Decision conflict and regret among surrogate decision makers in the medical intensive care unit

Journal of Critical Care
Jesse J MillerMichael Young

Abstract

Family members of critically ill patients in the intensive care unit face significant morbidity. It may be the decision-making process that plays a significant role in the psychological morbidity associated with being a surrogate in the ICU. We hypothesize that family members facing end-of-life decisions will have more decisional conflict and decisional regret than those facing non-end-of-life decisions. We enrolled a sample of adult patients and their surrogates in a tertiary care, academic medical intensive care unit. We queried the surrogates regarding decisions they had made on behalf of the patient and assessed decision conflict. We then contacted the family member again to assess decision regret. Forty (95%) of 42 surrogates were able to identify at least 1 decision they had made on behalf of the patient. End-of-life decisions (defined as do not resuscitate [DNR]/do not intubate [DNI] or continuation of life support) accounted for 19 of 40 decisions (47.5%). Overall, the average Decision Conflict Scale (DCS) score was 21.9 of 100 (range 0-100, with 0 being little decisional conflict and 100 being great decisional conflict). The average DCS score for families facing end-of-life decisions was 25.5 compared with 18.7 for all...Continue Reading

References

Jan 1, 1995·Medical Decision Making : an International Journal of the Society for Medical Decision Making·A M O'Connor
Feb 24, 2001·Medical Decision Making : an International Journal of the Society for Medical Decision Making·V GoelA M O'Connor
Jan 16, 2003·Intensive Care Medicine·Daren K HeylandChristopher J O'Callaghan
Aug 21, 2003·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Jamie C BrehautDeb Feldman-Stewart
Jan 25, 2005·American Journal of Respiratory and Critical Care Medicine·Elie AzoulayUNKNOWN FAMIREA Study Group
Apr 21, 2006·Critical Care Medicine·Renee D StapletonJ Randall Curtis
Nov 8, 2006·Journal of the American Geriatrics Society·Elizabeth K VigKelly Fryer-Edwards
Feb 3, 2007·The New England Journal of Medicine·Alexandre LautretteElie Azoulay
Jan 17, 2008·Chest·Cynthia J GriesRuth A Engelberg
Jun 4, 2008·Critical Care Medicine·Mark D SiegelHolly G Prigerson
Jun 17, 2008·Critical Care Medicine·Shannon S CarsonTimothy S Carey
Jun 25, 2008·Journal of General Internal Medicine·R Brac SelphDouglas B White
Jul 3, 2009·The American Journal of Hospice & Palliative Care·Steven RadwanySudy Jahangiri
Sep 23, 2009·Critical Care Medicine·Christopher E CoxJames A Tulsky
Nov 3, 2010·American Journal of Respiratory and Critical Care Medicine·Sara K JohnsonDouglas B White
Mar 2, 2011·Annals of Internal Medicine·David Wendler, Annette Rid

❮ Previous
Next ❯

Citations

Sep 24, 2019·Journal of Palliative Care·Chiahui ChenMary Ann Meeker
Jun 12, 2020·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Hélène ElidorFrance Légaré
Jun 20, 2020·Neurocritical Care·Savina SahgalDarin B Zahuranec
Jul 28, 2020·Contemporary Nurse·Hasanali JafarpoorHouman Manoochehri
Jun 25, 2020·International Journal of Environmental Research and Public Health·Wan-Na SunYu-Tung Huang
Oct 23, 2020·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Hélène ElidorFrance Légaré
Sep 22, 2018·The Journal of Pediatrics·Savithri NageswaranNancy M P King
Jul 29, 2018·Patient Education and Counseling·Kristen E PecanacDouglas B White
Jul 22, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·R GeurtzenM Hogeveen

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
K L MeertA P Sarnaik
© 2021 Meta ULC. All rights reserved