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Surrogates' Decisional Conflict and Needs Regarding Invasive Procedures for Intensive Care Unit Patients: A Mixed-Methods Study. 针对重症监护病房患者的侵入性手术,代理人的决策冲突和需求:一项混合方法研究。
IF 3.5 3区 医学 Q1 NURSING Pub Date : 2026-02-02 DOI: 10.1111/jocn.70213
Wan-Na Sun, Su-Ying Fang

Background: Surrogates make decisions for critically ill patients in intensive care units (ICUs). Because such decisions are critical, many surrogates experience decisional conflict, which can lead to long-term regret and psychological distress. Understanding surrogates' needs during decision-making, particularly when invasive procedures are involved, is essential to improving patient outcomes.

Aim: To identify and analyse the needs of surrogates and the decisional conflict they experience during the decision-making process for invasive procedures in ICUs.

Methods: This convergent, parallel, mixed-methods study was conducted at a tertiary medical centre in southern Taiwan. Eligible participants were surrogates aged 20 years or older. The patients represented by these surrogates had a Glasgow Coma Scale (GCS) score of < 12 and were expected to undergo at least one invasive procedure. Quantitative data were collected from 100 surrogates using a structured questionnaire assessing decisional conflict and needs, and qualitative data were obtained through in-depth interviews with 13 surrogates.

Results: The following factors were significantly associated with decisional conflict: lower education level (β = -6.24, p = 0.042), lower family income (β = -9.91, p = 0.027), and resuscitative types of invasive procedure (β = -6.40, p = 0.045). Information needs were the most critical because information is often overwhelming without a medical background. Meeting surrogates' support needs, including the need for support from family members, can help reduce isolation in decision-making. The findings also indicate that internal resources played a key role in alleviating decisional conflict in surrogates.

Conclusion: The informational, support, and resource needs of surrogates play a critical role in decision-making for invasive procedures. Their informational needs primarily indicate difficulties in comprehending and integrating complex medical information within a limited timeframe. Clear, structured communication and emotional support may reduce decisional conflict and long-term regret.

背景:代理人为重症监护病房(icu)的危重病人做决定。因为这样的决定是至关重要的,许多代理人经历了决策冲突,这可能导致长期的后悔和心理困扰。在决策过程中,特别是涉及侵入性手术时,了解代孕者的需求对改善患者的预后至关重要。目的:了解和分析代理医师在icu有创手术决策过程中的需求和决策冲突。方法:本研究在台湾南部某三级医疗中心进行。符合条件的参与者是年龄在20岁或以上的代孕母亲。结果:以下因素与决策冲突显著相关:教育程度较低(β = -6.24, p = 0.042),家庭收入较低(β = -9.91, p = 0.027),有创手术复苏类型(β = -6.40, p = 0.045)。信息需求是最关键的,因为如果没有医学背景,信息往往是压倒性的。满足代孕母亲的支持需求,包括获得家庭成员支持的需求,有助于减少决策过程中的孤立感。研究结果还表明,内部资源在缓解代理人决策冲突方面发挥了关键作用。结论:代孕母亲的信息、支持和资源需求在有创手术的决策中起着至关重要的作用。他们的信息需求主要表明在有限的时间内难以理解和整合复杂的医疗信息。清晰、有组织的沟通和情感支持可以减少决策冲突和长期后悔。
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Comments on 'Parental Experiences of Decision Making After Children's New Cancer Diagnoses: A Phenomenological Study'. 《儿童新癌症诊断后的父母决策经验:现象学研究》述评
IF 3.5 3区 医学 Q1 NURSING Pub Date : 2026-02-02 DOI: 10.1111/jocn.70237
Jiule Yu
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IF 3.5 3区 医学 Q1 NURSING Pub Date : 2026-01-31 DOI: 10.1111/jocn.70222
Yue Zhang
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Comment on: 'A Lived Experience of Intensive Care Unit Survivors Regarding Post-Intensive Care Syndrome After Liver Transplantation: A Phenomenological Study'. 评论:“肝移植后重症监护综合征重症监护病房幸存者的生活经验:现象学研究”。
IF 3.5 3区 医学 Q1 NURSING Pub Date : 2026-01-31 DOI: 10.1111/jocn.70229
Chengying Hu
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IF 3.5 3区 医学 Q1 NURSING Pub Date : 2026-01-29 DOI: 10.1111/jocn.70228
Yijia Ren, Sanglin Zhao
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Family QoL Burden in CSU: Cultural Adaptation and Caregiver Mental Health. CSU家庭生活质量负担:文化适应与照顾者心理健康
IF 3.5 3区 医学 Q1 NURSING Pub Date : 2026-01-27 DOI: 10.1111/jocn.70227
Wenwen Wang
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IF 3.5 3区 医学 Q1 NURSING Pub Date : 2026-01-27 DOI: 10.1111/jocn.70200
Swapnil Vitthal Rahane, Janki Rathva, Seeta Devi
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Letter to the Editor Regarding 'Risk Prediction Models for Enteral Nutrition Aspiration in Adult Inpatients: A Systematic Review and Critical Appraisal'. 致编辑关于“成人住院患者肠内营养误吸风险预测模型:系统回顾和关键评价”的信。
IF 3.5 3区 医学 Q1 NURSING Pub Date : 2026-01-26 DOI: 10.1111/jocn.70223
Xudong Wang
{"title":"Letter to the Editor Regarding 'Risk Prediction Models for Enteral Nutrition Aspiration in Adult Inpatients: A Systematic Review and Critical Appraisal'.","authors":"Xudong Wang","doi":"10.1111/jocn.70223","DOIUrl":"https://doi.org/10.1111/jocn.70223","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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{"title":"Comment on 'Unpacking Mechanisms of Rapid Response for Mental State Deterioration: A Realist-Informed Analysis of Field Observations in Acute Hospital Settings'.","authors":"Yiqi Guo, Lijuan Chen","doi":"10.1111/jocn.70225","DOIUrl":"https://doi.org/10.1111/jocn.70225","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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引用次数: 0
期刊
Journal of Clinical Nursing
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