干旱区生态环境知识资源中心(Arid): Surrogate Decision-Making After Stroke in a Community Setting: The OASIS Project

Arid

DOI	10.1161/STROKEAHA.123.043947
	Surrogate Decision-Making After Stroke in a Community Setting: The OASIS Project
	Zahuranec, Darin B.; Ortiz, Carmen; Lank, Rebecca J.; Zhang, Guanghao; Shi, Xu; Case, Erin; Morgenstern, Lewis B.
通讯作者	Zahuranec, DB
来源期刊	STROKE
ISSN	0039-2499
EISSN	1524-4628
出版年	2024
卷号	55 期号:3 页码:678-686
英文摘要	BACKGROUND:Patients with severe stroke often rely on surrogate decision-makers for life-sustaining treatment decisions. We investigated ethnic differences between Mexican Americans (MAs) and non-Hispanic White (NHW) individuals in surrogate reports of physician quality of communication and shared decision-making from the OASIS study (Outcomes Among Surrogate Decision Makers in Stroke) project.METHODS:Patients had ischemic stroke or intracerebral hemorrhage in Nueces County, TX. Surrogates self-identified as being involved in decisions about do-not-resuscitate orders, brain surgery, ventilator, feeding tube, or hospice/comfort care. Surrogate reports of physician quality of communication (scale score, range from 0 to 10) and shared decision-making (CollaboRATE scale score, binary score 1 versus 0) were compared by ethnicity with linear or logistic regression using generalized estimating equations, adjusted for prespecified demographics, clinical factors, and confounders.RESULTS:Between April 2016 and September 2020, 320 surrogates for 257 patients with stroke enrolled (MA, 158; NHW, 85; and other, 14). Overall quality of communication score was better among surrogates of MA patients than NHW individuals after adjustment for demographics, stroke severity, and patient survival though the ethnic difference was attenuated (beta, 0.47 [95% CI, -0.17 to 1.12]; P=0.15) after adjustment for trust in the medical profession and frequency of personal prayer. High CollaboRATE scale scores were more common among surrogates of MA patients than NHW individuals (unadjusted odds ratio, 1.75 [95% CI, 1.04-2.95]). This association persisted after adjustment for demographic and clinical factors though there was an interaction between patient age and ethnicity (P=0.04), suggesting that this difference was primarily in older patients.CONCLUSIONS:Surrogate decision-makers of MA patients generally reported better outcomes on validated measures of quality of communication and shared decision-making than NHW individuals. Further study of outcomes among diverse populations of stroke surrogate decision-makers may help to identify sources of strength and resiliency that may be broadly applicable.
英文关键词	communication decision-making, shared hospitals Mexican Americans stroke
类型	Article
语种	英语
收录类别	SCI-E
WOS记录号	WOS:001171542600014
WOS关键词	PATIENT PREFERENCES ; FAMILY-MEMBERS ; CARE ; COMMUNICATION ; ACCULTURATION ; MORTALITY ; OUTCOMES ; QUALITY ; SCALE
WOS类目	Clinical Neurology ; Peripheral Vascular Disease
WOS研究方向	Neurosciences & Neurology ; Cardiovascular System & Cardiology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/405684
推荐引用方式 GB/T 7714	Zahuranec, Darin B.,Ortiz, Carmen,Lank, Rebecca J.,et al. Surrogate Decision-Making After Stroke in a Community Setting: The OASIS Project[J],2024,55(3):678-686.
APA	Zahuranec, Darin B..,Ortiz, Carmen.,Lank, Rebecca J..,Zhang, Guanghao.,Shi, Xu.,...&Morgenstern, Lewis B..(2024).Surrogate Decision-Making After Stroke in a Community Setting: The OASIS Project.STROKE,55(3),678-686.
MLA	Zahuranec, Darin B.,et al."Surrogate Decision-Making After Stroke in a Community Setting: The OASIS Project".STROKE 55.3(2024):678-686.