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.

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 associatio...

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Published in:Journal of Research in Nursing Vol. 30; no. 5/6; pp. 479 - 491
Main Authors: Zhang, Shan, Liu, Lu, Ding, Shu, Peng, Tingting, Wang, Jun, Wu, Ying
Format: research tables/charts Journal Article
Published: Sage Publications Inc. Sep2025
Online Access:View this record in EBSCOhost
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      dt: Sep2025
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      place: Thousand Oaks, California
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        atl: 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.
      aug:
        au:
          Zhang, Shan
          Liu, Lu
          Ding, Shu
          Peng, Tingting
          Wang, Jun
          Wu, Ying
        affil: Associate Professor, School of Nursing, Capital Medical University, Beijing, China
      sug:
        subj:
          Cognition
          Task Performance and Analysis Evaluation
          Guideline Adherence Evaluation
          Nursing Staff, Hospital Psychosocial Factors
          Human
          Funding Source
          China
          Male
          Female
          Cross Sectional Studies
          Questionnaires
          Convenience Sample
          Tertiary Health Care
          Surveys
          Adult
          Middle Age
          Coefficient alpha
          Data Analysis Software
          Descriptive Statistics
          Pearson's Correlation Coefficient
          Multiple Linear Regression
          Structural Equation Modeling
          Mediation Analysis
          Job Experience
          Scales
          Professional Practice
          Sociodemographic Factors
          Self Report
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: 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 (a1 = 0.322, p < 0.001), intrinsic cognitive load significantly predicted guideline adherence (b1 = −0.113, p < 0.001), and task complexity had a direct impact on guideline adherence (c ′ = 0.126, p < 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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