目的 探究急危重症患者代理决策者疾病不确定感的潜在剖面类型及其影响因素。方法 2023年12月至2024年5月，采用便利抽样法选取南京市某三级甲等医院271名急危重症患者家属为研究对象，采用一般资料调查表、疾病不确定感家属量表、替代决策自我效能量表对其进行调查，并对代理决策者的疾病不确定感进行潜在剖面分析，应用Logistic回归分析不同剖面的影响因素。结果 急危重症患者代理决策者疾病不确定感分为低不确定感组（16.61%）、中不确定感组（61.99%）、高不确定感组（21.40%）3个潜在剖面。决策自我效能、决策者与患者关系、患者自理能力是代理决策者疾病不确定感潜在剖面的影响因素（均P＜0.05）。结论 急危重症患者代理决策者疾病不确定感存在群体差异性，可为制订个性化干预措施提供理论依据。

Objective To explore the latent profiles and influencing factors of illness uncertainty among surrogate decision-makers for critically ill patients.Methods The convenience sampling method was used to select 271 family members of critically ill patients from a tertiary A hospital in Nanjing from December 2023 to May 2024.Data were collected using General Information Questionnaire,Mishel Uncertainty In Illness Scale-Family Member Form,and Surrogate Decision-Making Self-Efficacy Scale.Latent profile analysis was performed to categorize illness uncertainty among surrogate decision-makers, and logistic regression was used to identify influencing factors.Results Three latent profiles of illness uncertainty among surrogate decision-makers were identified:Low Uncertainty（16.61%),Moderate Uncertainty（61.99%),and Fluctuating High Uncertainty（21.40%).Decision-making self-efficacy,surrogate-patient relationship,and patient self-care capacity were key influencing factors（all P＜0.05).Conclusions Illness uncertainty among surrogate decision-makers for critically ill patients exhibits subgroup heterogeneity,providing a theoretical foundation for personalized interventions.

R47-05

国家卫生健康委医院管理研究所“重症智能护理机器人系统研发”项目协作单位课题（HLJORS_2023A02）；江苏省科技计划（资金）项目（BE2022668）；南京大学中国医院改革发展研究院课题项目（NDYGN2023018）；南京鼓楼医院护理科研一般项目（2024-H560）