Current Status and Influencing Factors of Decisional Conflict in Lung Cancer Patients Receiving Systemic Therapy: A Cross-Sectional Analysis.

Abstract

Objective: To investigate the current status of decisional conflict in lung cancer patients receiving systemic therapy and to analyze its influencing factors, with the aim of providing a basis for developing decision support strategies.

Methods: From August to September 2024, a convenience sample of 500 patients receiving systemic therapy for lung cancer at the Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, was surveyed. Data were collected using a general information questionnaire, the Decisional Conflict Scale (DCS), Cancer Patient's Involvement in Treatment Decision-Making Scale (CPITDM), Preparation for Decision-Making Scale (PreDM), and Decisional Regret Scale (DRS).

Result: The mean DCS score was 47.28 ± 15.83, with subscale scores ranking from highest to lowest as decision support/effectiveness, decision uncertainty, and information/values. The mean CPITDM, PreDM, and DRS scores were 28.56 ± 3.91, 63.02 ± 11.65, and 9.46 ± 2.62, respectively. DCS was negatively correlated with CPITDM (r = -0.188, p < 0.001) and PreDM (r = -0.303, p < 0.001) but positively correlated with DRS (r = 0.342, p < 0.001). Multiple regression identified occupation, medical payment, treatment line, pathology, medication type, patient involvement, and preparedness as significant influencing factors (p < 0.05), explaining 59.9% of variance.

Conclusion: Lung cancer patients receiving systemic therapy experience a relatively high level of decisional conflict, with many exhibiting delayed decision-making. Healthcare providers should identify high-risk patients early based on key influencing factors and explore practical clinical decision support interventions. Enhancing decision readiness and reducing decision regret may help to improve quality of life and reduce decisional conflict.