Decision Self-Efficacy and Decisional Conflict on Reintubation among Surrogates of Ventilated Patients Undergoing Planned Extubation
Purpose: Although the medical decision-making process can be overwhelming for some surrogates, there is a lack of understanding regarding their experiences. The objectives of this study were to examine the decision self-efficacy and decisional conflict experienced by surrogates in intensive care uni...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Asian Nursing Research |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1976131723000531 |
| _version_ | 1797372034836070400 |
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| author | Shu-Ju Lu Shih-Chi Ku Kuei-Fen Liu Ching-Hui Chien |
| author_facet | Shu-Ju Lu Shih-Chi Ku Kuei-Fen Liu Ching-Hui Chien |
| author_sort | Shu-Ju Lu |
| collection | DOAJ |
| description | Purpose: Although the medical decision-making process can be overwhelming for some surrogates, there is a lack of understanding regarding their experiences. The objectives of this study were to examine the decision self-efficacy and decisional conflict experienced by surrogates in intensive care units (ICUs) when faced with the decision of whether to reintubate patients with respiratory failure after a planned extubation. In addition, predictors and mediators influencing these decision-making processes were identified. Methods: This study utilized a cross-sectional design to investigate the decision-making processes of 174 surrogates who were faced with the decision of whether to reintubate patients with respiratory failure after a planned extubation in the internal ICU of a medical center between August 2021 and February 2022. Structured questionnaires were administered to collect data on the surrogates' background information, decision self-efficacy, decisional conflict, and positive and negative affect. The patients’ background information was also collected. Univariate and multivariate analyses were performed to model the data. Results: The mean decision self-efficacy score of the surrogates was 82.41 points, and 20.7% surrogates had decisional conflict scores exceeding 37.5 points, suggesting that they faced challenges in the decision-making process. Surrogates' employment status and negative affect significantly predicted their decision self-efficacy. In addition, patients' activities of daily living prior to hospitalization and the decision self-efficacy of the surrogate significantly predicted surrogate decisional conflict. The impact of surrogates’ negative affect on decisional conflict was fully mediated by decision self-efficacy. Conclusions: Surrogate decision self-efficacy mediates the relationship between negative affect and decisional conflict. Providing clinical care interventions that focus on enhancing surrogate self-efficacy and reducing negative affect can help alleviate decisional conflict in this population. |
| first_indexed | 2024-03-08T18:29:39Z |
| format | Article |
| id | doaj.art-4ec9712ebca1457092236c70d86e560e |
| institution | Directory Open Access Journal |
| issn | 1976-1317 |
| language | English |
| last_indexed | 2024-03-08T18:29:39Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Nursing Research |
| spelling | doaj.art-4ec9712ebca1457092236c70d86e560e2023-12-30T04:43:17ZengElsevierAsian Nursing Research1976-13172023-12-01175235244Decision Self-Efficacy and Decisional Conflict on Reintubation among Surrogates of Ventilated Patients Undergoing Planned ExtubationShu-Ju Lu0Shih-Chi Ku1Kuei-Fen Liu2Ching-Hui Chien3Department of Nursing, National Taiwan University Hospital, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanSchool of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, TaiwanSchool of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Correspondence to: School of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Ming-te Road, Peitou District, Taipei City 11219, Taiwan. Tel: +886-2-28227101; Fax: +886 2 28213233.Purpose: Although the medical decision-making process can be overwhelming for some surrogates, there is a lack of understanding regarding their experiences. The objectives of this study were to examine the decision self-efficacy and decisional conflict experienced by surrogates in intensive care units (ICUs) when faced with the decision of whether to reintubate patients with respiratory failure after a planned extubation. In addition, predictors and mediators influencing these decision-making processes were identified. Methods: This study utilized a cross-sectional design to investigate the decision-making processes of 174 surrogates who were faced with the decision of whether to reintubate patients with respiratory failure after a planned extubation in the internal ICU of a medical center between August 2021 and February 2022. Structured questionnaires were administered to collect data on the surrogates' background information, decision self-efficacy, decisional conflict, and positive and negative affect. The patients’ background information was also collected. Univariate and multivariate analyses were performed to model the data. Results: The mean decision self-efficacy score of the surrogates was 82.41 points, and 20.7% surrogates had decisional conflict scores exceeding 37.5 points, suggesting that they faced challenges in the decision-making process. Surrogates' employment status and negative affect significantly predicted their decision self-efficacy. In addition, patients' activities of daily living prior to hospitalization and the decision self-efficacy of the surrogate significantly predicted surrogate decisional conflict. The impact of surrogates’ negative affect on decisional conflict was fully mediated by decision self-efficacy. Conclusions: Surrogate decision self-efficacy mediates the relationship between negative affect and decisional conflict. Providing clinical care interventions that focus on enhancing surrogate self-efficacy and reducing negative affect can help alleviate decisional conflict in this population.http://www.sciencedirect.com/science/article/pii/S1976131723000531decision makingemotionsintensive care unitsintubation |
| spellingShingle | Shu-Ju Lu Shih-Chi Ku Kuei-Fen Liu Ching-Hui Chien Decision Self-Efficacy and Decisional Conflict on Reintubation among Surrogates of Ventilated Patients Undergoing Planned Extubation Asian Nursing Research decision making emotions intensive care units intubation |
| title | Decision Self-Efficacy and Decisional Conflict on Reintubation among Surrogates of Ventilated Patients Undergoing Planned Extubation |
| title_full | Decision Self-Efficacy and Decisional Conflict on Reintubation among Surrogates of Ventilated Patients Undergoing Planned Extubation |
| title_fullStr | Decision Self-Efficacy and Decisional Conflict on Reintubation among Surrogates of Ventilated Patients Undergoing Planned Extubation |
| title_full_unstemmed | Decision Self-Efficacy and Decisional Conflict on Reintubation among Surrogates of Ventilated Patients Undergoing Planned Extubation |
| title_short | Decision Self-Efficacy and Decisional Conflict on Reintubation among Surrogates of Ventilated Patients Undergoing Planned Extubation |
| title_sort | decision self efficacy and decisional conflict on reintubation among surrogates of ventilated patients undergoing planned extubation |
| topic | decision making emotions intensive care units intubation |
| url | http://www.sciencedirect.com/science/article/pii/S1976131723000531 |
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