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Uncertainty and decision making for residents with dementia
Ruth Palan Lopez1, A J Guarino
1MGH Institute of Health Professions School of Nursing, Boston, MA 02129-4557, USA. rlopez@mghihp.edu
Clinical Nursing Research
|April 28, 2011
Summary
Surrogate decision makers (SDMs) for nursing home dementia patients experience uncertainty. Enhancing SDMs’ self-efficacy and social support can reduce this uncertainty, improving care decisions.
Area of Science:
- Gerontology
- Healthcare Decision Making
- Cognitive Impairment Research
Background:
- Uncertainty poses a significant challenge for surrogate decision makers (SDMs) involved in treatment choices for nursing home (NH) residents with dementia.
- Effective support for SDMs is crucial for ensuring quality care and decision-making aligned with resident wishes.
Purpose of the Study:
- To describe the level of uncertainty experienced by SDMs of NH residents with dementia.
- To identify key factors associated with increased uncertainty in this population.
Main Methods:
- A cross-sectional survey design was utilized, recruiting 155 SDM participants from eight NHs in New England.
- The Mishel Uncertainty in Illness Scale For Family Members was administered, alongside data on sociodemographics, Advance Directives, Credible Authority, Social Support, and Perceived Self-Efficacy.
Main Results:
- Simultaneous multiple regression analysis indicated that Perceived Self-Efficacy, Social Support, and being a Close Relative collectively explained 22% of the variance in uncertainty.
- Higher perceived self-efficacy and greater social support were associated with lower levels of uncertainty.
Conclusions:
- Close family relatives acting as SDMs for NH residents with dementia may benefit from interventions aimed at bolstering social support.
- Enhancing SDMs' self-efficacy in decision-making processes is a potential strategy to mitigate uncertainty and improve outcomes.
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