Factors Associated with Family Member’s Confidence in Decision-Making to Choose Palliative Care for Patients in Critical Care Units
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Abstract
This descriptive correlational research examined the confidence of family members acting as surrogate decision-makers in choosing palliative care for their relatives receiving treatment in critical care units and its related factors, including knowledge and attitudes toward palliative care, information received, perception of the patient’s needs, and family support. The sample consisted of 105 family members who were involved in decision-making for palliative care, selected based on purposive sampling, from private hospitals within the Phyathai and Paolo hospital networks. Data were collected using six questionnaires, each of which had a content validity index (CVI) of 1. The reliability of the Palliative Care Knowledge Questionnaire was tested, using the Kuder-Richardson (KR-20), with a value of 0.64. The Cronbach's alpha coefficient of the Information Received Questionnaire, the Perception of Patient Needs Questionnaire, the Multi-Dimensional Scale of Perceived Social Support (MSPSS), and the Family Decision Making Self-Efficacy Scale were 0.94, 0.98, 0.98 and 0.91, respectively. The Attitudes Toward Palliative Care Scale, including emotional, cognitive, and behavioral aspects, had Cronbach's alpha coefficients of 0.94, 0.90 and 0.71, respectively. Data were analyzed using Pearson correlation statistics.
The results indicated that the family members’ confidence in making palliative care decisions was at a moderate level (Mean = 10.27, SD = 3.10). Knowledge, information received, attitudes toward palliative care and perception of patient needs were positively correlated with the family decision-making confidence, with statistical significance (r = .196, r = .225, r = .295, r = .345, p < .05, respectively). However, family support was not significantly correlated with confidence (r = -.024, p > .05).
The findings suggest the need to develop support services for family members facing decisions regarding palliative care. Emphasis should be placed on enhancing knowledge and fostering positive attitudes, providing information about the patient’s condition, and promoting advance care planning. These measures aim to empower families to make informed and confident decisions regarding palliative care.
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