Maier Mona, Powell Daniel, Murchie Peter, Allan Julia L
Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Health Psychol Rev. 2025 Jul 1:1-46. doi: 10.1080/17437199.2025.2513916.
Decision fatigue is the tendency towards making less effortful decisions as the cumulative mental burden of effortful decision-making increases. Health professionals working long shifts may be particularly vulnerable to decision fatigue. This preregistered systematic review (Prospero ID = CRD42021260081, no external funding) aims to synthesise the empirical evidence on decision fatigue in the healthcare context. Systematic searches across eight databases identified 14,740 records. = 82 studies (72 quantitative, 1 qualitative, 1 review, 8 expert discussions) met the inclusion criteria (health professionals/trainees; medical decisions over time; healthcare context; any design). Study quality was assessed with the MMAT or relevant JBI checklist. Narrative synthesis revealed that 45% of cases that quantitatively assessed the decision fatigue hypothesis provided evidence of significant decision fatigue effects across diagnostic, test ordering, prescribing, and therapeutic decisions. Expert discussions confirmed healthcare professionals' recognition of decision fatigue as an important phenomenon. However, decision fatigue was inconsistently defined and inadequately operationalised, reflecting limitations in current theoretical understanding of the phenomenon. To address this, we propose a new definition for greater conceptual clarity and more consistent operationalisation in future research.' Future studies should prioritise the development and testing of different theoretical explanations for decision fatigue to improve understanding and facilitate the development of appropriate interventions.
决策疲劳是指随着需要付出努力的决策所带来的累积心理负担增加，人们倾向于做出不那么费力的决策。长时间轮班工作的医疗专业人员可能特别容易受到决策疲劳的影响。这项预先注册的系统评价（Prospero编号：CRD42021260081，无外部资金支持）旨在综合医疗背景下关于决策疲劳的实证证据。在八个数据库中进行的系统检索共识别出14,740条记录。82项研究（72项定量研究、1项定性研究、1项综述、8项专家讨论）符合纳入标准（医疗专业人员/实习生；随时间推移的医疗决策；医疗背景；任何设计）。使用MMAT或相关的JBI清单对研究质量进行评估。叙述性综合分析表明，在定量评估决策疲劳假设的案例中，45%的案例提供了证据，表明在诊断、检查开单、开药和治疗决策中存在显著的决策疲劳效应。专家讨论证实了医疗专业人员对决策疲劳这一重要现象的认识。然而，决策疲劳的定义不一致，操作化也不充分，这反映了当前对该现象的理论理解存在局限性。为了解决这个问题，我们提出了一个新的定义，以便在未来的研究中实现更大的概念清晰度和更一致的操作化。未来的研究应优先对决策疲劳的不同理论解释进行开发和测试，以增进理解并促进适当干预措施的制定。
