The relationship between state anxiety of surrogate decision-makers and decision-making duration in acute ischemic stroke thrombolysis

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.