ABSTRACT Background Surrogates make decisions for critically ill patients in intensive care units (ICUs). Because such decisions are critical, many surrogates experience decisional conflict, which can lead to long‐term regret and psychological distress. Understanding surrogates' needs during decision‐making, particularly when invasive procedures are involved, is essential to improving patient outcomes. Aim To identify and analyse the needs of surrogates and the decisional conflict they experience during the decision‐making process for invasive procedures in ICUs. Methods This convergent, parallel, mixed‐methods study was conducted at a tertiary medical centre in southern Taiwan. Eligible participants were surrogates aged 20 years or older. The patients represented by these surrogates had a Glasgow Coma Scale (GCS) score of < 12 and were expected to undergo at least one invasive procedure. Quantitative data were collected from 100 surrogates using a structured questionnaire assessing decisional conflict and needs, and qualitative data were obtained through in‐depth interviews with 13 surrogates. Results The following factors were significantly associated with decisional conflict: lower education level (β = −6.24, p = 0.042), lower family income (β = −9.91, p = 0.027), and resuscitative types of invasive procedure (β = −6.40, p = 0.045). Information needs were the most critical because information is often overwhelming without a medical background. Meeting surrogates' support needs, including the need for support from family members, can help reduce isolation in decision‐making. The findings also indicate that internal resources played a key role in alleviating decisional conflict in surrogates. Conclusion The informational, support, and resource needs of surrogates play a critical role in decision‐making for invasive procedures. Their informational needs primarily indicate difficulties in comprehending and integrating complex medical information within a limited timeframe. Clear, structured communication and emotional support may reduce decisional conflict and long‐term regret.
Sun et al. (2026) studied this question.