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Aim The aim of this article is to report the psychometric properties of the eight-item cognitive load scale. Background According to cognitive load theory, the formatting and delivery of healthcare education influences the degree to which patients and/or family members can engage their working memory systems for learning. However, despite its relevance, cognitive load has not yet been evaluated among surrogate decision makers exposed to electronic decision support for healthcare decisions. To date, no psychometric analyses of instruments evaluating cognitive load have been reported within healthcare settings. Methods A convenience sample of 62 surrogate decision makers for critically ill patients were exposed to one of two healthcare decision support interventions were recruited from four intensive care units at a tertiary medical center in Northeast Ohio. Participants were administered a battery of psychosocial instruments and the eight-item cognitive load scale (CLS). Results The CLS demonstrated a bidimensional factor structure with acceptable discriminant validity and internal consistency reliability (Cronbach's α = 0.75 and 0.89). Conclusions The CLS is a psychometrically sound instrument that may be used in the evaluation of decision support among surrogate decision makers of the critically ill. The authors recommend application of the cognitive load scale in the evaluation and development of healthcare education and interventions. [ABSTRACT FROM AUTHOR]

• This was the first known examination of the relationship between American Nurses Association's Healthy Nurse, Healthy Nation (HNHN) program, work system perceptions, and health-related quality of life (HRQOL) among registered nurses (RNs). • RNs who are affiliated with an institutional partner of HNHN report lower job demands, more job resources, and better health-related quality of life than RNs from nonpartner organizations. • After adjusting for HNHN partner affiliation status and other sociodemographic factors, individuals who identified as non-White reported greater perceived job demands than those who identified as White. There is limited research on the effects of nationally oriented health care workforce interventions on RNs' perceptions of their work systems and health-related quality of life (HRQOL). Guided by a systems framework, we examined the association of being affiliated with an organization partnered with the American Nurses Association's Healthy Nurse, Healthy Nation (HNHN) program on RNs' perceptions of their work systems and HRQOL. We performed a correlational, cross-sectional secondary analysis of a national RN sample (N = 2,166) with case-control matching. We used multiple linear and logistic regressions to evaluate our research questions. Affiliation with an HNHN partner organization was directly associated with more desirable work system perceptions, and indirectly associated with greater HRQOL. Organization-level workplace interventions hold promise to improve RN working conditions and well-being. There is an ongoing need to continue developing and evaluating scalable workplace well-being interventions for health care organizations. [ABSTRACT FROM AUTHOR]

Cognitive load predicts one's ability to process information and learn from decision support interventions. The present study compared intrinsic and extraneous cognitive load levels resulting from exposure to two different electronic decision aids. A convenience sample of ninety-seven surrogate decision makers for critically ill patients were randomly assigned to receive either a single dose of a video-based or avatar-based decision aid. Intrinsic and extraneous cognitive load levels among recipients of the video-based decision support resource were lower than recipients of the avatar-based decision support resource. After controlling for age, the observed differences in intrinsic cognitive load were not significantly different, whereas the observed differences in extraneous cognitive load remained. Extraneous cognitive load is a modifiable factor to consider for future developers of decision support interventions that may determine the efficacy of efforts to support patients and family members with decision making. • Surrogate decision makers for critically ill patients experience cognitive load from electronic decision aids. • Avatar-based decision aids can increase extraneous cognitive load. • Age independently predicts the cognitive load elicited by electronic decision aids. [ABSTRACT FROM AUTHOR]