ArticlePalliative & supportive care2022
Development and preliminary evaluation of EMPOWER for surrogate decision-makers of critically ill patients.
Article in Palliative & supportive care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
A Clinical Trial of Interventions to Support Family Surrogates of Critically Ill Patients
Empower-Grief: Study Protocol for a Pilot Randomized Controlled Trial
Who cites it
11 citing papers in PubMed, 23 citations in OpenAlex.
- Randomized Clinical Trial of the Four Supports Intervention for Surrogate Decision-Makers in Intensive Care Units.American journal of respiratory and critical care medicine · 2025Trial
- EMPOWER: A Multi-Site Pilot Trial to Reduce Distress in Surrogate Decision-Makers in the ICU.Journal of pain and symptom management · 2024Trial
- Meaning-Centered Psychotherapy for Cancer Caregivers: Study protocol of a randomized controlled trial.Trials · 2026Article
- Meaning-Centered Psychotherapy for Cancer Caregivers Study protocol of a randomized controlled trial.Research square · 2026Article
- Bereavement interventions for families in the ICU: a scoping review informed by a core outcome set.Annals of intensive care · 2025Article
- Empower-Grief for Relatives of Cancer Patients: Implementation and Findings from an Exploratory Randomized Controlled Trial.Behavioral sciences (Basel, Switzerland) · 2025Article
- Effectiveness of Empower-Grief for Relatives of Palliative Care Patients: Protocol for an Exploratory Randomized Controlled Trial.Clinical psychology in Europe · 2025Article
- Long-Term Psychological Distress Among Surrogate Decision Makers for Mexican American and Non-Hispanic White Patients With Severe Stroke.Neurology · 2024Article
- A Mixed-Methods Feasibility Study: Eliciting ICU Experiences and Measuring Outcomes of Family Caregivers of Patients Who Have Undergone Hematopoietic Stem Cell Transplantation.Journal of family nursing · 2023Article
- Associations between Latino ethnicity and the use of emotional support and completion of advance directives.Palliative & supportive care · 2023Article
- Quality indicators of palliative care for cardiovascular intensive care.Journal of intensive care · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 7 institutions in 2 countries.
Funding
Abstract
objectiveThe objectives of this study were to develop and refine EMPOWER (Enhancing and Mobilizing the POtential for Wellness and Resilience), a brief manualized cognitive-behavioral, acceptance-based intervention for surrogate decision-makers of critically ill patients and to evaluate its preliminary feasibility, acceptability, and promise in improving surrogates' mental health and patient outcomes.
methodPart 1 involved obtaining qualitative stakeholder feedback from 5 bereaved surrogates and 10 critical care and mental health clinicians. Stakeholders were provided with the manual and prompted for feedback on its content, format, and language. Feedback was organized and incorporated into the manual, which was then re-circulated until consensus. In Part 2, surrogates of critically ill patients admitted to an intensive care unit (ICU) reporting moderate anxiety or close attachment were enrolled in an open trial of EMPOWER. Surrogates completed six, 15-20 min modules, totaling 1.5-2 h. Surrogates were administered measures of peritraumatic distress, experiential avoidance, prolonged grief, distress tolerance, anxiety, and depression at pre-intervention, post-intervention, and at 1-month and 3-month follow-up assessments.
resultsPart 1 resulted in changes to the EMPOWER manual, including reducing jargon, improving navigability, making EMPOWER applicable for a range of illness scenarios, rearranging the modules, and adding further instructions and psychoeducation. Part 2 findings suggested that EMPOWER is feasible, with 100% of participants completing all modules. The acceptability of EMPOWER appeared strong, with high ratings of effectiveness and helpfulness (M = 8/10). Results showed immediate post-intervention improvements in anxiety (d = -0.41), peritraumatic distress (d = -0.24), and experiential avoidance (d = -0.23). At the 3-month follow-up assessments, surrogates exhibited improvements in prolonged grief symptoms (d = -0.94), depression (d = -0.23), anxiety (d = -0.29), and experiential avoidance (d = -0.30). SIGNIFICANCE OF
resultsPreliminary data suggest that EMPOWER is feasible, acceptable, and associated with notable improvements in psychological symptoms among surrogates. Future research should examine EMPOWER with a larger sample in a randomized controlled trial.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.