Yang Caixia, Ma Keke, Guo Lina, Li Yapeng, Fan Wenfeng, Gao Renke, Guo Yuanli
Neurology Department, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Zhengzhou City, 450000, Henan Province, China.
School of Nursing and Health, Zhengzhou University, 100 Science Avenue, Zhengzhou City, 450000, Henan Province, China.
Sci Rep. 2025 Apr 17;15(1):13363. doi: 10.1038/s41598-025-95937-4.
Intravenous thrombolysis is the preferred treatment for acute ischemic stroke (AIS). In China, obtaining written informed consent from patients or their surrogates is mandatory before administering thrombolysis, often leading to delays in treatment. This study aims to explore the relationship between the decision-making characteristics and psychological states of surrogates during thrombolysis for AIS patients. A total of 383 AIS patients and their surrogate decision-makers were recruited from the Emergency Department of the First Affiliated Hospital of Zhengzhou University between September 2021 and December 2023. Comprehensive sociodemographic and disease-related data were collected for both patients and surrogates. Surrogate decision-makers were assessed using the State-Trait Anxiety Inventory (STAI), Control Preference Scale(CPS), Wake Forest Physician Trust Scale (WFPTS), and Perceived Social Support Scale (PSS). Data were analyzed using SPSS 26.0 software. The average score of state anxiety of surrogates was 49.47 ± 9.04, indicating a relatively high level of anxiety. Specifically, the average state anxiety score of the surrogate decision-makers has already reached a moderate level, indicating significant anxiety. Additionally, 18.2% (70/383) of surrogates took more than 15 minutes to decide. There was a significant positive correlation between state anxiety scores and decision duration (r = 0.189, p < 0.001). Factors influencing surrogate anxiety included sociodemographic factors, psychological factors, patient-related factors, and decision-making process characteristics (all p < 0.05). In conclusion, the anxiety is influenced by various factors related to the decision-making process. Medical staff should address these emotional factors to reduce decision time, enhance decision quality, and expedite informed consent, thereby minimizing treatment delays.
静脉溶栓是急性缺血性脑卒中（AIS）的首选治疗方法。在中国，在进行溶栓治疗前必须获得患者或其代理人的书面知情同意书，这往往导致治疗延误。本研究旨在探讨AIS患者溶栓过程中代理人的决策特征与心理状态之间的关系。2021年9月至2023年12月期间，从郑州大学第一附属医院急诊科招募了383例AIS患者及其代理决策者。收集了患者和代理人的综合社会人口学和疾病相关数据。使用状态-特质焦虑量表（STAI）、控制偏好量表（CPS）、维克森林医生信任量表（WFPTS）和感知社会支持量表（PSS）对代理决策者进行评估。使用SPSS 26.0软件进行数据分析。代理人的状态焦虑平均评分为49.47±9.04，表明焦虑水平相对较高。具体而言，代理决策者的平均状态焦虑评分已达到中等水平，表明存在明显焦虑。此外，18.2%（70/383）的代理人花费超过15分钟做出决定。状态焦虑评分与决策持续时间之间存在显著正相关（r = 0.189，p < 0.001）。影响代理人焦虑的因素包括社会人口学因素、心理因素、患者相关因素和决策过程特征（均p < 0.05）。总之，焦虑受与决策过程相关的各种因素影响。医务人员应处理这些情绪因素，以减少决策时间，提高决策质量，并加快知情同意，从而尽量减少治疗延误。
