Study On The Status And Influencing Factors Of Advanced Lung Cancer Patients Involving In Treatment Decision-Making

Background:With the improvement of medical level,the treatment of advanced lung cancer has been improving increasingly,and the survival rate and overall survival time were significantly improved,but lead to new problems such as economic burden and adverse events of treatment.The traditional way of treatment decision-making(TDM)only made by medical staff is difficult to meet the health need of patients,and medical disputes will even be caused.In this context,advocating and encouraging patients to involve in TDM are an important clinical task.Patients involving in TDM can not only improve patients’ treatment compliance,reduce anxiety,but also make TDM in line with their personal preferences to achieve the best diagnosis and treatment results.In China,advaned lung cancer patients are involving in TDM to a low degree and with less positive attitude,but the influencing factors are not clear.Objective:To describe the attitude and actual involvement degree of TDM among advanced lung cancer patients;to explore the influencing factors of advanced lung cancer patients involved in TDM.Methods:This is a descriptive study.Patients with advanced lung cancer admitted to the Department of Respiratory and Critical Care Medicine in Peking Union Medical College Hospital from April to November 2022 were selected by convenience sampling method.The status and influencing factors were investigated by using the general data questionnaire,Social Support Rating Scale,medical decision evaluation questionnaire,Control Preference Scale,and cancer patients’ involvement in TDM questionnaire.SPSS 25.0 was used for data analysis.Results:(1)A total of 301 valid questionnaires were collected,among which 110 cases had positive attitude towards involving in TDM and 191 cases involved in negative attitude.There were 73 cases with a high degree of actual involvement in TDM and 228 cases with a low degree.Patients with a positive attitude towards TDM have a higher proportion of high actual involvement degree than those with a negative attitude,with the difference having statistical significance(P<0.001).(2)Univariate analysis showed that patients with different types of excepted involvement in TDM,utilization of social support,doctorpatient communication level,doctors involve patients in TDM and medical decisionmaking evaluation had different involvement attitude,with statistical significance(P<0.05);Patients with different types of excepted involvement in TDM,awareness of disease types,the utilization of social support,doctor-patient communication level,doctors involve patients in TDM and medical decision-making evaluation had different actual involvement degree in TDM,with statistical significance(P<0.05).(3)Multivariate logistic analysis showed that,doctors involve patients in TDM,medical burden,the active type of excepted involvement in TDM,and the shared type of excepted involvement in TDM were the factors influencing the attitude,accounting for 76.1%of the total variation.Doctors involve patients in TDM,utilization of social support,the shared type of excepted involvement in TDM,were factors influencing the actual involvement degree,accounting for 76.7%of the total variation.Conclusions:Due to the influence of various factors,patients with advanced lung cancer had less positive attitude to involve in TDM,and the actual involvement degree was low.Medical staff should identify the main influencing factors,focus on assessing the current situation of patients’ involvement in TDM,and take timely targeted intervention measures,so as to improve the attitude of patients to involve in TDM and enhance their actual involvement degree.