Grant Pignatiello
Case Western Reserve University, OH·Psychology
When an adult is admitted to an intensive care unit (ICU), a family member often has to make urgent treatment decisions on their behalf. These surrogate decision-makers (SDMs) are usually unprepared and under heavy emotional stress.
- Fields
Psychology
Medicine & Clinical Research
Public Health & Epidemiology
- Topics
surrogate decision-makers
intensive care unit
critical illness
- Grants
- 1 known grant, through May 2031
What they work on
- Test whether REFRAME, a tablet-based cognitive reappraisal program, reduces depressive symptoms in ICU surrogate decision-makers compared with informational support, in a 387-person randomized controlled trial.
- Assess whether REFRAME lowers PTSD symptoms and decision regret among surrogate decision-makers 90 days after enrollment, compared with an attention-matched control condition.
- Compare state emotion regulation, meaning in-the-moment use of cognitive reappraisal versus expressive suppression, between REFRAME and control participants 24–48 hours after the intervention.
- Test whether changes in emotion regulation mediate, or explain, REFRAME's effects on depression, PTSD symptoms and decision regret.
More about the research
That stress can cloud their decisions. It can also lead to lasting harm, such as post-traumatic stress disorder (PTSD) and regret about the choices they made. Few proven, scalable programs exist to support them while the patient is still in the ICU.
Why it matters
Families who make medical decisions for loved ones in the ICU often face depression, PTSD and regret afterward. If REFRAME proves effective, it could become a widely accessible tablet tool. Such a tool could ease emotional suffering and improve the quality of decisions families make during a crisis, both in critical care and in other settings where surrogates must decide.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
Closest labs
Jacqueline Kruser
University of Wisconsin-Madison, WI·Medicine & Clinical Research
Map how time-limited trials of mechanical ventilation are actually carried out in five ICUs, using focused ethnography of 50 trials in patients with acute respiratory failure.
Pervez Sultan
Stanford University, CA·Medicine & Clinical Research
Test the feasibility and acceptability of Written Exposure Therapy, a five-session expressive writing treatment, and Capnometry Guided Respiratory Intervention, a home breathing program, in a randomized pilot trial of 60 postpartum patients with PTSD symptoms.
Douglas White
University of Pittsburgh, PA·Medicine & Clinical Research·Early-career
Elicit from people with surrogate decision-making experience how clinicians should support surrogates of patients with acute respiratory failure in order to achieve care that matches patients' goals and values.
The school
Case Western Reserve University: 34 labs on PI Pages, $643M a year on research, 213 research doctorates a year.
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