Patient Education and Counseling最新文献

{"title":"Patient and family-centered care among Middle Eastern and North African children living in the United States","authors":"Grace Ellen Brannon ,&nbsp;Tiffany B. Kindratt","doi":"10.1016/j.pec.2025.109350","DOIUrl":"10.1016/j.pec.2025.109350","url":null,"abstract":"<div><h3>Objectives</h3><div>National estimates of the quality of care received by Middle Eastern and North African (MENA) individuals are unknown. Perceptions of patient-centered care (PCC) are important indicators of quality of care that differ by racial/ethnic minority groups. Our study aimed to estimate differences in parents’ perceptions of patient- and family-centered care (PFCC), an indicator of quality of care perceived by parents, between foreign-born MENA and other racial and ethnic groups.</div></div><div><h3>Methods</h3><div>Data from 2000 to 2017 National Health Interview Survey and 2001–2018 Medical Expenditure Panel Survey was combined and analyzed at a federal statistical research data center, using the Head and Bute’s extension of Street’s ecological model as theoretical lens. The sample included 33,677 parents of foreign-born MENA children who reported visiting a health care provider within the past 12 months. Dependent variables included parent reports of communication variables related to how often providers: listened; showed respect; spent enough time; and explained things well. Multivariable logistic regression was used to evaluate the odds of receiving PFCC using a composite measure of PFCC quality and separate domains.</div></div><div><h3>Results</h3><div>Parents of foreign-born MENA children had higher odds of reporting all PFCC qualities compared to foreign-born White (OR=2.49; 95 %CI=1.04–5.97) and Asian (OR=2.54; 95 %CI=1.13–5.68) groups. When separated by PFCC quality, parents of foreign-born MENA children had 3.23 times higher odds (95 %CI= 1.18–8.81) of reporting that their provider spent enough time with them compared to foreign-born Hispanics.</div></div><div><h3>Conclusions</h3><div>This study provides the first estimates of PFCC among MENA adults. Future studies can be designed to test unique health interventions and make recommendations for providers to deliver more culturally responsive care.</div></div><div><h3>Practice Implications</h3><div>Findings add to the timely dialog advocating for a separate racial/ethnic category for MENA populations recently proposed by the US government and acknowledged by scientists for more rigorous and accurate assessments of health equity for all US populations.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109350"},"PeriodicalIF":3.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parents’ perspectives on cost conversations in pediatric asthma care: Findings from a qualitative interview study","authors":"Jennifer A. Heisler-MacKinnon ,&nbsp;Wei Yi Kong ,&nbsp;Kathryn L. Kennedy ,&nbsp;Ceila E. Loughlin ,&nbsp;Corinne N. Lawler ,&nbsp;Alison A. Galbraith ,&nbsp;Melissa B. Gilkey","doi":"10.1016/j.pec.2025.109351","DOIUrl":"10.1016/j.pec.2025.109351","url":null,"abstract":"<div><h3>Objectives</h3><div>Asthma care teams may be well-positioned to help parents navigate the high cost of pediatric asthma care, but little is known about how cost concerns are addressed in specialty clinics. To inform future interventions to support cost conversations and reduce cost burden, we sought to understand how parents and asthma care teams discuss costs, as well as parents’ preferences for cost conversations.</div></div><div><h3>Methods</h3><div>We interviewed 21 parents with asthma care cost concerns recruited from a large pediatric asthma specialty clinic in North Carolina. We used thematic analysis to qualitatively describe parents’ experiences of and preferences for cost conversations.</div></div><div><h3>Results</h3><div>Parents described incurring a range of direct and indirect asthma care costs, with direct costs being especially burdensome for commercially-insured children. Parents wanted cost conversations to be a routine part of office visits to reduce assumptions and stigma about their ability to afford care. Yet, cost conversations were inconsistent. When cost conversations did occur, the care team often found ways to reduce costs, such as switching to lower-cost medications. Most parents believed that both families and the asthma care team would benefit from having more cost-related information. Parents had mixed views on having cost conversations in front of their children.</div></div><div><h3>Conclusions</h3><div>Findings of our qualitative study suggest that asthma care teams have opportunities to address and destigmatize parents’ financial concerns by making cost conversations part of routine care.</div></div><div><h3>Practice implications</h3><div>Parents want asthma care teams to regularly initiate cost of care conversations, while carefully considering their preferences for privacy when discussing costs in front of children. Parents and care teams likely need more information about costs and available resources to maximize the impact of these conversations.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109351"},"PeriodicalIF":3.