Research Article
Volume 3 Issue 3 - 2021
A Path Analysis of Spiritual and Religious Coping on the Depressive Symptoms, Role Stress, and Self-Efficacy of Surrogate Decision Makers of ICU Patients
Ronald L Hickman1*, John M Clochesy2 and Grant A Pignatiello3
1The Ruth M. Anderson Endowed Associate Professor and Associate Dean for Research, Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA
2Professor, University of Miami, College of Nursing and Health Sciences, Florida, USA
3Instructor and KL2 Scholar, Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA
*Corresponding Author: Ronald L Hickman, The Ruth M. Anderson Endowed Associate Professor and Associate Dean for Research, Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA.
Received: December 04, 2020; Published: February 27, 2021


Background: Under heightened states of high uncertain and emotional distress, surrogate decision makers (SDMs) are often expected to make informed medical decisions that align with the critically patient’s preferences for life-sustaining care. Under these circumstances, some SDMs use spiritual and religious coping (SRC) to mitigate the negative influence of situational and role-related stressors. However, there is a relative dearth of evidence that has explored the relationships among SRC and other determinants of surrogate decision making, such as SDM’s depressive symptoms, role stress and decision making self-efficacy, on the perceived care preference of the critically ill patient.

Purpose: To evaluate the direct and indirect influence of SRC on key determinants of surrogate decision making and care preference.

Methods: This is a cross-sectional, correlational study consisting of a convenience sample of 281 SDMs of critically ill adults. A battery of measures were administered to capture the SDMs’ sociodemographic data, SRC, depressive symptoms, role stress, decision making self-efficacy, and the perceived care preferences of patients. Data were analyzed using descriptive statistics and a path analysis.

Results: Our sample was predominantly, middle-aged (M = 54.4, SD = 13.6), white (76%), female (73%), and identified as being a relative (94%) of the critically ill patient. The path model had excellent fit to the data (c2 = 26.7, p = .37; TLI = .99; CFI = .98, RMSEA = .02). Depressive symptoms (b = -.14, p < .05) and decision making self-efficacy (b = .16, p < .05) was directly associated with spiritual and religious coping. However, the only direct predictor of care preference was decision making self-efficacy (b = -.21, p < .05).

Conclusion: These data clearly provide evidence that SRC influences depressive symptom severity and the decision making self-efficacy of SDMs. Based on our findings, we recommend that future research explore how to incorporate SRC into decision support interventions to improve SDMs’ decision making self-efficacy and delivery of preference concordant care to the critically ill.

Keywords: Spiritual and Religious Coping; Surrogate Decision Makers; Critically Ill; Decision Making Self-Efficacy


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Citation: Ronald L Hickman., et al. “A Path Analysis of Spiritual and Religious Coping on the Depressive Symptoms, Role Stress, and Self- Efficacy of Surrogate Decision Makers of ICU Patients”. EC Nursing and Healthcare 3.3 (2021): 156-167.

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