Learned Helplessness Among Families and Surrogate Decision-makers of Patients Admitted to Medical, Surgical and Trauma Intensive Care Units.
Chest. 2012 May 31;
Authors: Sullivan DR, Liu X, Corwin DS, Verceles AC, McCurdy MT, Pate DA, Davis JM, Netzer G
Abstract
Abstract BACKGROUND:We sought to determine the prevalence of and clinical variables associated with learned helplessness, a psychological state characterized by reduced motivation, difficulty in determining causality and depression, in family members of patients admitted to intensive care units. METHODS:Observational, survey study of a prospectively defined cohort of family members, spouses and partners of patients admitted to surgical, medical and trauma intensive care units at a large, academic medical center. Two validated instruments, the Learned Helplessness Scale and the Perceived Stress Scale were used, and self-report of patient clinical characteristics and subject demographics were collected. RESULTS:499 family members were assessed. Of these, 238/460 (51.7%) had responses consistent with a significant degree of learned helplessness. Among surrogate decision-makers, this proportion was 50% (92/184). Characteristics associated with significant learned helplessness included grade or high school education (OR=3.27, 95% CI: 1.29 to 8.27, p=0.01) and Perceived Stress Scale score >18 (OR=4.15, 95% CI: 2.65 to 6.50, p<0.001). The presence of a patient advance directive or DNR order was associated with reduced odds of significant learned helplessness (OR=0.56, 95% CI: 0.32 to 0.98, p=0.05). CONCLUSIONS:The majority of family members of intensive care unit patients suffer significant learned helplessness. Risk factors for learned helplessness include lower educational levels, absence of an advance directive or DNR order and higher stress levels among family members. Significant learned helplessness in family members may have negative implications in the collaborative decision-making process.
PMID: 22661454 [PubMed - as supplied by publisher]