Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study

Abstract

Emotional support of hospital surrogates is consistently associated with better psychological outcomes and decision quality, suggesting an opportunity to improve decision making and well-being.

Decisional conflict in end‐of‐life cancer treatment among family surrogates: A cross‐sectional survey

“…Because a variety of decisions, including end‐of‐life and other treatment decisions, are assessed in the ICU (Miller et al, ), further studies are warranted to understand family surrogates' decision conflicts in making end‐of‐life decisions. Moreover, for the factors associated with decisional conflicts among family surrogates, the presence of advance care planning (Chiarchiaro et al, ) and emotional support (Torke et al, ) were shown to be associated with less decisional conflict among family surrogates, but no other factors have been investigated in empirical studies.…”

Modifiable elements of ICU supportive care and communication are associated with surrogates’ PTSD symptoms

“…A multicenter study of key stakeholders found that that a majority of family surrogates, clinicians, and non-clinician experts identified increased attention to family emotional support as an important concept when caring for the critically ill [32]. Torke and colleagues found that higher satisfaction with communication was associated with lower symptoms of PTSD in surrogate decision makers of elderly patients admitted to the hospital, but this cohort included patients both on the wards and in the ICU, severity of illness was generally low, and specific elements of communication were not assessed [33]. Azoulay and colleagues found that family perception that information in the ICU was incomplete was associated with increased PTSD symptoms at 90 days, but further data was not provided regarding which elements of communication were perceived as being incomplete by the surrogate decision makers [7].…”

Risk Factors for Post-Traumatic Stress Disorder Symptoms in Surrogate Decision-Makers of Patients with Chronic Critical Illness

“…Investigation of a German cohort found that higher relationship satisfaction between the patient and the surrogate was protective against post-traumatic stress in the CCI population, but this study was limited by low follow-up rate with only 12% of enrolled patient-surrogate dyads available for 6 month follow-up (25). A recent study by Torke and colleagues (26) demonstrated that baseline distress, as measured by the Kessler six-item Psychological Distress Scale, was positively associated with post-traumatic stress at 6-8 weeks after hospitalization for family surrogate decision-makers of older adults admitted to either the ICU or the general wards. As compared with the population in this study, our patients had a much higher severity of illness and worse long-term outcomes, and family members had a more significant degree of PTSD symptoms.…”