A latent profile analysis of decision-making dilemmas of surrogate decision-makers for patients with severe traumatic brain injury and the study of its influencing factors
WAN Wei
ZHOU Hao
JI Xueli
CHEN Feng
ZHANG Yangchun
Abstract：Objective To explore the latent profiles of decision-making dilemmas of surrogate decision-makers for patients with severe traumatic brain injury(sTBI)and analyze the influencing factors.Methods A total of 160 sTBI patients and their surrogate decision-makers admitted to our hospital from May 2023 to December 2024 were selected as the research subjects.General information questionnaires,Decision-Making Dilemma Scale(DCS),Social Support Rating Scale(SSRS),and Wake Forest Physician Trust Scale(WFPTS)were used for questionnaire surveys.Pearson correlation analysis was conducted to explore the correlation between decision-making dilemmas of surrogate decision-makers for sTBI patients and social support and trust in physicians.Mplus7.2 statistical software was used for latent profile analysis(LPA)of decision-making dilemmas of surrogate decision-makers for sTBI patients.The influencing factors of latent profile categories of decision-making dilemmas of surrogate decision-makers for sTBI patients were investigated by multivariate logistic stepwise regression analysis.Results The total scores of DCS,SSRS and WFPTS for surrogate decision-makers of sTBI patients were(32.46±4.28),(38.48±4.41)and(31.39±4.25)respectively.Decision-making dilemmas of surrogate decision-makers for sTBI patients were negatively correlated with social support and trust in physicians(P<0.05).Latent profile analysis showed that decision-making dilemmas of surrogate decision-makers for sTBI patients could be divided into three latent profile categories,including low decision-making dilemma group(n=61,38.13%),medium decision-making dilemma group(n=67,41.87%),and high decision-making dilemma group(n=32,20.00%).There were statistically significant differences in family per capita monthly income,decision-maker age,decision-maker educational level,decision-maker employment status,decision-maker's understanding of the disease,decision-maker's understanding of the treatment plan,social support score,and trust in physicians score among different latent profile categories(P<0.05).High family per capita monthly income,high decision-maker educational level,and high trust in physicians were protective factors for decision-making dilemmas of surrogate decision-makers for sTBI patients(P<0.05);high family per capita monthly income,high decision-maker educational level,high decision-maker's understanding of the disease,high social support level,and high trust in physicians were protective factors for high decision-making dilemmas of surrogate decision-makers for sTBI patients(P<0.05).Conclusions Decision-making dilemmas of surrogate decision-makers for sTBI patients can be divided into three latent profile categories,with significant individual differences.Family per capita monthly income,decision-maker educational level,decision-maker's understanding of the disease,social support,and trust in physicians can effectively predict different latent profile categories of decision-making dilemmas.
Keywords：severe traumatic brain injurysurrogate decision-makersdecision dilemmalatent profile analysisinfluencing factors
Publication Date：2026-03-28
Online Publishing Date：2026-03-26(First online date of this platform, not the publication date of the document)
Pages：7( 92-98 )