provided insights into their experiences during lengthy shifts and the impact of prolonged periods of work on clinical decision-making. Four main themes were identified and developed: (1) Healthcare professionals (HCPs) are aware of decision fatigue effects over the course of a shift; (2) Multiple factors help and hinder stable decision-making quality; (3) HCPs deliberately use strategies to help keep the quality of their decision-making stable; and (4) HCPs are aware of contextual changes, likely related to the decision fatigue phenomenon. Conclusions: The findings of this study underscore the intricate interplay of personal, social, and systemic factors in decision-making quality and highlight healthcare professionals' deliberate efforts to mitigate decision fatigue's effects in practice. |
DOI Link: | 10.1111/jep.70050 |
Rights: | © 2025 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
Licence URL(s): | http://creativecommons.org/licenses/by/4.0/ |
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Evaluation Clinical Practice - 2025 - Maier - Lengthy Shifts and Decision Fatigue in Out___of___Hours Primary Care A.pdf | Fulltext - Published Version | 336.5 kB | Adobe PDF | View/Open |
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