Preliminary Identification of Coping Profiles Relevant to Surrogate Decision Making in the ICU

Abstract

ObjectiveThe Intensive Care Unit (ICU) is a stressful environment for families of critically ill patients and these individuals are at risk to develop persistent psychological morbidity. Our study objective was to identify individual differences in coping with stress and information presentation preferences of respondents exposed to a simulated ICU experience.MethodsParticipants were recruited from a university and two community populations. Participants completed questionnaires that measured demographic information and characteristics that may be relevant to an individual’s ICU experience. Quality of life was measured by the EQ-5D, personality dimensions were examined with the abbreviated Big Five inventory, coping with stress was assessed with Brief COPE. Shared decision making preferences were assessed by the Degner Control Preferences Scale (CPS) and information seeking style was assessed with the Miller Behavioral Style Scale (MBSS). Social support was examined using an abbreviated version of the Social Relationship Index. Participants also completed a vignette-based simulated ICU experience, in which they made a surrogate decision on behalf of a loved one in the ICU.ResultsThree hundred forty-three participants completed the study. Three distinct coping profiles were identified: adaptive copers, maladaptive copers, and disengaged copers. Profiles differed primarily on coping styles, personality, quality of their closest social relationship, and history of anxiety and depression. Responses to the simulated ICU decision making experience differed across profiles. Disengaged copers (15%) were more likely to elect to refuse dialysis on behalf of an adult sibling compared to adaptive copers (7%) or maladaptive copers (5%) (p = 0.03). Notably, the MBSS and the CPS did not differ by coping profile.ConclusionDistinct coping profiles are associated with differences in responses to a simulated ICU experience. Tailoring communication and support to specific coping profiles may represent an important pathway to improving ICU experience for patients and families.

Family Experience during Patient Assistance Process in General Intensive Care Unit: A Phenomenology Study

“…Shocked and unbelieved that their loved one should be admitted to ICU is one aspect that made the family feel fearful of getting medical equipment inside ICU [17]. However, this unfortunate experience will help families find an appropriate solution to their problems [27].…”

Directions for 21st Century Lifelong Learning Institutes: Elucidating Questions from Osher Lifelong Learning Institute Studies

“…Many of such studies highlighted the cognitive benefits of lifelong learning (Lamb, 2011;Lamb & Brady, 2005;Pstross, Talmage, Peterson, & Knopf, 2017b;Simone & Cesena, 2010;Simone & Scuilli, 2006;Spiers, 2012Spiers, , 2015, such as resiliency (Lamb, Brady, & Lohman, 2009) and dementia deferral (Richeson, Boyne, & Brady, 2007). Others focused on tools to promote health management (Butler et al, 2016;Zettel-Watson & Tsukerman, 2016) and health care education (Sierpina, Kreitzer, & Sierpina, 2009). If it follows that lifelong learning helps individuals achieve their full human potential (Lamb, 2011), we ask: What are effective lifelong learning strategies to help older adults reach their highest potential(s) for physical and cognitive health?…”

Reliability and Validity of the Turkish Version of the Brief Scales for Coping Profile in Textile Workers

“…For example, the ways of coping questionnaire, COPE inventory, the coping flexibility scale, the perceived ability to cope with trauma [12] and Coping with Harassment Questionnaire [7] have been used abroad. The Brief COPE scale also has been used widely in research to assess coping strategies which contains 28 items and 14 two-item subscales [9,[13][14][15]. Among coping measurements, the Coping style scale has been used in Turkey which was derived from Lazarus and Folkman's Ways of Coping Inventory.…”