Investigating stress, social support, and decisional conflict dynamics in surrogates of intensive care unit patients with cancer.

Abstract

Purpose: The purpose of this study is to examine fluctuations in stress, social support, and decisional conflict among surrogates during the admission and discharge phases of intensive care unit (ICU) patients with cancer. Additionally, this study seeks to identify the factors that influence changes in decisional conflict experienced by these surrogates.

Methods: This study involved surrogates of ICU patients with cancer. Data were collected within three days of ICU admission and during the discharge phase.

Results: The study included 115 surrogates of ICU patients with cancer. Following ICU discharge, the surrogates experienced a significant reduction in mean stress levels (t =  - 7.205; p < .001), improved family support (t = 3.748; p < .001), and decreased support from healthcare professionals (t =  - 3.286; p = .001). Younger surrogates, high-stress levels in surrogates, and low social support from healthcare professionals were associated with high decisional conflict. Stepwise multiple regression analysis indicated that surrogates' age, changes in stress, and changes in healthcare professionals' support explained 5%, 8%, and 16% of the variation in changes in decisional conflict, respectively.

Conclusions: To effectively reduce decisional conflict, particularly during the transition of patients with cancer from the ICU, a robust support system and comprehensive information on the treatment and prognosis of diseases in patients with cancer should be provided to younger surrogates. Healthcare professionals can facilitate family meetings and ensure comprehensive communication of the treatment plan. Practical guidance, social work assistance, timely clarification, and thorough information healthcare professionals provide can effectively mitigate decisional conflicts and enhance decision-making processes.