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Communicating with Clinicians: The Experiences of Surrogate Decision‐Makers for Hospitalized Older Adults
Author(s) -
Torke Alexia M.,
Petronio Sandra,
Purnell Christianna E.,
Sachs Greg A.,
Helft Paul R.,
Callahan Christopher M.
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2012.04086.x
Subject(s) - medicine , referral , psychological intervention , focus group , tertiary referral hospital , grounded theory , family medicine , public hospital , qualitative research , nursing , retrospective cohort study , social science , marketing , sociology , business
Objectives To describe communication experiences of surrogates who had recently made a major medical decision for a hospitalized older adult. Design Semistructured interviews about a recent hospitalization. Setting Two hospitals affiliated with one large medical school: an urban public hospital and a university‐affiliated tertiary referral hospital. Participants Surrogates were eligible if they had recently made a major medical decision for a hospitalized individual aged 65 and older and were available for an interview within 1 month (2–5 months if the patient died). Measurements Interviews were audio‐recorded, transcribed, and analyzed using methods of grounded theory. Results Thirty‐five surrogates were interviewed (80% female, 44% white, 56% African American). Three primary themes emerged. First, it was found that the nature of surrogate–clinician relationships was best characterized as a relationship with a “team” of clinicians rather than individual clinicians because of frequent staff changes and multiple clinicians. Second, surrogates reported their communication needs, including frequent communication, information, and emotional support. Surrogates valued communication from any member of the clinical team, including nurses, social workers, and physicians. Third, surrogates described trust and mistrust, which were formed largely through surrogates' communication experiences. Conclusion In the hospital, surrogates form relationships with a “team” of clinicians rather than with individuals, yet effective communication and expressions of emotional support frequently occur, which surrogates value highly. Future interventions should focus on meeting surrogates' needs for frequent communication and high levels of information and emotional support.