Behavioral barriers in the management of spinal muscular atrophy: The role of procrastination, regret, and burnout

Abstract

Background Decision-making in complex medical conditions is a cognitively demanding task influenced by clinician-specific behavioral factors. Procrastination, the voluntary delay of intended actions despite foreseeable adverse outcomes, is a self-regulation failure often exacerbated by high-stress clinical environments. This study evaluated the prevalence of procrastination among healthcare professionals (HCPs) managing spinal muscular atrophy (SMA) and analyzed its associations with burnout and healthcare-related regret. Methods We conducted a non-interventional, cross-sectional, web-based study of HCPs recruited through the Spanish CuidAME registry. Participants were assessed using a battery of validated instruments: the Pure Procrastination Scale (PPS), the Regret Intensity Scale (RIS-10), the Evidence-Based Practice Attitude Scale (EBPAS), and a single-item burnout measure. In addition to multivariate logistic regression, we employed a regression-based mediation analysis with bootstrap resampling to explore potential indirect effects of burnout on procrastination via regret intensity. Results Thirty-seven HCPs completed the study. Moderate-to-high procrastination was identified in 35.1% of the cohort. PPS scores correlated significantly with burnout (rho = 0.49, p = 0.002) and regret intensity (rho = 0.43, p = 0.007). Multivariate analysis identified burnout as the single independent factor associated with procrastination (OR: 8.17; 95%CI: 1.60–41.62; p = 0.011). Although burnout significantly predicted increased regret intensity, mediation analysis confirmed no significant indirect effect (beta = 0.98; 95%CI: −1.74 to 3.79). Burnout maintained a robust association with procrastination, independent of the mediator (beta = 5.11, p = 0.039). Conclusions Procrastination is a prevalent behavioral trait in SMA care. While procrastination correlates with healthcare-related regret, burnout serves as its primary independent predictor of this behavior. These exploratory findings suggest that targeted interventions to mitigate clinician burnout may facilitate the optimization of decision-making processes in complex neuromuscular care.