PMID- 36526251
OWN - NLM
STAT- MEDLINE
DCOM- 20230320
LR  - 20240402
IS  - 1873-6513 (Electronic)
IS  - 0885-3924 (Print)
IS  - 0885-3924 (Linking)
VI  - 65
IP  - 4
DP  - 2023 Apr
TI  - Effects of Spiritual Care on Well-Being of Intensive Care Family Surrogates: A 
      Clinical Trial.
PG  - 296-307
LID - S0885-3924(22)01030-2 [pii]
LID - 10.1016/j.jpainsymman.2022.12.007 [doi]
AB  - CONTEXT: Critical illness of a family member is associated with high emotional 
      and spiritual distress and difficult medical decisions. OBJECTIVES: To determine 
      if a semistructured spiritual care intervention improves the well-being of family 
      surrogate decision makers in intensive care (ICU) settings. METHODS: This study 
      is a randomized, allocation-concealed, parallel group, usual care-controlled, 
      single-blind trial of patient/surrogate dyads in five ICUs in one Midwest, 
      academic medical center. Patients were 18 and older admitted to the ICU and 
      unable to make medical decisions. The intervention involved proactive contact 
      from the chaplain, scheduled, semi-structured visits, weekly follow-up, and 
      bereavement calls. The control group received usual care. The primary endpoint 
      was the surrogate's anxiety (Generalized Anxiety Disorders-7 scale), six to eight 
      weeks after discharge. RESULTS: Of 192 patient/surrogate dyads enrolled, 128 
      completed outcome assessments. At follow-up, anxiety in the intervention group 
      was lower than control (median score 1 (interquartile range 0,6) vs. 4 (1,9), 
      P = 0.0057). The proportion of patients with a minimal clinically important 
      difference (MCID) in anxiety of 2+ was 65.2% in the intervention group vs. 49.2% 
      in control. The odds of an MCID remained higher in adjusted analysis (Odds Ratio 
      3.11, 95% confidence interval 1.18, 8.21; P = 0.0218) The adjusted odds of an 
      MCID were higher for spiritual well-being (OR 3.79, CI 1.41,10.17; P = 0.0081). 
      Satisfaction with spiritual care was also higher (adjusted mean 3.5 +/- 0.4 vs. 2.9 
      +/- 0.1); P < .0001). CONCLUSIONS: Proactive, semistructured spiritual care 
      delivered by chaplains improves well-being for ICU surrogates. Results provide 
      evidence for inclusion of chaplains in palliative and intensive care teams.
CI  - Copyright (c) 2022 American Academy of Hospice and Palliative Medicine. Published 
      by Elsevier Inc. All rights reserved.
FAU - Torke, Alexia M
AU  - Torke AM
AD  - Indiana University School of Medicine (A.M.T., S.M.M., S.K.B.), Indianapolis, 
      Indiana; Daniel F. Evans Center (A.M.T., S.E.V.P., S.M.M., B.J.P.), Indiana 
      University Health, Indianapolis, Indiana; IU Center for Aging Research (A.M.T., 
      S.E.V.P., E.S.B., T.A.T.), Regenstrief Institute, Indianapolis, Indiana. 
      Electronic address: atorke@iu.edu.
FAU - Varner-Perez, Shelley E
AU  - Varner-Perez SE
AD  - Daniel F. Evans Center (A.M.T., S.E.V.P., S.M.M., B.J.P.), Indiana University 
      Health, Indianapolis, Indiana; IU Center for Aging Research (A.M.T., S.E.V.P., 
      E.S.B., T.A.T.), Regenstrief Institute, Indianapolis, Indiana; Spiritual Care and 
      Chaplaincy Department (S.E.V.P., B.J.P.), Indiana University Health, 
      Indianapolis, Indiana.
FAU - Burke, Emily S
AU  - Burke ES
AD  - IU Center for Aging Research (A.M.T., S.E.V.P., E.S.B., T.A.T.), Regenstrief 
      Institute, Indianapolis, Indiana.
FAU - Taylor, Tracy A
AU  - Taylor TA
AD  - IU Center for Aging Research (A.M.T., S.E.V.P., E.S.B., T.A.T.), Regenstrief 
      Institute, Indianapolis, Indiana.
FAU - Slaven, James E
AU  - Slaven JE
AD  - Department of Biostatistics and Health Data Science (J.E.S.), Indiana University 
      School of Medicine, Indianapolis, Indiana.
FAU - Kozinski, Kathryn L
AU  - Kozinski KL
AD  - Maine General Health (K.L.K.), Augusta, Maine.
FAU - Maiko, Saneta M
AU  - Maiko SM
AD  - Indiana University School of Medicine (A.M.T., S.M.M., S.K.B.), Indianapolis, 
      Indiana; Daniel F. Evans Center (A.M.T., S.E.V.P., S.M.M., B.J.P.), Indiana 
      University Health, Indianapolis, Indiana.
FAU - Pfeffer, Bruce J
AU  - Pfeffer BJ
AD  - Daniel F. Evans Center (A.M.T., S.E.V.P., S.M.M., B.J.P.), Indiana University 
      Health, Indianapolis, Indiana; Spiritual Care and Chaplaincy Department 
      (S.E.V.P., B.J.P.), Indiana University Health, Indianapolis, Indiana.
FAU - Banks, Sarah K
AU  - Banks SK
AD  - Indiana University School of Medicine (A.M.T., S.M.M., S.K.B.), Indianapolis, 
      Indiana.
LA  - eng
SI  - ClinicalTrials.gov/NCT03702634
GR  - K24 AG053794/AG/NIA NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20221214
PL  - United States
TA  - J Pain Symptom Manage
JT  - Journal of pain and symptom management
JID - 8605836
SB  - IM
MH  - Humans
MH  - Single-Blind Method
MH  - *Decision Making
MH  - Critical Care
MH  - Spirituality
MH  - Intensive Care Units
MH  - *Spiritual Therapies
MH  - Family/psychology
PMC - PMC10129066
MID - NIHMS1865113
OTO - NOTNLM
OT  - Religion
OT  - anxiety
OT  - chaplain
OT  - intensive care
OT  - proxy decision making
OT  - spiritual care
OT  - spirituality
OT  - surrogate decision making
EDAT- 2022/12/17 06:00
MHDA- 2023/03/21 06:00
PMCR- 2024/04/01
CRDT- 2022/12/16 19:28
PHST- 2022/10/18 00:00 [received]
PHST- 2022/12/03 00:00 [revised]
PHST- 2022/12/07 00:00 [accepted]
PHST- 2022/12/17 06:00 [pubmed]
PHST- 2023/03/21 06:00 [medline]
PHST- 2022/12/16 19:28 [entrez]
PHST- 2024/04/01 00:00 [pmc-release]
AID - S0885-3924(22)01030-2 [pii]
AID - 10.1016/j.jpainsymman.2022.12.007 [doi]
PST - ppublish
SO  - J Pain Symptom Manage. 2023 Apr;65(4):296-307. doi: 
      10.1016/j.jpainsymman.2022.12.007. Epub 2022 Dec 14.