Uncertainty and Decision Making for Residents with Dementia

• Published in: Clinical nursing research Vol. 20; no. 3; pp. 228 - 240
• Main Authors: Lopez, Ruth Palan, Guarino, A.J.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-08-2011; SAGE PUBLICATIONS, INC
• Subjects: Aged; Aged, 80 and over; Boston; Cross-Sectional Studies; Decision Making; Dementia; Dementia - therapy; Dementia disorders; Family Relations; Female; Humans; Male; Middle Aged; Multiple regression analysis; Nursing; Nursing Homes; Older people; Palliative care; Proxy - psychology; Relatives; Self Efficacy; Selfefficacy; Social interactions; Social Support; Surrogates; Uncertainty; Boston; United States > US; nursing home; perceived self-efficacy; uncertainty; palliative care; end-of-life care
• ISSN: 1054-7738; 1552-3799
• DOI: 10.1177/1054773811405521

Uncertainty is a significant barrier confronting surrogate decision makers (SDMs) who make treatment decisions for nursing home (NH) residents with dementia. The study purpose is to describe uncertainty among SDMs of NH residents with dementia and to identify factors associated with greater Uncertainty. We employed a nonexperimental, cross-sectional design using mailed survey and recruited 155 SDM participants from eight NHs in New England. The survey contained the Mishel Uncertainty in Illness Scale For Family Members. Independent variables included resident and SDM sociodemographic characteristics, Advance Directives, Credible Authority, Social Support, and Perceived Self-Efficacy for Surrogate Decision Making. Results of a simultaneous multiple regression analysis identified Perceived Self-Efficacy, Social Support, and Close Relative explained 22% of the Uncertainty variance. These findings suggest that close family relatives who serve as SDMs for NH residents with dementia may benefit from increasing social support and enhancing SDMs’ self-efficacy for decision making.