Evaluation of the Decisional Fatigue Scale Among Surrogate Decision Makers of the Critically Ill
Open accessAbstract
Intense emotional distress and impaired information processing have been implicated in reducing a surrogate decision maker’s ability to formulate informed health care decisions for a critically ill patient. The heightened intensity of negative emotions, mental effort, and impaired judgment is consistent with the manifestation of decision fatigue. The aim of this article is to describe the validity and reliability of the Decision Fatigue Scale (DFS) among surrogate decision makers of the critically ill. A convenience sample of 101 surrogate decision makers were administered the DFS and a battery of psychosocial instruments at two time points. The DFS was specified as a unidimensional measure with adequate internal consistency (Cronbach’s αs = .87, .90) and stability reliability. Discriminant validity was established with measures of emotion regulation, anxiety, and depressive symptoms. The DFS is the first subjective measure of decision fatigue for surrogate decision makers of the critically ill that demonstrates satisfactory psychometric properties.
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Decision fatigue was measured using the 9-item DFS developed by Hickman et al. and translated and validated in Chinese by Pan Guocui et al.; in this study Cronbach's α = 0.912.
“Decision fatigue was measured using the 9-item DFS developed by Hickman et al.22 and translated and validated in Chinese by Pan Guocui et al.23 for ICU family caregivers.”
From Decisional conflict among Chinese family caregivers prior to ECMO initiation: a cross-sectional study (2025) · cites this paper as Hickman et al.22
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- Authors
- Hickman, R. L., Pignatiello, G. A., & Tahir, S.
- Affiliations
- Case Western Reserve University (US)
- Corresponding author
- Hickman, Ronald L.
- Venue
- Western Journal of Nursing Research
- Publisher
- SAGE Publications
- Published
- 2017-08-14
- Volume
- 40
- Issue
- 2
- Pages
- 191-208
- ISSN
- 0193-9459 (ISSN-L)
- 1552-8456
- PMC
- PMC5750078
- OpenAlex
- W2746216906
- Cited by
- 69
- References
- 37
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 10 · 2023: 6 · 2022: 5 · 2021: 5 · 2020: 2 · 2019: 3 · 2018: 3
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Western Journal of Nursing Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Nursing Research (T32NR015433, T32NR014213, R01NR015750)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
- Keywords
- decision fatigue, surrogate decision makers, critically ill patients, psychometric validation, reliability statistics, validity, emotion regulation, anxiety, depressive symptoms, family caregivers
- MeSH terms
- Adult, Aged, Decision Making, Fatigue, Female, Humans, Male, Middle Aged, Ohio, Psychometrics, Stress, Psychological, Reproducibility of Results, Critical Illness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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