A psychometric evaluation of the Family Decision-Making Self-Efficacy Scale among surrogate decision-makers of the critically ill.
OBJECTIVES
The purpose of this study was to report the psychometric properties, in terms of validity and reliability, of the Unconscious Version of the Family Decision-Making Self-Efficacy Scale (FDMSE).


METHODS
A convenience sample of 215 surrogate decision-makers for critically ill patients undergoing mechanical ventilation was recruited from four intensive care units at a tertiary hospital. Cross-sectional data were collected from participants between days 3 and 7 of a decisionally impaired patient's exposure to acute mechanical ventilation. Participants completed a self-report demographic form and subjective measures of family decision-making self-efficacy, preparation for decision-making, and decisional fatigue. Exploratory factor analyses, correlation coefficients, and internal consistency reliability estimates were computed to evaluate the FDMSE's validity and reliability in surrogate decision-makers of critically ill patients.


RESULTS
The exploratory factor analyses revealed a two-factor, 11-item version of the FDMSE was the most parsimonious in this sample. Furthermore, modified 11-item FDMSE demonstrated discriminant validity with the measures of fatigue and preparation for decision-making and demonstrated acceptable internal consistency reliability estimates.


SIGNIFICANCE OF RESULTS
This is the first known study to provide evidence for a two-factor structure for a modified, 11-item FDMSE. These dimensions represent treatment and palliation-related domains of family decision-making self-efficacy. The modified FDMSE is a valid and reliable instrument that can be used to measure family decision-making self-efficacy among surrogate decision-makers of the critically ill.
['Pignatiello|Grant A|GA|0000-0002-0119-6979', 'Irani|Elliane|E|', 'Tahir|Sadia|S|', 'Tsivitse|Emily|E|', 'Hickman|Ronald L|RL|']
D000368:Aged D016638:Critical Illness D003430:Cross-Sectional Studies D003657:Decision Making D005260:Female D006801:Humans D007362:Intensive Care Units D008297:Male D008875:Middle Aged D011594:Psychometrics D015203:Reproducibility of Results D020377:Self Efficacy
Psychometrics Decision-making Self-efficacy Critical care Family members