{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T18:04:13Z","timestamp":1780423453774,"version":"3.54.1"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019721","name":"Roche Espa\u00c3\u00b1a","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100019721","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2009=\u20090.49, p\u2009=\u20090.002) and regret intensity (rho\u2009=\u20090.43, p\u2009=\u20090.007). Multivariate analysis identified burnout as the single independent factor associated with procrastination (OR: 8.17; 95%CI: 1.60\u201341.62; p\u2009=\u20090.011). Although burnout significantly predicted increased regret intensity, mediation analysis confirmed no significant indirect effect (beta\u2009=\u20090.98; 95%CI: \u22121.74 to 3.79). Burnout maintained a robust association with procrastination, independent of the mediator (beta\u2009=\u20095.11, p\u2009=\u20090.039).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0350643","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T17:30:07Z","timestamp":1780421407000},"page":"e0350643","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Behavioral barriers in the management of spinal muscular atrophy: The role of procrastination, regret, and burnout"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9858-3555","authenticated-orcid":true,"given":"Jorge","family":"Maurino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Carrera-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paz","family":"Castro-Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4074-6870","authenticated-orcid":true,"given":"Ignacio","family":"M\u00e1laga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Nascimento","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5950-9886","authenticated-orcid":true,"given":"Gustavo","family":"Saposnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"issue":"2","key":"pone.0350643.ref001","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/S1474-4422(23)00419-2","article-title":"Challenges 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