We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The Stresses of Surrogate Decision-Making: Contributing Factors and Clinicians' Role in Mitigation.
- Authors
Mishkin, Adrienne D.; Allen, Nicole C.; Cheung, Stephanie G.; Faccini, Maria Carla; Flicker, Lauren S.; Shalev, Daniel
- Abstract
Background: Surrogate Decision-Makers (surrogates) are frequently employed in decision-making for critically ill adults. There are insufficient data considering the surrogate experience, stress, and potential for mitigation. Methods: An anonymous online survey queried (1) medical situation (2) total stress (3) demographics (4) potential factors, including sources of information about patient wishes, external sources of support or competing stressors, and their interactions with the medical team through the experience. Results: 108 respondents were included; 91 completed all items. Most respondents ranked their experience as a surrogate as one of the most stressful experiences of their lives; this was associated with whether it was an end-of-life decision (P =.003), Respondent Religion (P =.015), or religious or spiritual beliefs (P =.024), and having their own health problems (P =.008). On individual Likert responses, surrogates reported significant stress mitigation when they felt they had been helpful (P <.001), knew the patient's wishes (P =.0011), specifically discussed patient wishes (P <.001), or patient's wishes were documented (P <.001). Items about surrogate-team interaction also met significance, including the physician being communicative and available (P <.001), respectful (P =.007), honest (P <.001), and validating (P =.001). Conclusions: Surrogate stress is an evolving area for research. Significant factors included relationship with the medical team, making this an important area for HPM to play a key role in mitigating surrogate stress.
- Subjects
UNITED States; RISK assessment; SCALE analysis (Psychology); PROXY; OCCUPATIONAL roles; STRESS management; MEDICAL personnel; DATA analysis; RESEARCH funding; CRITICALLY ill; PATIENTS; HEALTH status indicators; RESPECT; STATISTICAL sampling; KRUSKAL-Wallis Test; MULTIPLE regression analysis; DECISION making; DESCRIPTIVE statistics; MANN Whitney U Test; MULTIVARIATE analysis; PSYCHOLOGICAL stress; ANALYSIS of variance; STATISTICS; RELIGION; SPIRITUALITY; COMMUNICATION; PALLIATIVE medicine; COMPARATIVE studies; SOCIODEMOGRAPHIC factors; SOCIAL support; TERMINAL care; PHYSICIANS; HONESTY; PSYCHOSOCIAL factors; HOSPICE care; PATIENTS' attitudes
- Publication
American Journal of Hospice & Palliative Medicine, 2024, Vol 41, Issue 8, p895
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/10499091231198750