title: A conceptual model of the role of communication in surrogate decision making for hospitalized adults.
abstract: OBJECTIVE
  To build a conceptual model of the role of communication in decision making, based on literature from medicine, communication studies and medical ethics.
  
  
  METHODS
  We proposed a model and described each construct in detail. We review what is known about interpersonal and patient-physician communication, described literature about surrogate-clinician communication, and discussed implications for our developing model.
  
  
  RESULTS
  The communication literature proposes two major elements of interpersonal communication: information processing and relationship building. These elements are composed of constructs such as information disclosure and emotional support that are likely to be relevant to decision making. We propose these elements of communication impact decision making, which in turn affects outcomes for both patients and surrogates. Decision making quality may also mediate the relationship between communication and outcomes.
  
  
  CONCLUSIONS
  Although many elements of the model have been studied in relation to patient-clinician communication, there is limited data about surrogate decision making. There is evidence of high surrogate distress associated with decision making that may be alleviated by communication-focused interventions. More research is needed to test the relationships proposed in the model.
  
  
  CONCLUSIONS
  Good communication with surrogates may improve both the quality of medical decisions and outcomes for the patient and surrogate.
authors: Indiana University Center for Aging Research, Regenstrief Institute, Indianapolis, IN 46202, USA. atorke@iupui.edu
authors: Alexia M
authors: AM
authors: Torke
authors: Sandra
authors: S
authors: Petronio
authors: Greg A
authors: GA
authors: Sachs
authors: Paul R
authors: PR
authors: Helft
authors: Christianna
authors: C
authors: Purnell
mesh_terms: D000328:Adult; D003142:Communication; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006760:Hospitalization; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010817:Physician-Patient Relations; D019727:Proxy; D020458:Third-Party Consent