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paying it forward","authors":"Yumi Kagawa ,&nbsp;Tsuyoshi Okuhara","doi":"10.1016/j.pec.2025.109349","DOIUrl":"10.1016/j.pec.2025.109349","url":null,"abstract":"","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109349"},"PeriodicalIF":3.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does oncologists’ communication affect patients’ well-being and online health information seeking? – A randomized experiment","authors":"Tanja Henkel ,&nbsp;Chamoetal Zeidler ,&nbsp;Annemiek J. Linn ,&nbsp;Julia C.M. van Weert ,&nbsp;Ellen M.A. Smets ,&nbsp;Marij A. Hillen","doi":"10.1016/j.pec.2025.109352","DOIUrl":"10.1016/j.pec.2025.109352","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with cancer increasingly rely on online information about their disease. However, the impact of clinicians’ responses to patients presenting this information remains unclear. This randomized experiment tested the effects of oncologists’ communication approaches on patients’ trust, satisfaction, and intentions to seek and discuss online information. Additionally, we explored moderating effects of patients’ psychological characteristics.</div></div><div><h3>Methods</h3><div>In an online vignette experiment, we manipulated clinicians' communication approaches (patient-centered vs. clinician-centered) in hypothetical oncology consultations. (Former) cancer patients (N = 270, 62 ± 13 years, 55 % female) were randomly assigned to one out of eight conditions. We performed 1-way ANOVA’s, independent samples t-tests and multiple regressions.</div></div><div><h3>Results</h3><div>Participants exposed to a patient-centered approach reported higher satisfaction with the consultation (<em>d</em> =0.62, <em>p</em> &lt; .001), stronger trust in the clinician (<em>d</em> =0.49, <em>p</em> &lt; .001), and stronger intentions to seek (<em>d</em> =0.40, <em>p</em> &lt; .001) and <em>d</em>iscuss online information (<em>d</em> =0.69, <em>p</em> &lt; .001) compared to participants exposed to a clinician-centered approach. Moderation analyses indicated that the effect of communication approach on intention to discuss online information depended on participants‘ trait anxiety (<em>b</em> =-0.43, <em>p</em> = .017) and uncertainty intolerance (<em>b</em> =-0.35, <em>p</em> = .041). Uncertainty intolerance further moderated patient satisfaction with the consultation (<em>b</em> =-0.33, <em>p</em> = .049). Participants‘ monitoring coping style moderated the effect of communication approach on online information seeking (<em>b</em> =0.23<em>, p</em> = .036).</div></div><div><h3>Conclusion</h3><div>Clinicians’ patient-centered responses to online information seeking may positively affect patient satisfaction with the consultation, trust in the consultation, and online information seeking behavior. We provide initial evidence that these effects do not apply equally to every patient: levels of trait anxiety, uncertainty intolerance and monitoring coping style influence the relationship between the applied communication approach and patient outcomes.</div></div><div><h3>Practice implications</h3><div>Clinicians are advised to emphasize collaborative information exchange and guide patients to trustworthy online sources.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109352"},"PeriodicalIF":3.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy needs in the diagnosis and treatment of acoustic neuroma patients from timing it right theory perspective: A qualitative study","authors":"Huimin Liang ,&nbsp;Cong Fu ,&nbsp;Dongrui Wang ,&nbsp;Pengjiao Xi ,&nbsp;Hua Zhang ,&nbsp;Chunmei Wang ,&nbsp;Haize Ge ,&nbsp;Yan Zhang","doi":"10.1016/j.pec.2025.109345","DOIUrl":"10.1016/j.pec.2025.109345","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of acoustic neuroma (AN) has steadily increased in recent years. AN patients' post-surgical quality of life is closely linked to their health literacy. Previous research has indicated that AN patients encounter various challenges at different phases of the disease. Understanding patients’ experiences and health literacy needs throughout the diagnostic and treatment processes is crucial for improving their overall health outcomes. The Timing It Right (TIR) framework emphasizes patients’ needs evolving across phases which is highly consistent with exploring the evolving health literacy needs of AN patients.</div></div><div><h3>Objective</h3><div>To explore the challenges and the evolving health literacy needs of patients with acoustic neuroma (AN) in different phase across the diagnosis and treatment journey, using TIR framework and considering Eastern cultural influences in healthcare context.</div></div><div><h3>Methods</h3><div>This qualitative descriptive study was conducted based on TIR framework. A total of 51 acoustic neuroma (AN) patients at different phases of the diagnosis and treatment process were included. Semi-structured interviews were employed for data collection, with the interview data analyzed and organized using Colaizzi's phenomenological analysis method.</div></div><div><h3>Results</h3><div>The study identified themes reflecting the unique experiences and health literacy needs of AN patients at each phase of diagnosis and treatment: 1. Diagnosis phase: urgent need for disease information and sense of uncertainty, strong need for psychological support, anxiety in treatment decision-making. 