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A psychometric evaluation of the Family Decision-Making Self-Efficacy Scale among surrogate decision-makers of the critically ill

Published online by Cambridge University Press:  08 November 2019

Grant A. Pignatiello Open the ORCID record for Grant A. Pignatiello [Opens in a new window] ,
Elliane Irani ,
Sadia Tahir ,
Emily Tsivitse  and
Ronald L. Hickman Jr.
Grant A. Pignatiello*
Affiliation:
Case Western Reserve University, Cleveland, OH
Elliane Irani
Affiliation:
Case Western Reserve University, Cleveland, OH
Sadia Tahir
Affiliation:
Case Western Reserve University, Cleveland, OH
Emily Tsivitse
Affiliation:
Case Western Reserve University, Cleveland, OH
Ronald L. Hickman Jr.
Affiliation:
Case Western Reserve University, Cleveland, OH
*
Author for correspondence: Grant A. Pignatiello, 2120 Cornell Road, Cleveland, OH44106-4904, USA. E-mail: gap54@case.edu
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Abstract

Objectives

The purpose of this study was to report the psychometric properties, in terms of validity and reliability, of the Unconscious Version of the Family Decision-Making Self-Efficacy Scale (FDMSE).

Methods

A convenience sample of 215 surrogate decision-makers for critically ill patients undergoing mechanical ventilation was recruited from four intensive care units at a tertiary hospital. Cross-sectional data were collected from participants between days 3 and 7 of a decisionally impaired patient's exposure to acute mechanical ventilation. Participants completed a self-report demographic form and subjective measures of family decision-making self-efficacy, preparation for decision-making, and decisional fatigue. Exploratory factor analyses, correlation coefficients, and internal consistency reliability estimates were computed to evaluate the FDMSE's validity and reliability in surrogate decision-makers of critically ill patients.

Results

The exploratory factor analyses revealed a two-factor, 11-item version of the FDMSE was the most parsimonious in this sample. Furthermore, modified 11-item FDMSE demonstrated discriminant validity with the measures of fatigue and preparation for decision-making and demonstrated acceptable internal consistency reliability estimates.

Significance of results

This is the first known study to provide evidence for a two-factor structure for a modified, 11-item FDMSE. These dimensions represent treatment and palliation-related domains of family decision-making self-efficacy. The modified FDMSE is a valid and reliable instrument that can be used to measure family decision-making self-efficacy among surrogate decision-makers of the critically ill.

Keywords

Critical careDecision-makingFamily membersPsychometricsSelf-efficacy
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Issue 5 , October 2020 , pp. 537 - 543
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Copyright
Copyright © Cambridge University Press 2019

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