Characteristic Clustering of Thrombolytic Agent Decision-making in Acute Ischemic Stroke and Analysis of Influencing Factors

Abstract

Abstract Aim To explore the categories of different decision-making psychological characteristics of thrombolysis proxy decision-makers in acute ischemic stroke and analyze the influencing factors of different categories. Background Thrombolysis proxy decision-makers suffered from decision-making dilemmas, which correlated with their multiple psychosocial factors.Identifying the psychological characteristics of different decision-makers may help healthcare professionals develop decision-support programs applicable to different categories of decision-makers. This is essential for improving decision-making efficiency, reducing dilemmas, and decreasing hospital delays. Methods To facilitate the selection of acute ischemic stroke patients and their proxy decision makers who attended the emergency department of a comprehensive tertiary hospital in Zhengzhou City, Henan Province, from April 2023 to December 2023 as the survey subjects, and to collect the survey subjects' general information questionnaire, perceived social support scale, state anxiety scale, and decision-making dilemma scale. The final clustering was completed using K-means cluster analysis, and the influencing factors were analyzed by unordered multiclassified logistic regression. Results Acute ischemic stroke thrombolysis proxy decision makers can be divided into "high social support-low anxiety-high trust-decision effective", "high social support-high anxiety-moderate trust-decision conflict", "high social support-high anxiety-low trust-decision delay" three categories, which were influenced by the decision maker's gender, number of decision makers, decision maker's literacy level, whether they lived with the patient, whether they were the patient's main financial source, the patient's age, NIHSS score, and the time of the onset of the disease. Conclusion There are differences in the decision-making psychological characteristics of different thrombolysis agent decision-makers, and healthcare professionals should provide personalized decision-making aids for their psychological characteristics to improve the efficiency of thrombolysis decision-making, and strive for valuable time to save patients' neurological function. Implications for nursing policy and health policy Cluster analysis can be used to classify thrombolytic agent decision makers into three categories based on psychological characteristics and decision-making challenges. This is the first step in developing targeted decision aids for thrombolytic agent decision makers in the future.