Analysis of the current situation and influencing factors of decision-making conflicts among alternative decision-makers in critically ill patients after cardiac surgery: a cross-sectional study

Abstract

Abstract Objective This study aims to examine the prevailing state of decision-making conflict among alternative decision-mkers in postoperative critically ill cardiac surgery patients and analyze the factors that contribute to this conflict.Methods A convenience sampling method was employed to select 200 postoperative critically ill cardiac surgery patients and their substitute decision-mkers from a tertiary-level hospital in Shandong Province, between September 2023 and November 2023. The survey subjects were assessed using a general information questionnaire,family inpatient communication Survey, and the scale of the decisional engagement.Results The study found that substitute decision-mkers of postoperative critically ill cardiac surgery patients had a mean decision conflict scale score of (15.59 ± 8.58) and a standardized score of (24.36 ± 13.42). Among the substitute decision-mkers,7.5% had a medium level of decision conflict, while 51% had a high level of decision conflict. Correlation analysis revealed a negative correlation between the decision conflict level of alternative decision-mkers and the communication status of inpatient family members (r=-0.238, p < 0.01), as well as a negative correlation with the expectation level of participation in decision making (r=-0.195,p < 0.01);The results of the multiple linear regression analysis indicate that several factors significantly influenced the decisions made by substitute decision-mkers.These factors include whether the patient was admitted to the hospital for the first time, the decision maker's awareness of the patient's condition, the level of Decisional Engagement, and the communication status of the hospitalized patient's family members.Conclusion Decision-making conflicts among alternative decision-mkers in postoperative critically ill cardiac surgery patients are prevalent and influenced by various factors.