Phenomenological study on decision fatigue among surrogate decision-makers for ICU patients

Surrogate decision-makers often face multiple medical decisions under psychological and time pressures, leading to decision fatigue. Current research on decision fatigue in intensive care unit (ICU) surrogates focuses primarily on quantitative aspects, lacking an in-depth exploration of their experiences. This study aims to explore the experience of decision fatigue among surrogate decision-makers for ICU patients within the first 48 hours of ICU admission and to provide insights for clinical medical staff to implement decision support strategies and improve decision quality. This study employed purposive sampling, with sufficient samples being reached when no new themes emerged from the interviews, to select surrogate decision-makers of patients admitted to the ICU within 48 hours. Then, qualitative phenomenological research methods were employed for semi-structured interviews. Colaizzi method was used to analyze and refine the interview data. Ten surrogate decision-makers were included in this study. Surrogate decision-makers experienced decision fatigue during the early stages of ICU admission, characterized by 5 primary themes: emotional exhaustion, increased cognitive load, hesitation in decision-making, conflicting decisions, and inadequate support systems. Within the initial 48 hours in the ICU, surrogate decision-makers of patients may experience decision fatigue during the decision-making process. Medical staff should be aware of this phenomenon, take appropriate intervention measures, and provide decision-making support to enhance the quality of decisions.