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Indian J Palliat Care. 2019 Jan-Mar;25(1):3-8. doi: 10.4103/IJPC.IJPC_147_18.

Factors Associated with Surrogate Self-Efficacy in Decision-Making for Patients with End-Stage Renal Disease.

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La Salle University, Mexican Faculty of Medicine, Mexico City, México.
Internal Medicine Department, Nuevo Sanatorio Durango, Mexico City, México.
Geriatrics Department, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, México.



The aim of the study is to assess which factors are associated with self-efficacy for making these decisions in surrogates of end-stage kidney disease patients.

Materials and Methods:

Cross-sectional study conducted in the hemodialysis clinic of a private hospital in Mexico City. A total of 124 surrogates of patients in hemodialysis were included in the study. Self-efficacy for decision-making was assessed with the Family Decision-Making Self-Efficacy Scale. As factors related to decision-making self-efficacy, sociodemographic data, health information, and professional help received for dealing with end-of-life issues were assessed in both patients and surrogates. Functional status and advanced directives of the patient as well as prior experience in decision-making of the surrogates were also included. Logistic regression models were used to establish the associations.


The mean age of participants was 49.4 years (standard deviation: 14). Factors associated to decision-making self-efficacy were awareness of the surrogate about the terminal disease of the patient (P < 0.001), prior conversation between the surrogate and the patient about end-of-life preferences (P = 0.037), time between the patient was told dialysis was required and accepting it inferior to 1 month (P = 0.016), and visual impairment of the patient (0.040).


This study provides information of which factors are associated with self-effectiveness in surrogates of terminally ill renal patients so that strategies based on these considerations might be implemented in the future.


Decision-making; self-efficacy; surrogates

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