Social support  is associated with the outcome of shared decision-making regarding treatment limitations. An observational study with older patients in the emergency department.

Social support is associated with the outcome of shared decision-making regarding treatment limitations. An observational study with older patients in the emergency department. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Social support is associated with the outcome of shared decision-making regarding treatment limitations. An observational study with older patients in the emergency department. Anneleen van Nieuwenhuijzen, Suzanne Schol-Gelok, Joost van Rosmalen, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6189407/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Although advance care planning (ACP) and shared decision making (SDM) concerning treatment limitations are ideally conducted by long-term caregivers in a stable environment, in practice many older patients encounter these decisions in the emergency department (ED), making it essential to understand the factors associated with SDM outcomes in this context. Purpose : This study explores the impact of the psychological well-being, perspective, and needs in SDM regarding treatment limitations among older ED patients. Based on these findings, we aim to provide recommendations for ACP. Methods : A cross-sectional, observational study was conducted in the ED of a general hospital in the Netherlands. Patients aged 70 and older with indications for hospital admission were included. Participants completed questionnaires assessing anxiety (STAI-6), health locus of control (MHCLS), social support and satisfaction with SDM. Data on treatment limitations and frailty (APOP) were extracted from patient records. Associations between these variables and treatment limitations were analysed using multinomial regression. Results : Of 105 participants (mean age 80.07, 49.5% female), treatment limitations were recorded for 99 patients. Overall satisfaction with SDM was high. Regression analysis revealed no significant association between anxiety or health locus of control and treatment limitations. However, older age was negatively associated with treatment limitations (p < .001), while social support was associated with more comprehensive treatment limitations (p=0.0063). Conclusion : Age and social support show significant associations with SDM outcomes regarding treatment limitations in older ED patients. These findings highlight the importance of early ACP and involvement of supporting caregivers when discussing treatment limitations. Geriatric medicine Shared decision making Emergency care Advance Care Planning Treatment limitations Full Text Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6189407","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":435301214,"identity":"2e79bfed-9f43-4e28-8bfa-022db85e9fae","order_by":0,"name":"Anneleen van Nieuwenhuijzen","email":"data:image/png;base64,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","orcid":"https://orcid.org/0009-0006-7611-5287","institution":"Albert Schweitzer Hospital: Albert Schweitzer Ziekenhuis","correspondingAuthor":true,"prefix":"","firstName":"Anneleen","middleName":"van","lastName":"Nieuwenhuijzen","suffix":""},{"id":435301215,"identity":"f50aa724-18d1-407f-a5b1-77f79d953ceb","order_by":1,"name":"Suzanne Schol-Gelok","email":"","orcid":"https://orcid.org/0000-0003-3897-5113","institution":"Albert Schweitzer Ziekenhuis Locatie Dordwijk: Albert Schweitzer Ziekenhuis","correspondingAuthor":false,"prefix":"","firstName":"Suzanne","middleName":"","lastName":"Schol-Gelok","suffix":""},{"id":435301216,"identity":"76d119fd-da28-47f6-94f1-95a4316ace43","order_by":2,"name":"Joost van Rosmalen","email":"","orcid":"https://orcid.org/0000-0002-9187-244X","institution":"Erasmus Medical Center: Erasmus MC","correspondingAuthor":false,"prefix":"","firstName":"Joost","middleName":"van","lastName":"Rosmalen","suffix":""},{"id":435301217,"identity":"f1ab3085-63a0-4687-a408-c61e4e538549","order_by":3,"name":"Annemieke Ansems-Holterman","email":"","orcid":"","institution":"Albert Schweitzer Ziekenhuis Locatie Dordwijk: Albert Schweitzer Ziekenhuis","correspondingAuthor":false,"prefix":"","firstName":"Annemieke","middleName":"","lastName":"Ansems-Holterman","suffix":""},{"id":435301218,"identity":"8d81ed2a-56d9-4a7d-9460-4c83d739c26f","order_by":4,"name":"Daphne Everaerd","email":"","orcid":"https://orcid.org/0000-0003-4516-2874","institution":"Radboudumc","correspondingAuthor":false,"prefix":"","firstName":"Daphne","middleName":"","lastName":"Everaerd","suffix":""}],"badges":[],"createdAt":"2025-03-09 15:17:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6189407/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6189407/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":80827643,"identity":"a91dbd95-df81-4fb4-a4b0-72396566c367","added_by":"auto","created_at":"2025-04-17 13:32:57","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":432578,"visible":true,"origin":"","legend":"","description":"","filename":"2025.3.AvN.journalsubmissionSDMTreatlim.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6189407/v1_covered_d93b0b1c-50e2-473c-8526-2c05c5aaf1cf.pdf"}],"financialInterests":"","formattedTitle":"Social support is associated with the outcome of shared decision-making regarding treatment limitations. An observational study with older patients in the emergency department.","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Geriatric medicine, Shared decision making, Emergency care, Advance Care Planning, Treatment limitations","lastPublishedDoi":"10.21203/rs.3.rs-6189407/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6189407/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Although advance care planning (ACP) and shared decision making (SDM) concerning treatment limitations are ideally conducted by long-term caregivers in a stable environment, in practice many older patients encounter these decisions in the emergency department (ED), making it essential to understand the factors associated with SDM outcomes in this context.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e: This study explores the impact of the psychological well-being, perspective, \u0026nbsp;and needs in SDM regarding treatment limitations among older ED patients. Based on these findings, we aim to provide recommendations for ACP.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e:\u0026nbsp; A cross-sectional, observational study was conducted in the ED of a general hospital in the Netherlands. Patients aged 70 and older with indications for hospital admission were included. Participants completed questionnaires assessing anxiety (STAI-6), health locus of control (MHCLS), social support and satisfaction with SDM. Data on treatment limitations and frailty (APOP) were extracted from patient records. Associations between these variables and treatment limitations were analysed using multinomial regression.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Of 105 participants (mean age 80.07, 49.5% female), treatment limitations were recorded for 99 patients. Overall satisfaction with SDM was high. Regression analysis revealed no significant association between anxiety or health locus of control and treatment limitations. However, older age was negatively associated with treatment limitations (p \u0026lt; .001), while social support was associated with more comprehensive treatment limitations (p=0.0063).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Age and social support show significant associations with SDM outcomes regarding treatment limitations in older ED patients. These findings highlight the importance of early ACP and involvement of supporting caregivers when discussing treatment limitations.\u003c/p\u003e","manuscriptTitle":"Social support is associated with the outcome of shared decision-making regarding treatment limitations. 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