认知负荷对临床护士任务复杂性与指南遵循之间关系的中介作用：中国护士的横断面调查

Mediator effects of cognitive load on the relationship between task complexity and guideline adherence among clinical nurses: a cross-sectional survey of nurses in China.

作者信息

Zhang Shan, Liu Lu, Ding Shu, Peng Tingting, Wang Jun, Wu Ying

机构信息

Associate Professor, School of Nursing, Capital Medical University, Beijing, China.

Master Student, School of Nursing, Capital Medical University, Beijing, China.

出版信息

J Res Nurs. 2025 Aug 7:17449871251329197. doi: 10.1177/17449871251329197.

DOI:10.1177/17449871251329197

PMID:40787650

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12331640/

Abstract

BACKGROUND

Suboptimal adherence to guidelines is a common phenomenon in clinical settings. Studies regarding the complexity of tasks, cognitive load, and adherence to guidelines among clinical nurses are noteworthy, but limited.

PURPOSE

To investigate whether cognitive load mediates the association between task complexity and guideline adherence in clinical nurses.

METHODS

In total, 580 clinical nurses from 8 tertiary hospitals were included in the cross-sectional survey. A self-reported survey included guideline adherence, task complexity, and cognitive load. We conducted correlation and multiple linear regression analysis and performed a mediation effect analysis using PROCESS with 5000 resamples.

RESULTS

The linear regression showed that task complexity significantly predicted intrinsic cognitive load ( = 0.322, < 0.001), intrinsic cognitive load significantly predicted guideline adherence ( = -0.113, < 0.001), and task complexity had a direct impact on guideline adherence (' = 0.126, < 0.001). Both intrinsic cognitive load (effect size = -0.037, 95%CI: -0.061, -0.019) and germane cognitive load (effect size = 0.180, 95%CI: -0.269, -0.171) played a partial mediating effect between task complexity and guideline adherence among nurses, contributing to 53.16% of the overall effect.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Nursing administrators should prioritise the cognitive load for clinical nurses when allocating intricate assignments.

摘要

背景

在临床环境中，对指南的依从性欠佳是一种常见现象。关于临床护士任务复杂性、认知负荷以及对指南的依从性的研究值得关注，但数量有限。

目的

调查认知负荷是否在临床护士的任务复杂性与指南依从性之间起中介作用。

方法

共有来自8家三级医院的580名临床护士纳入了横断面调查。一项自陈式调查包括指南依从性、任务复杂性和认知负荷。我们进行了相关性和多元线性回归分析，并使用带有5000次重抽样的PROCESS进行中介效应分析。

结果

线性回归显示，任务复杂性显著预测内在认知负荷（β = 0.322，P < 0.001），内在认知负荷显著预测指南依从性（β = -0.113，P < 0.001），且任务复杂性对指南依从性有直接影响（β' = 0.126，P < 0.001）。内在认知负荷（效应量 = -0.037，95%CI：-0.061，-0.019）和相关认知负荷（效应量 = 0.180，95%CI：-0.269，-0.171）在护士的任务复杂性和指南依从性之间均起部分中介作用，占总效应的53.16%。

结论/实践启示：护理管理者在分配复杂任务时应优先考虑临床护士的认知负荷。