Surrogate Decision-Makers' Trust in Health Care Professionals in the Adult Intensive Care Unit: A Scoping Review.

Abstract

Background: Surrogate decision-makers frequently experience negative emotional and physical outcomes due to their decision-making role in the adult intensive care unit. These negative outcomes may be mitigated by high-quality communication, but for this type of communication to occur, surrogate decision-makers must have trust in health care professionals.

Objective: To explore what is known about surrogate decision-makers' trust in health care professionals in the adult intensive care unit setting.

Methods: In this scoping review, CINAHL, APA PsycArticles, APA PsycInfo, MEDLINE, the Cochrane Library, the Web of Science, and Google Scholar were searched from inception to March 9, 2024.

Results: A total of 64 articles met the inclusion criteria. Surrogate decision-makers step into their decision-making role with a baseline level of trust in health care professionals, which is then modified by those professionals' behaviors such as technical competence, communication, honesty, benevolence, and interpersonal skills. The surrogate decision-maker's level of trust in health care professionals affects the surrogate's decision-making and behavior in the intensive care unit. A high-quality instrument is needed to measure surrogate decision-maker trust in health care professionals in the adult intensive care unit setting so that future research can focus on validating various trust-building interventions in this population.

Conclusion: Bedside staff members should incorporate the currently available research findings about building trust with surrogate decision-makers into their professional practice. Future research should focus on the development, validation, and dissemination of a new instrument designed specifically to measure surrogate decision-maker trust in health care professionals.