Factors Influencing Critical Care Nurses’ Mental Workload: A Scoping Review

  • Farida Farida Universitas Diponegoro
  • Bagoes Widjanarko Universitas Diponegoro
  • Luky Dwiantoro Universitas Diponegoro
Keywords: cognitive workload, critical care, ICU, intensive care unit, mental workload, nurse

Abstract

The mental workload of critical care nurses significantly impacts their well-being, job satisfaction, and overall performance, ultimately affecting the quality of care in critical care environments. This study aimed to identify and categorize the factors influencing mental workload among critical care nurses through a scoping review guided by Arksey and O'Malley’s framework. A comprehensive literature search across five databases (PubMed, ScienceDirect, EBSCOhost - CINAHL Complete, Medline, and Scopus) resulted in the inclusion of 8 relevant studies, which examined the psychosocial, organizational, and environmental factors contributing to critical care nurses' mental workload. The findings revealed that mental workload is influenced by a range of factors, including nurse-to-patient ratios, patient complexity, demographic characteristics (such as age and experience), and psychosocial stressors such as job dissatisfaction, lack of organizational support, and high emotional demands. Additionally, higher patient loads, long shifts, and inadequate support systems were identified as key contributors to mental strain, leading to increased fatigue, burnout, and reduced job satisfaction. The study emphasized the critical role of organizational support, motivation, and leadership in mitigating mental workload. Interventions aimed at improving staffing, work conditions, and leadership quality, alongside the reduction of excessive patient loads, are essential for enhancing nurse resilience, reducing burnout, and ultimately improving patient care outcomes in critical care settings.

References

Ageel, M., & Shbeer, A. (2022). Exploring Occupational Stress Among Intensive Care Units Nurses in Saudi Arabia Using the Health and Safety Executive Management Standards Indicator Tool. Nursing: Research and Reviews, Volume 12, 247–258. https://doi.org/10.2147/nrr.s386670

Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology: Theory and Practice, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616

Bakhshi, E., Mazlomi, A., & Hoseini, S. M. (2019). Relationship Between Mental Fatigue and Mental Workload Among Nurses. Zahedan Journal of Research in Medical Sciences, In Press(In Press), 1–8. https://doi.org/10.5812/zjrms.83082

Bazazan, A., Dianat, I., Bahrampour, S., Talebian, A., Zandi, H., Sharafkhaneh, A., & Maleki-Ghahfarokhi, A. (2019). Association of musculoskeletal disorders and workload with work schedule and job satisfaction among emergency nurses. International Emergency Nursing, 44(February), 8–13. https://doi.org/10.1016/j.ienj.2019.02.004

Ceballos-Vásquez, P., Rolo-González, G., Hérnandez-Fernaud, E., Díaz-Cabrera, D., Paravic-Klijn, T., & Burgos-Moreno, M. (2015). Psychosocial factors and mental work load: A reality perceived by nurses in intensive care units. Revista Latino-Americana de Enfermagem, 23(2), 315–322. https://doi.org/10.1590/0104-1169.0044.2557

Falguera, C. C., De los Santos, J. A. A., Galabay, J. R., Firmo, C. N., Tsaras, K., Rosales, R. A., Mirafuentes, E. C., & Labrague, L. J. (2021). Relationship between nurse practice environment and work outcomes: A survey study in the Philippines. International Journal of Nursing Practice, 27(1), 1–10. https://doi.org/10.1111/ijn.12873

Ferramosca, F. M. P., De Maria, M., Ivziku, D., Raffaele, B., Lommi, M., Tolentino Diaz, M. Y., Montini, G., Porcelli, B., De Benedictis, A., Tartaglini, D., & Gualandi, R. (2023). Nurses’ Organization of Work and Its Relation to Workload in Medical Surgical Units: A Cross-Sectional Observational Multi-Center Study. Healthcare (Switzerland), 11(2), 1–13. https://doi.org/10.3390/healthcare11020156

Fischbacher, S., Exl, M. T., Simon, M., Dhaini, S., & Jeitziner, M.-M. (2024). A prospective longitudinal cohort study of the association between nurses’ subjective and objective workload. Scientific Reports, 14(1), 22694. https://doi.org/10.1038/s41598-024-73637-9

Hoogendoorn, M. E., Brinkman, S., Spijkstra, J. J., Bosman, R. J., Margadant, C. C., Haringman, J., & de Keizer, N. F. (2021). The objective nursing workload and perceived nursing workload in Intensive Care Units: Analysis of association. International Journal of Nursing Studies, 114. https://doi.org/10.1016/j.ijnurstu.2020.103852

Jin, M., Qian, R., Wang, J., Long, J., Yuan, Z., Zeng, L., Liao, D., Liu, X., Tang, S., & Huang, S. (2024). Influencing factors associated with mental workload among nurses: A latent profile analysis. International Journal of Nursing Sciences, 11(3), 330–337. https://doi.org/https://doi.org/10.1016/j.ijnss.2024.04.002

Kang, J. H., Kim, C. W., & Lee, S. Y. (2016). Nurse-Perceived Patient Adverse Events depend on Nursing Workload. Osong Public Health and Research Perspectives, 7(1), 56–62. https://doi.org/10.1016/j.phrp.2015.10.015

Lestari, I. B., Jingga, N. A., & Wahyudiono, Y. D. A. (2023). The Relationship Between Physical and Mental Workload with Fatigue on Nurses. Indonesian Journal of Occupational Safety and Health, 12(1), 10–18. https://doi.org/10.20473/ijosh.v12i1.2023.10-18

