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 inter-personal 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.