重新考虑遗憾:重新评估倾向缓冲 ICU 替代者在患者死亡后的遗憾
Grant A Pignatiello1, Paul J Tuschman2, Stephanie Griggs1
1Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.
Western journal of nursing research
|June 16, 2025
概括
替代已故患者的决策者面临更高的遗憾. 情绪调节,特别是认知重新评估,显著减少了这种决策后悔,为支持干预提供了目标.
科学领域:
- 关键护理医学 关键护理医学
- 心理学 心理学 心理学
- 决策科学 决策科学 决策科学
背景情况:
- 超过一半的代孕决策者在为重症监护室 (ICU) 的患者做出决定后感到遗憾.
- 患者死亡增加了代理决策者遗憾的风险.
- 情绪调节倾向可能缓冲这种风险.
研究的目的:
- 调查患者生存结果 (活着/已故) 对代孕决策者的影响.
- 检查认知重新评估倾向如何减轻决策遗憾的风险.
主要方法:
- 从4个ICU的随机对照试验中对158名代理决策者的二次分析.
- 在入学时对认知重新评估倾向的测量和在入学后90天后对决定的遗憾.
- 逻辑回归用于分析生存结果,决策后悔和认知再评估的调节作用之间的关联.
主要成果:
- 50%的代理决策者表示后悔他们的决定.
- 已故患者的替代人与幸存者的替代人相比,后悔的几率是5.7倍.
- 在认知重新评估倾向中,一个标准偏差的增加与已故患者的替代品中遗憾率减少四倍有关.
结论:
- 替代已故患者的决策者更有可能经历遗憾.
- 对认知重新评估的倾向增加与遗憾的几率下降有关.
- 促进认知重新评估的干预措施可能会改善重症监护中代理决策者的心理结果.
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