目的 了解危重产妇代理决策者的决策困境现状及其影响因素。方法 选择2022年10月—2023年10月许昌市中心医院产科及ICU的262例危重产妇及其代理决策者作为研究对象。应用一般资料问卷、母婴健康素养问卷、决策困境量表、决策参与期待量表进行调查。结果 决策困境量表总分为（39.38±14.58）分,其中信息提供和价值观明确总分为（13.91±7.16）分、社会支持和决策有效性总分为（20.41±8.25）分、不确定性总分为（5.06±1.96）分。多元线性回归分析发现,性别、学历、决策时间和脑卒中防治知识总分对危重产妇代理决策者决策困境均有影响（P<0.05）。结论 危重产妇代理决策者存在决策困境,医护人员需要根据代理决策者的人口学特征、疾病防治知识以及患者疾病特征进行决策辅助,减轻其决策困境,提升决策质量。

Objective To understand the current situation and influencing factors of decision-making difficulties among surrogate decision-makers for critically ill puerpera．Methods A total of 262 critically ill puerpera and their surrogate decision-makers from the obstetrics and ICU of Xuchang Central Hospital from October 2022 to October 2023 were selected．A survey was conducted using the General Information Questionnaire,Maternal and Child Health Literacy Questionnaire,Decision Dilemma Scale,and Decision Participation Expectancy Scale．Results The total score of the Decision Dilemma Scale was（39.38±14.58）,with a total score of（13.91±7.16）for information provision and clear values,（20.41±8.25）for social support and decision effectiveness,and（5.06±1.96）for uncertainty．Multiple linear regression analysis found that gender,education level,decision time and total score of stroke prevention and control knowledge all have an impact on the decision-making difficulties of surrogate decision-makers in critically ill puerpera（P<0.05）．Conclusions There is a decision-making dilemma for the surrogate decision-makers of critically ill puerpera．Medical staff need to provide decision-making assistance based on the demographic characteristics,disease prevention and control knowledge,and patient disease characteristics of the surrogate decision-makers,in order to alleviate their decision-making difficulties and improve the quality of decision-making．