Study On The Influencing Factors And Experience Of Patients With Lung Cancer Participating In Treatment Decision-making

Purpose:The study used quantitative method to investigate the influencing factors of lung cancer patients’ participation in decision-making.Qualitative method is used to investigate further of the influencing factors and patients’ experience in the decision-making process.Methods:1.Analysis of the influencing factors of lung cancer patients’ participation in treatment decision-making:convenience sampling method.A questionnaire survey was used to investigate 340 lung cancer patients in the thoracic surgery and oncology departments of a tertiary hospital in Shandong Province from March 2021 to October 2021.Finally,311 lung cancer patients were included.The survey tools include general information and basic disease questionnaire,assessment tool of decision-making participation preference and actual decision-making participation method,patients’health questionnaire,depression scale,generalized anxiety scale,Chinese version of the comprehensive health literacy measurement scale,general self-efficacy scale,Decision Conflict Scale,Social Support Rating Scale,Chinese Version of Wake Forest Physician Trust Scale and Promotion of Patient Engagement Scale.SPSS26.0 software was used for data analysis,and the concrete analysis methods include descriptive statistics,χ2 test,variance analysis and multivariate Logistics regression.2.Qualitative research on the participation of lung cancer patients in treatment decisionmaking:purposeful sampling method.Face-to-face and semi-structured interviews were conducted among inpatients in the Department of Thoracic Surgery and Oncology in a tertiary general hospital in Shandong Province from October 2021 to January 2022.Data Collation and Analysis were conducted with the help of Nvivo 12.0.The content of the interviews was analyzed by the Colaizzi seven-step analysis method.Results:1.A survey of 311 lung cancer patients in this study showed that:(1)The current status of participation in treatment decision-making for patients with lung cancer57 patients choose the active decision-making participation method,accounting for 18.3%.The cooperative decision-making participation method was chosen by 104 patients,accounting for 33.4%.And 150 patients choose the passive decision-making participation method,accounting for 48.2%.The main actual treatment decision of lung cancer patients was passive decision-making participation method.(2)The results of univariate analysis of participation in treatment decision-makingFactors as age,household registration location,per capita monthly income of family,preferences for decision-making participation,depression,decision-making conflict and social support had statistically significant differences in patients’ actual participation in treatment decision-making.(3)The results of multivariate analysis of participation in treatment decision-making Multi-category Logistic regression analysis showed that there were statistically significant differences in family per capita monthly income,preference for decision-making participation,depression and decision-making conflict in patients’ participation in actual treatment decision-making(P<0.05).Among them,low income level,high level of depression,and high level of decision-making conflict are hindering factors of patients’ actual active and cooperative treatment decision-making participation methods,while patients’ preference towards active and cooperative decision-making participation is a facilitator.2.The study conducted semi-structured interviews and comprehensive analysis of 19 inpatients with lung cancer,and finally identified five themes,namely:direct factors in treatment decision-making(ability factors,cognitive factors,conflict factors);indirect factors(social support factors,trust in doctors);negative experience(depressed emotional distress,lack of confidence in treatment prognosis,self-abuse,stagnation in life and work,heavy selfperceived burden);positive experience(increased sense of responsibility,strong desire for survival,etc.);related needs(desire to participate in decision-making,reliance on family support,hope for support from relevant national policies,and demand for relevant decisionmaking information).Conclusions:1.The main actual decision-making participation method of lung cancer patients is passive decision-making participation method.The actual decision-making participation mode of lung cancer patients is affected by factors such as per capita monthly income of the family,preference for decision-making participation,depression and decision conflict.2.Lung cancer patients’ participation in the treatment decision-making process includes five aspects,i.e.,direct factors,indirect factors,negative experience,positive experience and related needs3.Clinical staff should respect patients’decision-making participation preferences and promote patients’ participation in the treatment decision-making.Clinical staff ought to provide corresponding information and emotional support to meet the needs of patients in treatment decision-making.Moreover,clinical staff must pay attention to the emotional and psychological changes of patients and help patients cope with negative emotions.At the same time,family support should be provided to help patients actively participate in treatment decision.