Relationship Between Nurses' Decision-Making Styles and Stage-Specific Missed Care in Oncology: A Nursing Process...

Healthcare systems worldwide struggle with the phenomenon of omitted clinical tasks, which directly compromises patient safety and treatment outcomes in high-stakes environments. Prior research has shown that environmental factors such as high patient-to-nurse ratios and resource scarcity frequently contribute to these omissions. While structural variables are well-documented, the internal cognitive processes that govern how clinicians prioritize tasks remain poorly understood. Individual differences in how professionals process information and reach conclusions likely influence which specific duties they choose to defer or skip. Most existing literature focuses on general omission rates rather than examining how cognitive styles affect distinct phases like assessment or planning. The complexity of oncology care requires a nuanced understanding of how these psychological traits manifest during long-term treatment cycles involving the Oncology Missed Nursing Care Self-Rating Scale. This absence of evidence motivated a deeper investigation into how specific psychological profiles correlate with task omission within specialized cancer care units.

This investigation evaluates the correlation between various decision-making frameworks and the prevalence of omitted tasks across different clinical stages of the nursing process. Researchers sought to determine if specific cognitive patterns, such as rational or avoidant styles, predict failures in assessment, planning, or implementation. The study specifically targets the oncology setting where complex treatment regimens require high levels of precision and consistent monitoring. By categorizing omissions according to the nursing process, the team aimed to identify which phases are most vulnerable to specific psychological traits. The project also intended to provide actionable data for hospital administrators to develop personalized training programs for their staff across the three participating hospitals. Identifying high-risk stages for missed care allows for the implementation of more effective safety protocols and targeted resource allocation. Ultimately, the work strives to enhance patient safety by uncovering the behavioral drivers behind missed clinical interventions.

Investigators employed a cross-sectional design involving oncology practitioners recruited from three distinct hospital facilities through convenience sampling techniques. Participants completed a comprehensive sociodemographic questionnaire alongside the Oncology Missed Nursing Care Self-Rating Scale (OMNCS) to quantify task omissions. The General Decision-Making Style Scale (GDMS) served as the primary instrument for assessing the cognitive preferences of the surveyed personnel. Statistical analysis utilized Mann-Whitney U tests to compare scores between groups that reported omissions and those that did not. Binary logistic regression models were constructed to calculate odds ratios and identify significant predictors of missed care across various dimensions. The research team specifically looked at the assessment and evaluation, planning, and implementation stages as independent variables within the regression framework. The research team adhered to the STROBE checklist to ensure rigorous reporting of the observational data collected during the study.

Analysis revealed that the planning phase of the nursing process exhibited the highest frequency of omitted clinical activities among the participants. The rational decision-making style emerged as the most prevalent approach, showing significantly higher scores in the group that did not omit care. A rational approach was negatively associated with omissions during the implementation stage, yielding an odds ratio of 0.460 with a p-value of 0.012. The intuitive-impulsive style demonstrated a consistent protective effect across all measured dimensions, with odds ratios ranging from 0.254 to 0.337. Conversely, nurses exhibiting dependent or avoidant styles faced a significantly increased risk of missing tasks during the assessment and evaluation phases. These findings indicate that cognitive traits exert varying levels of influence depending on the specific nature of the clinical task. Statistical significance was maintained across these associations, highlighting the robust link between psychological profile and professional performance in oncology settings.

Nursing administrators should integrate assessments of cognitive styles into their management strategies to identify individuals at higher risk for task omission. Targeted interventions are necessary to support clinicians who rely on dependent or avoidant approaches, particularly during the foundational assessment phase. Implementing simulated training programs can help staff transition effectively between rational and intuitive methods to optimize care delivery. The introduction of digital decision support systems represents a promising technological solution for reducing stage-specific failures in oncology environments. Future organizational policies must prioritize the development of personalized management pathways that account for individual behavioral differences and professional experience. Enhancing these decision-making competencies will likely lead to substantial improvements in overall nursing quality and long-term patient safety outcomes. This study provides a new management pathway to reduce missed care and enhance patient safety through evidence-based behavioral interventions.