title: Surrogate expectations in severe brain injury.
abstract: OBJECTIVE
  To understand what influences surrogate decision-makers' expectation that a patient with a disorder of consciousness (DOC; those in a coma, the vegetative state or the minimally conscious state) will recover.
  
  
  METHODS
  Forty-one surrogates representing 37 DOC patients completed a survey about their experiences in having a family member with a DOC.
  
  
  METHODS
  A quantitative questionnaire assessed surrogate and patient's demographic, medical and psychosocial features that may explain surrogate's expectation of patient recovery.
  
  
  RESULTS
  Surrogates who were more relationally enmeshed with the patient thought the patient could communicate better and thought technology would improve treatment of patients with brain injury had greater expectations of recovery. Source of injury and patient's current diagnosis did not explain expectations.
  
  
  CONCLUSIONS
  Relational factors between the patient and the surrogate may explain the surrogate's expectation that the patient will recover more than factors that matter to clinicians such as the source of injury or the patient's diagnosis.
authors.affiliation: Division of Medical Ethics, Weill Medical College of Cornell University, New York, NY, USA. acs2008@columbia.edu.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Suppes
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Fins
mesh_terms: D000293:Adolescent; D000328:Adult; D032722:Advance Care Planning / Q000458:organization & administration* / Q000639:trends; D016223:Advance Directives / Q000639:trends; D001930:Brain Injuries / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D017028:Caregivers / Q000523:psychology*; D002648:Child; D003128:Coma / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006117:Grief; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D018458:Persistent Vegetative State / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D010819:Physician's Role; D011368:Professional-Family Relations; D011379:Prognosis; D019727:Proxy; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000453:epidemiology
references.citation: Nature. 2007 Aug 2;448(7153):600-3
references.pmid: 17671503
references.citation: J Pain Symptom Manage. 2005 Jan;29(1):55-68
references.pmid: 15652439
references.citation: N Y State J Med. 1992 Nov;92(11):489-93
references.pmid: 1488205
references.citation: Curr Opin Neurol. 2007 Dec;20(6):620-6
references.pmid: 17992079
references.citation: Palliat Support Care. 2006 Jun;4(2):169-78
references.pmid: 16903588
references.citation: Brain Inj. 1994 Apr;8(3):211-30
references.pmid: 8004080
references.citation: BMC Neurol. 2009 Jul 21;9:35
references.pmid: 19622138
references.citation: Ann Oncol. 2010 Sep;21(9):1905-1909
references.pmid: 20231301
references.citation: Patient Educ Couns. 2005 Mar;56(3):257-67
references.pmid: 15721967
references.citation: Neurol Clin. 2011 Nov;29(4):723-37
references.pmid: 22032656
references.citation: Dev Psychobiol. 2005 Nov;47(3):253-67
references.pmid: 16252293
references.citation: Hastings Cent Rep. 2005 Mar-Apr;35(2):22-4
references.pmid: 15957315
references.citation: Science. 2006 Sep 8;313(5792):1402
references.pmid: 16959998
references.citation: J Pers Assess. 1985 Feb;49(1):71-5
references.pmid: 16367493
references.citation: J Rehabil Med. 2010 Feb;42(2):97-110
references.pmid: 20140404
references.citation: Brain Inj. 1998 Dec;12(12):1045-59
references.pmid: 9876864
references.citation: Arch Phys Med Rehabil. 2009 Jun;90(6):939-46
references.pmid: 19480869
references.citation: Neurology. 2002 Feb 12;58(3):349-53
references.pmid: 11839831
references.citation: Clin Rehabil. 2007 Jan;21(1):82-8
references.pmid: 17213245
references.citation: Brain Inj. 2010;24(11):1336-42
references.pmid: 20722502
references.citation: Brain Inj. 2011;25(7-8):691-7
references.pmid: 21561295