Subjective Workload and Cognitive Failure Among Emergency Nurses: A Cross-Sectional Mediation Analysis of Job Content...

To examine associations between subjective workload and cognitive failure among emergency nurses and assess whether job content and job burnout statistically mediate these associations.

Cognitive failure in nurses is associated with occupational and psychological demands and may compromise patient safety and well-being. Examining the relationships among subjective workload, job-related factors, and cognitive failure may inform management interventions in emergency care.

A descriptive, cross-sectional correlational study.

The study population comprised 320 eligible emergency nurses in Urmia. Using proportional quota sampling based on the number of nurses in each hospital, 295 nurses were recruited. Ultimately, 255 completed questionnaires were included in the final analysis. Data were collected using a demographic questionnaire, the Broadbent Cognitive Failures Questionnaire, the NASA Task Load Index (NASA-TLX), the Maslach Burnout Inventory, and the Karasek Job Content Questionnaire. Data analysis was conducted using SPSS version 26 and SmartPLS version 4.

Subjective workload was positively associated with cognitive failure (β = 0.478, p < 0.001), job content (β = 0.577, p < 0.001) and job burnout (β = 0.425, p < 0.001). Job content was positively associated with cognitive failure (β = 0.241, p < 0.001) and job burnout (β = 0.278, p < 0.001), whereas job burnout was not significantly associated with cognitive failure (β = -0.030, p = 0.639). Job content showed significant indirect associations between subjective workload and cognitive failure (β = 0.139, p = 0.001) and between subjective workload and job burnout (β = 0.160, p < 0.001). The indirect association between subjective workload and cognitive failure through job burnout was not statistically significant (β = -0.013, p > 0.05).

Higher subjective workload was associated with greater cognitive failure among emergency nurses. Job content, but not job burnout, demonstrated a statistically significant indirect association in the relationship between subjective workload and cognitive failure. These cross-sectional findings should be interpreted with caution, and longitudinal studies are needed to clarify the temporal sequence and examine potential causal pathways.

Healthcare organizations should consider strategies to optimize job content, including enhancing workplace support and addressing prolonged or excessive working hours. These strategies may be relevant to addressing cognitive strain and job-related challenges among emergency nurses and may support staff well-being and patient safety.