Abstract:
BACKGROUND:Recent studies suggest that surrogate decision makers may be too optimistic about their end-of-life decision making abilities for loved ones. We examined surrogates' decision making confidence with an emphasis on its linkages to their understandings of patients' values and goals for end-of-life care. METHODS:We used baseline data from a randomized trial with 58 dyads of African-American dialysis patients and their surrogates who separately completed the Values of Life-Sustaining Treatment Outcomes and the Goals of Care documents. Surrogates also completed a Surrogate Decision Making Confidence Scale. RESULTS:Overall, 60% of surrogates were unsure how their loved ones would feel about continuing life-sustaining treatment, including dialysis, in at least one of the four outcomes presented in the Values of Life-Sustaining Treatment Outcomes. For goals of care near end of life, 67.2% to 69.0% of patients preferred comfort care only, but only 20 (34.5%) surrogates were congruent with patients on Goals of Care. Nonetheless, surrogates' confidence was high (M=3.23 out of 4.0). Surrogates' confidence was positively associated with dyad congruence in values for life-sustaining treatment at only a small magnitude (Spearman's rho=.31, p=.02), but not with dyad congruence in goals of care (χ(2)=2.13, df=1, p=.19). CONCLUSIONS:Surrogates' confidence had little association with their actual understanding of patients' values and goals. Interventions to prepare patients and surrogates for end-of-life decision making may need to address overconfidence and help surrogates recognize their limited understanding of patients' values and goals.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Song MK,Ward SE,Lin FCdoi
10.1089/jpm.2011.0330subject
Has Abstractpub_date
2012-04-01 00:00:00pages
412-7issue
4eissn
1096-6218issn
1557-7740journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Methadone is an attractive medication for treating children with advanced cancer with pain as it is the only long-acting opioid available as a liquid. However, it is not frequently used due to concerns about potential toxicities and side effects. OBJECTIVE:Evaluate the efficacy and safety of methadone as th...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2018-09-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
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更新日期:2018-04-01 00:00:00
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journal_title:Journal of palliative medicine
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更新日期:2020-08-01 00:00:00
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更新日期:2006-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2012-02-01 00:00:00
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pub_type: 共识发展会议,杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2013-11-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
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更新日期:2011-02-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2004-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-10-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2012-04-01 00:00:00
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更新日期:2019-11-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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更新日期:2008-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-10-01 00:00:00
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pub_type: 杂志文章
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