Caring for the Whole Person: Resilience, Spirituality and Religious Coping in the Neurocritical Care Environment

Objective: To determine the correlation between spiritualty/religiosity and resilience in individuals admitted to neurocritical care and compare to surrogate perceived patient spiritualty/religiosity and resilience Background: Resilience and spirituality have been well studied in psychiatric disorders but little is known about how these factors influence outcomes in the neurocritical care setting. Individuals identified as resilient have better outcomes in disorders like major depression while spirituality has been shown to enhance an individual’s level of reported resilience. Surrogate decision makers are important in patient centered decision-making. Bridging the gap between physiological and psychological factors as well as understanding surrogate perceptions is needed in neurocritical care as it may reveal important contradictions in patient, surrogate and physician expectations. Our hypothesis is patient reported resilience would correlate with spirituality/religiosity, and surrogate-reported patient attributes would correlate to patient-reported ones. Design/Methods: Since April 2016 among English speaking adult patients admitted to the Neuro ICU at Mount Sinai Hospital for 48 hours or longer, 67 surrogates and 61 patients were enrolled. Participants provided answers to two scales, the Connor-Davidson Resilience-10 and the Brief RCOPE. Data was analyzed using Social Science Statistics. Non-parametric Spearman correlation between the score totals from these scales were calculated. Results: According to patient reported scales of positive religious coping and resilience, there was no correlation between the two scores rs= −0.04 p =0.75. However, scores of surrogate perceptions of patient’s positive religious coping were moderately correlated to scores of surrogate perceptions of patient resilience rs= .32, p = 0.007. Conclusions: The differences seen in the patient reported resilience and spirituality/religiosity scales versus surrogate’s reported perception of the patient’s resilience and spirituality/religiosity may indicate some effects of “projection” by surrogates. The surrogate’s view of the patient may be influenced by many factors while they are in a neurocritical care setting and this could impact surrogate decision-making in goals-of-care discussions. Disclosure: Dr. Gordon has nothing to disclose. Dr. Dangayach has nothing to disclose. Dr. Griffiths has nothing to disclose. Dr. Kornspurn has nothing to disclose. Dr. Davidson has nothing to disclose. Dr. Keough has nothing to disclose. Dr. Wheelwright has nothing to disclose. Dr. Sobotka has nothing to disclose. Dr. Sharma has nothing to disclose. Dr. Marin has nothing to disclose. Dr. Gordon has nothing to disclose. Dr. Bederson has nothing to disclose. Dr. Mocco has received personal compensation for activities with Concentric Inc. as a consultant. Dr. Mayer has received personal compensation for activities with Bard Medical.