Longo, L., Wickens, C. D., Hancock, P. A., & Hancock, G. M. (2022). Human Mental Workload: A Survey and a Novel Inclusive Definition. Frontiers in Psychology, 13(June), 1–26. https://doi.org/10.3389/fpsyg.2022.883321

López-Núñez, M. I., Rubio-Valdehita, S., Diaz-Ramiro, E. M., & Aparicio-García, M. E. (2020). Psychological capital, workload, and burnout: What’s new? The impact of personal accomplishment to promote sustainableworking conditions. Sustainability (Switzerland), 12(19), 1–13. https://doi.org/10.3390/su12198124

Mirzaee, S., Zamanian, Z., & Zade, J. H. (2015). Effects of Work Shifts and Mental Workload on Chronic Fatigue among Female Nurses in Intensive Care Units. Journal of Health Sciences and Surveillance System, 3(3), 113–118.

Moghadam, K. N., Masouleh, S. R., Chehrzad, M. M., & Leili, E. K. (2019). The Mental Workload and Its Correlated Factors in Nurses Working in Intensive Care Units. Journal of Holistic Nursing and Midwifery, 29(2), 82–89. https://doi.org/10.32598/JHNM.29.2.82

Nasirizad Moghadam, K., Chehrzad, M. M., Reza Masouleh, S., Maleki, M., Mardani, A., Atharyan, S., & Harding, C. (2021). Nursing physical workload and mental workload in intensive care units: Are they related? Nursing Open, 8(4), 1625–1633. https://doi.org/10.1002/nop2.785

Neuraz, A., Guérin, C., Payet, C., Polazzi, S., Aubrun, F., Dailler, F., Lehot, J. J., Piriou, V., Neidecker, J., Rimmelé, T., Schott, A. M., & Duclos, A. (2015). Patient mortality is associated with staff resources and workload in the icu: A multicenter observational study. Critical Care Medicine, 43(8), 1587–1594. https://doi.org/10.1097/CCM.0000000000001015

Nourollahi-Darabad, M., Afshari, D., Karimi, N., & Seyedtabib, M. (2024). Psychosocial and Demographic Factors Impacting the Mental Workload of Nurses: A Proposed Structural Equation Model.

Pamungkas, R. A., Ruga, F. B. P., Kusumapradja, R., & Kusumapradja, R. (2022). Impact of Physical Workload and Mental Workload on Nurse Performance: A Path Analysis. International Journal of Nursing and Health Services (IJNHS), 5(2), 219–225. https://doi.org/10.35654/ijnhs.v5i2.604

Peters, M. D. J., Marnie, C., Tricco, A. C., Pollock, D., Munn, Z., Alexander, L., McInerney, P., Godfrey, C. M., & Khalil, H. (2020). Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Synthesis, 18(10), 2119–2126. https://doi.org/10.11124/JBIES-20-00167

Rushton, C. ., Batcheller, J., Schroeder, K., & Donohue, P. (2015). Burnout and Resilience among Nurses Practicing in High-Intensity Settings. 24(5), 412–421.

Sert, H., Gulbahar Eren, M., & Ucgul, K. (2024). Occupational fatigue, compassion competence and caring behaviours of intensive care nurses: A structural equation modelling approach. Nursing in Critical Care, March 2023, 1–11. https://doi.org/10.1111/nicc.13027

Shan, Y., Shang, J., Yan, Y., Lu, G., Hu, D., & Ye, X. (2021). Mental workload of frontline nurses aiding in the COVID-19 pandemic: A latent profile analysis. Journal of Advanced Nursing, 77(5), 2374–2385. https://doi.org/10.1111/jan.14769

Tirvienė, G., Spirgienė, L., & Šimatonienė, V. (2020). Fatigue among Intensive Care Unit Nurses. Nerp, 10(1), 4–9.

Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., … Straus, S. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850

Umansky, J., & Rantanen, E. (2016). Workload in nursing: Proceedings of the Human Factors and Ergonomics Society 2016 Annual Meeting. Los Angeles, CA. Rochester Institute of Technology, Rochester, NY, 551–555.

Wihardja, H., Hariyati, R. T. S., & Gayatri, D. (2019). Analysis of factors related to the mental workload of nurses during interaction through nursing care in the intensive care unit. Enfermeria Clinica, 29, 262–269. https://doi.org/10.1016/j.enfcli.2019.06.002

Yanbei, R., Dongdong, M., Yun, L., Ning, W., & Fengping, Q. (2023). Does perceived organization support moderates the relationships between work frustration and burnout among intensive care unit nurses? A cross-sectional survey. BMC Nursing, 22(1), 1–9. https://doi.org/10.1186/s12912-023-01180-5

Young, M. S., Brookhuis, K. A., Wickens, C. D., & Hancock, P. A. (2015). State of science: mental workload in ergonomics. In Ergonomics (Vol. 58, Issue 1, pp. 1–17). Taylor & Francis. https://doi.org/10.1080/00140139.2014.956151

Published
2025-02-01
How to Cite
Farida, F., Widjanarko, B., & Dwiantoro, L. (2025). Factors Influencing Critical Care Nurses’ Mental Workload: A Scoping Review. Indonesian Journal of Global Health Research, 7(1), 795-804. https://doi.org/10.37287/ijghr.v7i1.5069

Most read articles by the same author(s)