The Effect of Shared Decision‐Making on Emergency Management Knowledge, Anxiety, and Mental Health Among Family Members of Terminally Ill Patients in the ICU: A Quasiexperimental Study

TL;DR

Shared decision-making in ICU settings improved family members' emergency management knowledge but did not reduce anxiety or improve mental health.

Contribution

This study evaluates the impact of a three-talk SDM model on ICU family members' knowledge, anxiety, and mental health.

Findings

SDM significantly increased emergency management knowledge among family members.

Anxiety levels increased in the SDM group but not significantly compared to controls.

Mental health scores declined in both groups, showing ongoing emotional distress.

Abstract

Shared decision‐making (SDM) in intensive care units (ICUs) aids family decision‐making and mental health; its impact on emergency management knowledge, anxiety, and mental health is unclear. In a quasi‐experimental pre–post study at a teaching hospital in southern Taiwan, 60 family members of terminally ill ICU patients (30 SDM, 30 control) were enrolled. The SDM group received a three‐talk model intervention (choice, options, decision talk); the control group received usual care. Emergency management knowledge, anxiety, and mental health were assessed via self‐administered questionnaires before and after the intervention. Data were analyzed using Mann–Whitney U and Wilcoxon signed‐rank tests and multivariable linear regression. In the SDM group, emergency management knowledge increased from a pretest mean of 16.87 (SD 3.45) to a post‐test mean of 19.33 (SD 1.49), albeit statistically significant (p < 0.05). Anxiety scores rose in the SDM group (post‐test mean 47.13, SD 4.77) versus a slight decrease in controls (post‐test mean 43.63, SD 6.56), with no significant intergroup difference (p = 0.284). Mental health scores (a secondary outcome) declined in both groups, indicating persistent emotional distress. After adjusting for confounders, the SDM intervention remained a significant predictor of increased knowledge. SDM enhanced knowledge of emergency management but did not alleviate anxiety or improve mental health among ICU family members. Integrating targeted emotional support into SDM models warrants exploration.

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