Two instruments to measure interdisciplinary bioethical decision making

Area of Science:

• Bioethics
• Medical Decision Making
• Nursing Research

Background:

• Intensive care unit (ICU) decision-making regarding patient care aggressiveness is complex.
• Understanding care providers' perceptions is crucial for improving patient outcomes and satisfaction.

Purpose of the Study:

• To develop and validate two instruments: Decisions about Aggressiveness of Patient Care (DAC) and Decisions about Aggressiveness of Patient Care for Specific Patients (DAC[SP]).
• To measure general and situation-specific perceptions of decision-making aggressiveness in ICU patient care.

Main Methods:

• A two-phase psychometric instrument evaluation was conducted.
• Phase I involved a national survey of 22 ICU experts.
• Phase II involved 43 staff nurses and resident physicians in a northeastern medical ICU.

Main Results:

• Both instruments demonstrated content and face validity, supported by expert and staff feedback.
• Reliability analyses showed acceptable internal consistency (r = 0.53, r = 0.73) and test-retest reliability (r = 0.73).
• Instruments exhibited variance in responses, indicating sensitivity to different perceptions.

Conclusions:

• The developed DAC and DAC[SP] instruments can enhance understanding of bioethical decision-making in ICUs.
• Findings may inform interventions to promote collaborative, interdisciplinary decision-making.
• Improved decision-making processes could lead to increased provider satisfaction and better patient outcomes.