ArticleJournal of clinical nursing2014
Advance directives lessen the decisional burden of surrogate decision-making for the chronically critically ill.
Article in Journal of clinical nursing, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed.
- Review
- Trauma Survivors Network: how does it really work?Trauma surgery & acute care open · 2025Article
- Life-sustaining treatment preferences in older patients when referred to the emergency department for acute geriatric assessment: a descriptive study in a Dutch hospital.BMC geriatrics · 2021Article
- Caring for Chronically Ill Older Adults: A View Over the Last 75 Years.The journals of gerontology. Series B, Psychological sciences and social sciences · 2020Article
- Factors Associated with Family Caregivers' Confidence in Future Surrogate Decision Making for Persons with Cancer.Journal of palliative medicine · 2018Article
- Just-in-time consent: The ethical case for an alternative to traditional informed consent in randomized trials comparing an experimental intervention with usual care.Clinical trials (London, England) · 2018Article
- Racial and Ethnic Differences in Advance Directive Possession: Role of Demographic Factors, Religious Affiliation, and Personal Health Values in a National Survey of Older Adults.Journal of palliative medicine · 2016Article
- Prior Advance Care Planning Is Associated with Less Decisional Conflict among Surrogates for Critically Ill Patients.Annals of the American Thoracic Society · 2015Article
- Advance Care Planning. Does It Benefit Surrogate Decision Makers in the Intensive Care Unit?Annals of the American Thoracic Society · 2015Article
- Being a legal guardian - the nursing perspective.Israel journal of health policy research · 2015Article
- Advance directive screening among veterans with incident heart failure: Comparisons among people aging with and without HIV.Heart & lung : the journal of critical careArticle
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
AIMS AND
objectivesTo identify the relationships between advance directive status, demographic characteristics and decisional burden (role stress and depressive symptoms) of surrogate decision-makers (SDMs) of patients with chronic critical illness.
backgroundAlthough the prevalence of advance directives among Americans has increased, SDMs are ultimately responsible for complex medical decisions of the chronically critically ill patient. Decisional burden has lasting psychological effects on SDMs. There is insufficient evidence on the influence of advance directives on the decisional burden of surrogate decision-makers of patients with chronic critical illness.
designThe study was a secondary data analysis of cross-sectional data. Data were obtained from 489 surrogate decision-makers of chronically critically ill patients at two academic medical centres in Northeast Ohio, United States, between September 2005-May 2008.
methodsData were collected using demographic forms and questionnaires. A single-item measure of role stress and the Center for Epidemiological Studies Depression (CESD) scale were used to capture the SDM's decisional burden. Descriptive statistics, t-tests, chi-square and path analyses were performed.
resultsSurrogate decision-makers who were nonwhite, with low socioeconomic status and low education level were less likely to have advance directive documentation for their chronically critically ill patient. The presence of an advance directive mitigates the decisional burden by directly reducing the SDM's role stress and indirectly lessening the severity of depressive symptoms.
conclusionsMost SDMs of chronically critically ill patients will not have the benefit of knowing the patient's preferences for life-sustaining therapies and consequently be at risk of increased decisional burden. RELEVANCE TO CLINICAL PRACTICE: Study results are clinically useful for patient education on the influence of advance directives. Patients may be informed that SDMs without advance directives are at risk of increased decisional burden and will require decisional support to facilitate patient-centred decision-making.
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