Decision regret following peripherally inserted central catheter placement in patients with breast cancer: a latent profile analysis

Abstract Background Peripherally inserted central catheters (PICCs) are widely used to deliver chemotherapy in patients with breast cancer. The decision to place a PICC, however, also carries psychological consequences. Decision regret is a negative emotional response to a healthcare decision, arising when patients appraise that decision unfavourably in hindsight. It may compromise patients' quality of life and incline later treatment choices toward undue conservatism. Most existing studies have treated decision regret as a single homogeneous construct, and have therefore overlooked the possibility that patients occupy distinct latent profiles of regret. The present study used latent profile analysis (LPA) to identify subgroups of patients with breast cancer who differ in their patterns of decision regret after PICC placement, and to examine the factors associated with profile membership. Methods This cross-sectional study recruited 288 patients with breast cancer undergoing first-time PICC placement by convenience sampling at the Daytime Chemotherapy and Radiotherapy Center of a tertiary hospital in Anhui Province, China, between January and May 2026. Data were collected with a general information questionnaire and five validated instruments: the Decision Regret Scale (DRS), the Decisional Conflict Scale (DCS), the PICC Self-Management Ability Scale, the Treatment Burden Questionnaire (TBQ), and the Social Support Rating Scale (SSRS). LPA was conducted in Mplus 8.3 to identify the latent profiles of decision regret. Multinomial logistic regression examined the factors associated with profile membership, with the low-level regret profile as the reference category. The study was reported in accordance with the STROBE statement. Results A total of 263 valid questionnaires were returned, an effective response rate of 91.32%. Three distinct profiles of decision regret emerged: a low-level regret profile (74.50%, n = 196), a moderate-level regret profile (13.70%, n = 36), and a high-level regret profile (11.80%, n = 31). Classification accuracy for this three-profile solution was high (entropy = 0.975). In multinomial logistic regression, five factors were significantly associated with profile membership (all P < 0.05): PICC-related complications, decisional conflict, PICC self-management ability, treatment burden, and social support. Compared with the low-level regret profile, the high-level profile showed a higher likelihood of complications (OR = 5.049, P = 0.002) and greater treatment burden (OR = 1.028, P = 0.042), together with lower PICC self-management ability (OR = 0.971, P = 0.021) and lower social support (OR = 0.800, P < 0.001). Decisional conflict (OR = 1.044, P = 0.022) and PICC self-management ability (OR = 0.976, P = 0.012) separated the moderate-level profile from the low-level profile. Conclusions Decision regret after PICC placement in patients with breast cancer is heterogeneous and falls into three distinct profiles with different clinical characteristics. Patients in the high-level regret profile, marked by complications, higher treatment burden, poorer self-management ability, and limited social support, form a priority group for targeted intervention. Matching vascular access decision support and post-placement care to these profile-specific features may help reduce decision regret and improve the experience of PICC-based chemotherapy.