What does this research mean for the field?

Surrogate medical decision-making in dementia is an iterative process of appraisal, coping, and reappraisal shaped by contextual, relational, and organizational factors that lead to varied emotional outcomes. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To synthesize empirical evidence on the decision-making factors and emotional outcomes experienced by surrogate medical decision-makers for individuals with dementia.

August 22, 2026Journal of Advanced Nursing

Surrogate Medical Decision‐Making in Dementia: A Theory‐Informed Integrative Review

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Authors

CMClaire McGowanDuquesne University RZRick ZouchaDuquesne University MKMelissa A. KalarchianDuquesne University

Discussion

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Implication

Integrative review reveals how stress appraisal, coping resources, and communication shape surrogate medical decision-making in dementia, highlighting the need for tailored caregiver support.

Key Points

To synthesize empirical evidence on the decision-making factors and emotional outcomes experienced by surrogate medical decision-makers for individuals with dementia.
Conducted an integrative review searching PubMed, CINAHL, Embase, Scopus, and PsycINFO through August 2025 following Whittemore and Knafl's methodology and PRISMA 2020 guidelines.
Appraised eligible studies using the Mixed Methods Appraisal Tool and analyzed findings through inductive content analysis guided by the Transactional Model of Stress and Coping.
Included 18 studies representing a total of 574 surrogate decision-makers for people with dementia.
Identified surrogate decision-making as an iterative process of stress appraisal and coping, influenced by informational needs, communication quality, family dynamics, cultural values, and organizational barriers.
Documented emotional outcomes spanning negative responses like guilt, anxiety, and regret, as well as positive responses like relief, acceptance, and personal growth.

Cite This Study

McGowan et al. (2026) studied this question.

synapsesocial.com/papers/6a895f2aca7ade938187dacc https://doi.org/10.1111/jan.70721

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Implication

Integrative review reveals how stress appraisal, coping resources, and communication shape surrogate medical decision-making in dementia, highlighting the need for tailored caregiver support.

Surrogate Medical Decision‐Making in Dementia: A Theory‐Informed Integrative Review

Discussion

Member takes

Implication

Key Points

Cite This Study

Surrogate Medical Decision‐Making in Dementia: A Theory‐Informed Integrative Review

Discussion

Member takes

Implication

Key Points

Cite This Study

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