This descriptive, nonexperimental, cross-sectional, in vivo study examined factors influencing decisions about life-sustaining treatment decisions (CPR, mechanical ventilation, tube feeding, and hemodialysis), and perceptions of the benefits and barriers associated with these decisions in a central Florida (USA) sample of health care surrogates and proxies (N = 132). Derived from the Health Beliefs Model, a surrogate decision-making model portrayed relationships among study variables assessed with hierarchical multiple regression (HMR). A three-step variable entry process and post hoc case analysis produced the final surrogate decision model: R² = .381 (F = 6.43, [F = .05; 9, 94] = 10.65, p Surrogates were reassured by knowing patients' verbal and/or written advance treatment instructions. Sustained by knowing "what Mom wanted", 97.8% of respondents expressed a higher degree of personal decision acceptance by carrying out patient wishes, accepting those decisions as the best alternatives. Following treatment decisions, surrogates expressed high self-reliance and significantly appreciated the benefits associated with treatment decisions. As surrogates must possess essential patient information prior to legitimately exercising legal and moral obligations to the patient in a decision reflecting patient wishes, engagement between social workers and surrogates at hospital/ICU admission can facilitate surrogate-patient communication and information exchange with remaining healthcare professionals. New measurement tools to clarify patient treatment preferences and surrogate role demands enable social workers to prepare surrogates for their role, counter barriers associated with treatment decisions, and mitigate stressors associated with surrogacy. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2007. / December 1, 2006. / Proxy Decisions, Surrogate Decision-Making, Health Belief Model, Health Care Decision-Making / Includes bibliographical references. / Neil Abell, Professor Directing Dissertation; Michelle S. Bourgeois, Outside Committee Member; Nicholas F. Mazza, Committee Member.
| Identifer | oai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_181043 |
| Contributors | Buckey, Julia Winchester (authoraut), Abell, Neil (professor directing dissertation), Bourgeois, Michelle S. (outside committee member), Mazza, Nicholas F. (committee member), College of Social Work (degree granting department), Florida State University (degree granting institution) |
| Publisher | Florida State University, Florida State University |
| Source Sets | Florida State University |
| Language | English, English |
| Detected Language | English |
| Type | Text, text |
| Format | 1 online resource, computer, application/pdf |
| Rights | This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s). The copyright in theses and dissertations completed at Florida State University is held by the students who author them. |
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