Our research team has designed a chaplain delivered intervention focused on surrogate decision makers for hospitalized adults in the ICU. In this study, surrogates will complete an enrollment interview with research staff, including the completion of anxiety screening (GAD-7). Based on their score the surrogate will be put into one of two groups, and then randomized to either the control or intervention group. Control group members will receive usual care, while intervention group members will meet with our study chaplain, who will provide the SCAI (Spiritual Care Assessment and Intervention) framework.
Unmet spiritual needs may have at least two negative consequences for surrogates. First, they may have high levels of spiritual distress, an important aspect of the surrogate's well-being. Second, surrogates include their religious and spiritual beliefs when making serious medical decisions . Therefore unmet spiritual needs may have a negative effect on the surrogate's ability to make good decisions for the patient, especially when facing extremely distressful decisions such as whether to continue life sustaining treatment or enroll in hospice. The specific aims of this proposed study are: 1. To determine the effect of the spiritual care intervention on psychological well-being for family surrogates at 3 months post discharge, including anxiety (primary outcome: GAD-7), depression (PHQ-9), Posttraumatic stress (IES-R), and overall distress. 2. To determine the effect of the spiritual care intervention on spiritual well-being for family surrogates, (FACIT-SP- non-illness) and on religious coping (Brief RCOPE positive and negative). 3. To determine the effects of the spiritual care intervention on other aspects of the surrogates' experience, including satisfaction with spiritual care (Patient Satisfaction Instrument--Chaplaincy) communication (FICS), overall satisfaction with the hospital stay (Picker single item) and decision conflict (DCS). 4. To determine the effect of the intervention on treatment at the end of life (life sustaining treatments and hospice utilization) for patients who die in the hospital. 5. To determine differences in outcomes between the intervention group, who will receive our intervention, and the control group, who will receive the usual care provided by the hospital chaplaincy service.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
192
The study chaplain will work with the surrogate, using questions in four domains of spiritual care, to assess them and tailor the visit to their specific needs. The study chaplain will then utilize a pre-determined list of spiritual care interventions, and also document observable outcomes that occur at each visit (which are also listed within the SCAI framework).
IU Health Methodist Hospital
Indianapolis, Indiana, United States
IU Health University Hospital
Indianapolis, Indiana, United States
Change in anxiety from baseline enrollment interview to 6-8 weeks post patient discharge
GAD-7 (7 item inventory of anxiety)
Time frame: Assessed at enrollment and again 6-8 weeks after hospital discharge
Change in depression from baseline enrollment interview to 6-8 weeks post patient discharge
PHQ-9 (9 item inventory of depression)
Time frame: Assessed at enrollment and again 6-8 weeks after hospital discharge
Presence of post traumatic stress at 6-8 weeks post patient discharge
IES-R (Impact of Events scale- inventory for PTSD)
Time frame: Assessed 6-8 weeks after hospital discharge
Change in overall distress from baseline enrollment interview to 6-8 weeks post patient discharge
Distress thermometer (a 1-10 scale developed by our team to assess distress)
Time frame: Assessed at enrollment and again 6-8 weeks after hospital discharge
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