title: Decision Making on the Labor and Delivery Unit: An Investigation of Influencing Factors.
abstract: Objective The aim of this study was to describe the relationship between negative affect (NA), decision-making style, time stress, and decision quality in health care. Background Health care providers must often make swift, high-stakes decisions. Influencing factors of the decision-making process in this context have been understudied. Method Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report measures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). In Study 2, we observed the influence of state NA, state decision-making style, state time stress, and their relationship with decision quality on real clinical decisions. Results In Study 1, we found that trait NA significantly predicted avoidant decision-making style. Furthermore, those who were higher on trait time stress and trait avoidant decision-making style exhibited poorer decisions. In Study 2, we observed associations between state NA with state avoidant and analytical decision-making styles. We also observed that these decision-making styles, when considered in tandem with time stress, were influential in predicting clinical decision quality. Conclusion NA predicts some decision-making styles, and decision-making style can affect decision quality under time stress. This is particularly true for state factors. Application Individual differences, such as affect and decision-making style, should be considered during selection. Training to reduce time stress perceptions should be provided.
authors.affiliation: Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Gregory
authors.affiliation: University of Central Florida, Orlando.
authors.forename: Shirley C
authors.initials: SC
authors.lastname: Sonesh
authors.affiliation: City University of New York, Brooklyn.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Feitosa
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Benishek
authors.affiliation: Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Hughes
authors.affiliation: Rice University, Houston, Texas.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Salas
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D000066491:Clinical Decision-Making / Q000379:methods*; D005260:Female; D006801:Humans; D007206:Individuality; D008297:Male; D008875:Middle Aged; D009775:Obstetrics and Gynecology Department, Hospital; D000073397:Occupational Stress / Q000523:psychology*; D010564:Personnel, Hospital / Q000523:psychology*
keywords: health care; individual differences; naturalistic decision making; stress