Role Incongruence and Psychological Stress Symptoms in Substitute Decision Makers of Intensive Care Patients.
Background: Most intensive care patients require substitute decision makers (SDMs) to make decisions. The SDMs may prefer an active, shared, or passive decision-making role. Role incongruence is when preferred and actual roles differ. Objective: To evaluate the impact of decision-making role prefere...
| Publicado en: | American Journal of Critical Care Vol. 29; no. 4; pp. 301 - 311 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
American Association of Critical-Care Nurses
Jul2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149768378&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149768378 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10623264 44L jtl: American Journal of Critical Care issn: 10623264 maglogo: N pubinfo: dt: Jul2020 vid: 29 iid: 4 pid: 2559 pub: American Association of Critical-Care Nurses place: Alisa Veijo, California artinfo: ui: 149768378 149768378 149768378 10.4037/ajcc2020307 149768378 ppf: 301 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Role Incongruence and Psychological Stress Symptoms in Substitute Decision Makers of Intensive Care Patients. aug: au: Smith, Orla M. Metcalfe, Kelly Puts, Martine McDonald, Ellen Sue-Chee, Shivon Friedrich, Jan O. affil: About the Authors: Orla M. Smith is an associate scientist at Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada, and an adjunct lecturer at Lawrence S. Bloomberg Faculty of Nursing, University of Toronto. sug: subj: Decision Making Stress, Psychological Symptoms Critical Care Critically Ill Patients In Adulthood Human Interviews Surveys Adult Scales Male Female Stress Disorders, Post-Traumatic Anxiety Depression Multivariate Analysis Logistic Regression Odds Ratio Confidence Intervals Cross Sectional Studies Data Analysis Software Outcomes (Health Care) Questionnaires Middle Age Aged Funding Source Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Most intensive care patients require substitute decision makers (SDMs) to make decisions. The SDMs may prefer an active, shared, or passive decision-making role. Role incongruence is when preferred and actual roles differ. Objective: To evaluate the impact of decision-making role preferences and role incongruence on psychological distress symptoms in SDMs. Methods: A multicenter, interviewer-administered survey was conducted among SDMs of critically ill adults. The Control Preferences Scale was used to evaluate role preferences. Psychological distress was defined as anxiety, depression, or posttraumatic stress symptoms with predefined cut points on the Hospital Anxiety and Depression Scale (score > 10 on the anxiety or the depression subscale) and Impact of Events Scale (score > 30). Results: One hundred eighty SDMs were recruited; 64% responded. Most were white (71%) and female (65%); 46% were spouses. Role preferences varied: active, 24%; shared, 44%; and passive, 31%. Almost half (49%) reported incongruence. Symptom prevalence was 50% for posttraumatic stress, 32% for anxiety, and 16% for depression. Most (56%) reported some psychological distress. In multivariable logistic regression, the composite outcome of psychological distress was independently associated with patient death (odds ratio, 2.95; 95% CI, 1.08-8.02; P =.03), female sex of SDM (odds ratio, 2.96; 95% CI, 1.49-5.89; P =.002), and incongruence (odds ratio, 3.26; 95% CI, 1.67-6.36; P <.001). Conclusions: Adverse psychological symptoms are prevalent in SDMs of critically ill patients and are related to role incongruence. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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