A Moderation Analysis of Gender on the Link Between ICU Decision-Making and Family Loyalty Using SEM-AMOS Approach
DOI:
https://doi.org/10.37231/jmtp.2025.6.2.473Keywords:
family, decision making, gender, moderation, loyaltyAbstract
This study investigates the extent to which gender moderates the relationship between family involvement in ICU decision-making and family loyalty in a non-Western cultural environment. It also assesses whether gender-based differences influence the direction or magnitude of this relationship among family members of ICU patients. A descriptive cross-sectional study design was adopted, and the Hypothesised model was examined using Structural Equation Modelling with AMOS (SEM-AMOS). A total of 199 family members of ICU patients were recruited through convenience sampling. Data collection was conducted from January to December 2024 at a tertiary public hospital located on the East Coast of Peninsular Malaysia. Two instruments were employed in this study: the Family Satisfaction–ICU questionnaire and a self-reported service quality scale. These measures were employed?to evaluate the relationship between family participation in ICU decision-making and family trust. The data collected using these instruments facilitated the testing of the structural relationships Hypothesised by the model. The results show that the families' decision-making in the ICU?has a direct influence on family loyalty. ICU decision-making moderates?the relationship between gender and family loyalty. The moderation hypothesis by gender in ICU decision-making, considering family loyalty, is significant (b = 3.34, p < 0.008) and moderate (b = -5.13, p < 0.009). Gender appears to be a critical factor in the way ICU decision-making influences family loyalty. These results emphasis the importance of gender appropriate communication strategies in ICU care, which may enhance trust and relational satisfaction among families. The results of this analysis indicated that the gender differences in decision-acceptance and family-loyalty effects are not monotonic across all levels of these moderators. Therefore, this data helps inform healthcare professionals on how to enhance the integration of FCC and partner with the family.
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