Predictors of Medical Mistrust Among Surrogate Decision-Makers in the ICU
Author Information
Author(s): Vasher Scott T. MD, MSCR, Laux Jeff PhD, Carson Shannon S. MD, Wendlandt Blair MD, MSCR
Primary Institution: University of North Carolina School of Medicine
Hypothesis
What are the potential sociodemographic risk factors for high medical mistrust among surrogate decision-makers of critically ill patients at high risk of death?
Conclusion
The study found that sociodemographic characteristics, such as race and prior exposure to hospice care, are associated with medical mistrust among surrogate decision-makers.
Supporting Evidence
- Race was associated with medical mistrust, with Black participants showing higher medical mistrust compared to White participants.
- Religiousness was associated with lower medical mistrust.
- Prior exposure to hospice or comfort-focused care was associated with higher medical mistrust.
Takeaway
This study looked at why some people in charge of making medical decisions for loved ones in the ICU might not trust doctors. It found that things like race and past experiences with hospice care can affect that trust.
Methodology
A pilot cross-sectional study was conducted at a single academic medical center, enrolling adult patients and their surrogate decision-makers to measure medical mistrust using the Medical Mistrust Multiformat Scale.
Potential Biases
Potential selection bias due to lower participation rates among those with higher medical mistrust.
Limitations
The study was a pilot and not statistically powered for definitive conclusions, and it was limited to a single center with low racial and ethnic diversity.
Participant Demographics
Mean age of surrogates was 53.8 years, with 77.4% female, and 45.2% White, 32.3% Black.
Statistical Information
P-Value
P = .010
Confidence Interval
95% CI, 3.40-17.02
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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