Latent profile analysis of ICU nurses' difficulties in caring for patients with delirium and their relationship with clinical nursing problem-solving ability.

چکیده اصلی

BACKGROUND: Critical care nurses face various difficulties in delirium care, potentially related to their clinical problem-solving ability. Previous studies have focused on overall levels and associated factors, overlooking within-group heterogeneity. AIM: This study aimed to identify latent profiles of delirium care difficulties among ICU nurses and examine differences in clinical nursing problem-solving ability and related factors across profiles. METHODS: This cross-sectional study recruited 304 ICU nurses from nine hospitals in Zhejiang Province through convenience sampling between July and August 2026. Data were collected using a demographic questionnaire, the Difficulty Scale for Nurses who Care for Patients with Delirium in the Intensive Care Unit (DSNCPD-ICU), and the self-evaluation scale of oriented problem solving behavior in nursing practice (OPSN). Latent profile analysis identified difficulty profiles, and multinomial logistic regression was performed to explore associated factors. RESULTS: Four latent profiles were identified: "low-difficulty/well-adapted" (32.89%), "moderately low-difficulty/safety-focused" (31.91%), "moderately high-difficulty/care-management pressure" (22.04%), and "high-difficulty/comprehensive care pressure" (13.16%). Age, years of ICU work experience, night shifts per month, ICU specialty nurse qualification, whether delirium assessments were routinely conducted in the ICU department, and assessment frequency were associated with profile membership (P < 0.05). OPSN scores differed significantly across profiles (P < 0.05), with the "low-difficulty/well-adapted" profile scoring higher than the other three profiles. The DSNCPD-ICU total score was negatively correlated with OPSN total score (rₛ = -0.572, P < 0.001). CONCLUSIONS: Delirium care difficulties among ICU nurses show marked heterogeneity. These findings may support the development of profile-specific training and organizational strategies for ICU nurses.

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