A Qualitative Analysis of Factors Influencing Critical Care Trial Enrollment Among Surrogates

被引:5
|
作者
Krutsinger, Dustin C. [1 ]
Hetland, Breanna D. [2 ]
O'Leary, Kelly L. [3 ]
Halpern, Scott D. [4 ,5 ,6 ,7 ,8 ,9 ,10 ]
Courtright, Katherine R. [5 ,6 ,7 ,8 ,9 ,10 ]
机构
[1] Univ Nebraska Med Ctr, Div Pulm Crit Care & Sleep Med, Omaha, NE USA
[2] Univ Nebraska Med Ctr, Coll Nursing, 985330 Nebraska Med Ctr, Omaha, NE 68198 USA
[3] Childerens Hosp Philadelphia, Philadelphia, PA USA
[4] Univ Penn, Perelman Sch Med, Dept Biostat Epidemiol & Informat, Philadelphia, PA 19104 USA
[5] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA
[6] Palliat & Adv Illness Res PAIR Ctr, Philadelphia, PA USA
[7] Fostering Improvement End Of Life Decis Sci FIELD, Philadelphia, PA USA
[8] Ctr Hlth Incentives & Behav Econ CHIBE, Philadelphia, PA USA
[9] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA
[10] Univ Penn, Div Pulm Allergy & Crit Care, Perelman Sch Med, Philadelphia, PA 19104 USA
关键词
randomized controlled trials; enrollment; surrogate decision makers; medical decision making;
D O I
10.1177/0885066621998978
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: We sought to identify factors that influence surrogate decision makers' decisions to enroll patients into a critical care randomized controlled trial. Methods: We conducted a qualitative study embedded within a randomized controlled trial testing the effect of a behavioral nudge intervention for surrogate decision makers on enrollment rate in a sham ventilatory weaning trial among patients with acute respiratory failure. Participants were adult surrogate decision makers of patients receiving mechanical ventilation for acute respiratory failure. The study was conducted in 10 ICUs across 2 urban hospitals within an academic medical center in Philadelphia, Pennsylvanaia, United States. Immediately following their trial enrollment decision, surrogate decision makers were asked to enter free-text responses about the factors that influenced their decision. Responses were analyzed using content analysis. Results: Of the 90 (49%) participants who provided free-text responses, the mean age was 54.9 years (SD 14.3), 69 (79%) were Caucasian, and 48 (53%) were the spouse of the eligible patient. We identified 5 themes influencing enrollment decisions: (i) trial characteristics, (ii) patient clinical condition, (iii) decision making processes, (iv) altruism, and (v) enrollment attempt. Among surrogates who enrolled the patient in the trial (n = 40), the most commonly cited factors were helping future patients (n = 24, 60%) and following the patient's wishes (n = 11, 28%). In contrast, those who declined enrollment (n = 50) most commonly reported that the patient was too sick (n = 27, 54%) and that they feared complicating the patient's condition (n = 11, 22%). Conclusions: Surrogates who enroll patients into trials most often cite altruistic motivations, while those who decline enrollment are most often concerned with the severity of the patients' condition.
引用
收藏
页码:430 / 434
页数:5
相关论文
共 50 条
  • [21] A Randomized Controlled Trial of Behavioral Nudges to Improve Enrollment in Critical Care Trials
    Krutsinger, Dustin C.
    O'Leary, Kelly L.
    Ellenberg, Susan S.
    Cotner, Cody E.
    Halpern, Scott D.
    Courtright, Katherine R.
    ANNALS OF THE AMERICAN THORACIC SOCIETY, 2020, 17 (09) : 1117 - 1125
  • [22] A qualitative study of factors influencing Advanced Care Planning in oncology
    Donnelly, Candice
    Janssen, Anna
    Shah, Kavisha
    Harnett, Paul
    Greenaway, Sally
    Phillips, Jane
    Currow, David
    Bines, Catrina
    Sudini, Likhitha
    Mellor, Rhiannon
    Millican, Jared
    Shaw, Tim
    ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, 2022, 18 : 178 - 179
  • [23] Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study
    Artuso, Stella
    Cargo, Margaret
    Brown, Alex
    Daniel, Mark
    BMC HEALTH SERVICES RESEARCH, 2013, 13
  • [24] A qualitative assessment of factors influencing acceptance of a new rotavirus vaccine among health care providers and consumers
    Patel M.M.
    Janssen A.P.
    Tardif R.R.
    Herring M.
    Parashar U.D.
    BMC Pediatrics, 7 (1)
  • [25] Factors influencing utilization and perception of health care: a qualitative study among traumatized Yazidi refugees in Germany
    Tran, Virginia M.
    Fozouni, Laila
    Denkinger, Jana K.
    Rometsch, Caroline
    Junne, Florian
    Vinck, Patrick
    Pham, Phuong
    BMC PSYCHIATRY, 2021, 21 (01)
  • [26] Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study
    Stella Artuso
    Margaret Cargo
    Alex Brown
    Mark Daniel
    BMC Health Services Research, 13
  • [27] Factors influencing utilization and perception of health care: a qualitative study among traumatized Yazidi refugees in Germany
    Virginia M. Tran
    Laila Fozouni
    Jana K. Denkinger
    Caroline Rometsch
    Florian Junne
    Patrick Vinck
    Phuong Pham
    BMC Psychiatry, 21
  • [28] FACTORS INFLUENCING THE IMPLEMENTATION OF SPIRITUAL CARE BY NURSES IN CRITICAL CARE UNIT
    Dasan, Nathasha
    Sanjel, Chitra
    NURSING IN CRITICAL CARE, 2021, 26 : 28 - 28
  • [29] Factors influencing professionalism among nurse educators: A qualitative study
    Pareek, Bharat
    Batra, Kiran
    JOURNAL OF EDUCATION AND HEALTH PROMOTION, 2022, 11 (01) : 292
  • [30] Risk Factors for Hospitalization or Death Among Adults With Advanced HIV at Enrollment for Care in South Africa: A Secondary Analysis of the TB Fast Track Trial
    Calderwood, Claire J.
    Tlali, Mpho
    Karat, Aaron S.
    Hoffmann, Christopher J.
    Charalambous, Salome
    Johnson, Suzanne
    Grant, Alison D.
    Fielding, Katherine L.
    OPEN FORUM INFECTIOUS DISEASES, 2022, 9 (07):