The levels and related factors of mental workload among nurses: A systematic review and meta‐analysis

Abstract

AimThe aim was to determine the overall levels and related factors of mental workload assessed using the NASA‐TLX tool among nurses.BackgroundMental workload is a key element that affects nursing performance. However, there exists no review regarding mental workload assessed using the NASA‐TLX tool, focusing on nurses.DesignA systematic review and meta‐analysis.Data SourcesPubMed, MEDLINE, Web of Science, EMBASE, PsycINFO, Scopus, CINAHL, CNKI, CBM, Weipu and WanFang databases were searched from 1 January 1998 to 30 February 2022.Review MethodsFollowing the PRISMA statement recommendations, review methods resulted in 31 quantitative studies retained for inclusion which were evaluated with the evaluation criteria for observational studies as recommended by the Agency for Healthcare Research and Quality. The data were pooled and a random‐effects meta‐analysis conducted.ResultsFindings showed the pooled mental workload score was 65.24, and the pooled prevalence of high mental workload was 54%. Subgroup analysis indicated nurses in developing countries and emergency departments experienced higher mental workloads, and the mental workloads of front‐line nurses increased significantly during the COVID‐19 pandemic.ConclusionThese findings highlight that nurses experience high mental workloads as assessed using the NASA‐TLX tool and there is an urgent need to explore interventions to decrease their mental workloads.

Cognitive mental workload of emergency nursing: A scoping review

“…Empirical evidence of emergency nurses' high CMW is reported in several studies (Bakhoum et al, 2021;Forsyth et al, 2018;Kim et al, 2019;Yuan et al, 2023). Forsyth et al (2018) reported that emergency nurses experience an average of 85 interruptions in a shift and was concerned about the cognitive demand imposed on them.…”

“…Whereas the time motion study by Bakhoum et al (2021) pinpointed the effect of information technology on emergency nurses' cognitive workload experiences. The metaanalysis of 31 quantitative study including 16,189 nurses performed by Yuan et al (2023) reported that mental workload experiences of nurses estimated using NASA TLX were documented to be high. The same study also informed that emergency nurses experienced the highest level of mental workload of all other specialist nurses.…”

“…Currently, nurses' workloads are often measured based on objective measures like patient care needs, demands or number of patients under care. These measures do not reflect the actual workload, especially the mental workload perceived by nurses (Neill, 2006) (Kremer et al, 2022) and a meta-analysis on nurses' overall estimation of mental workload using the popular subjective scale, the Nasa Workload Index (NASA TLX) (Yuan et al, 2023). However, there is a gap in knowledge about subjective CMW measures, particularly for emergency nurses.…”

“…Though the reason is not clear, undoubtedly there is an intense need for further research in all settings and arenas of nurses' CMW to ensure the welfare of nurses and to sustain safe/ quality healthcare delivery in the midst of alarming global nurses' shortage.The results of this scoping review prove that emergency nurses' CMW experiences are comparatively less studied. The Metaanalytical study byYuan et al (2023) established that emergency nurses experience the highest CMW levels than all other nursing specialities. Although CMW is highlighted as the major causative factor for healthcare-related errors(Wolf et al, 2006) and emergency department being infamous for the highest nursing error rates(Abbaszadeh et al, 2021), the findings of this scoping review and meta-analytical review byYuan et al (2023) substantiates the scarcity of research in emergency nurses' CMW.…”

“…The Metaanalytical study byYuan et al (2023) established that emergency nurses experience the highest CMW levels than all other nursing specialities. Although CMW is highlighted as the major causative factor for healthcare-related errors(Wolf et al, 2006) and emergency department being infamous for the highest nursing error rates(Abbaszadeh et al, 2021), the findings of this scoping review and meta-analytical review byYuan et al (2023) substantiates the scarcity of research in emergency nurses' CMW. Hence, further knowledge generation in the field of emergency nurses' CMW is necessary to ensure safe and quality health care.…”