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Development and Validation of the Surrogate Decision-Maker Trust Scale.
Caleb Armstrong1,2, Kevin Gosselin3
1Parkland Health, Medical Intensive Care Unit, Dallas, TX, USA caleb.armstrong@unthsc.edu.
Journal of Nursing Measurement
|November 12, 2025
Summary
Researchers developed the Surrogate Decision-Maker Trust Scale (SDMTS) to measure trust in healthcare professionals. This validated scale is crucial for improving outcomes for patients in intensive care units.
Area of Science:
- Healthcare research
- Psychometrics
- Clinical nursing
Background:
- Surrogate decision-maker trust is vital for patient outcomes in adult intensive care units.
- No validated instrument currently exists to measure this trust.
- Developing a reliable scale is essential for clinical practice and research.
Purpose of the Study:
- To develop and validate the Surrogate Decision-Maker Trust Scale (SDMTS).
- To provide initial psychometric support for the SDMTS.
- To establish a tool for measuring surrogate trust in healthcare professionals.
Main Methods:
- Quantitative cross-sectional survey development design.
- Item generation through literature review and expert content validity evaluation.
- Exploratory factor analysis for construct validity and Cronbach's alpha for reliability.
Main Results:
- The final 22-item SDMTS demonstrated a three-factor structure explaining 48.4% of variance.
- The scale achieved a high Cronbach's alpha of .947, indicating excellent internal consistency.
- Initial validity and reliability were supported by the findings.
Conclusions:
- The SDMTS is a valid and reliable instrument for measuring surrogate decision-maker trust.
- Further validation through confirmatory factor analysis in diverse populations is recommended.
- The SDMTS can be used to assess and potentially improve patient care in intensive care settings.
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