2. Preoperative phase: need for individualized information about surgical treatment for AN. 3. Postoperative phase: need for timely healthcare services to address postoperative stress. 4. Home Recovery phase: need for information on recurrence prevention, demand for ongoing medical support, persistent challenges (complex negative emotions, social avoidance, and poor adaptability to physical sensations).</div></div><div><h3>Conclusion</h3><div>HL needs among AN patients evolve across treatment phases, shaped not only by clinical milestones but also by sociocultural values, family dynamics, and existential concerns. Culturally sensitive, phase-matched, and multidisciplinary care strategies are essential to improving patient empowerment and long-term well-being.</div></div><div><h3>Practice implications</h3><div>Clinicians should adopt phase-specific interventions that integrate personalized communication, cultural awareness, and digital tools. Constructing full-cycle care teams that align with the TIR framework can enhance HL support, patient engagement, and overall treatment outcomes.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109345"},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical invalidation: A concept analysis","authors":"Yi-Wen Chen ,&nbsp;Enyi Jen ,&nbsp;Jaw-Shiun Tsai ,&nbsp;Jen-Kuei Peng ,&nbsp;Chia-Chun Tang","doi":"10.1016/j.pec.2025.109338","DOIUrl":"10.1016/j.pec.2025.109338","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to define and clarify the concept of medical invalidation.</div></div><div><h3>Methods</h3><div>Following Walker and Avant’s eight-step concept analysis approach, a systematic literature search was conducted in PubMed, Embase, CINAHL, and PsycINFO, covering studies published between 2005 and July 2025. The analysis identified the defining attributes, model and contrary cases, antecedents, consequences, and empirical referents.</div></div><div><h3>Results</h3><div>Twenty-nine articles published between 2009 and 2025 were included. Medical invalidation is defined as “a communication behavior or self-belief that undermines an individual’s perception and autonomy in relation to their illness.” The key attributes included a lack of understanding, discounting, and pathologizing. Antecedents can be categorized into disease-, patient-, and provider-related factors. The consequences span psychological, physical, health-related quality of life, behavior, social, and systemic domains.</div></div><div><h3>Conclusion</h3><div>Medical invalidation is a significant yet still-evolving concept in health communication with implications for patient- and system-level outcomes. Findings from this concept analysis provide a foundational understanding that may inform the development of future interventions aimed at addressing the antecedents and consequences of medical invalidation. By guiding such efforts, this work has the potential to support improvements in patient-provider interactions and, in turn, contribute to better patient well-being.</div></div><div><h3>Practice implications</h3><div>Recognizing and addressing medical invalidation can enhance patient-centered care, foster more effective health communication, and reduce negative health outcomes. By increasing awareness of invalidation, healthcare providers, educators, and policymakers can better support patients’ experiences, strengthen therapeutic relationships, and promote a more empathetic and inclusive clinical environment.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109338"},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Counteracting cyberchondria in Chinese chronic disease patients: The divergent roles of health-related social media use and online patient-centered communication","authors":"Yuyuan Kylie Lai ,&nbsp;Ze Lai ,&nbsp;Xinshu Zhao","doi":"10.1016/j.pec.2025.109337","DOIUrl":"10.1016/j.pec.2025.109337","url":null,"abstract":"<div><h3>Objective</h3><div>Cyberchondria poses escalating challenges for chronic disease patients who increasingly rely on digital platforms for health information, yet the differential roles of online health engagement modalities remain understudied. Drawing on the stress-strain-outcome (SSO) model, this study examines how health-related social media use (SMU) and online patient-centered communication (OPCC) are associated with cyberchondria among Chinese chronic disease patients, investigating negative affect toward online health information as a mediator and eHealth literacy as a moderator.</div></div><div><h3>Methods</h3><div>A national survey was conducted from October 2024 to January 2025. This research encompassed a cohort of 827 chronic disease participants. R and RStudio were used for data analysis.</div></div><div><h3>Results</h3><div>More frequent health-related SMU was positively associated with cyberchondria, both directly and indirectly, through increased negative affect. In contrast, OPCC was exclusively linked to alleviated cyberchondria via reduced negative affect. Furthermore, patients with higher eHealth literacy experience less negative affect from health-related SMU.</div></div><div><h3>Conclusion</h3><div>These findings extend the SSO model by demonstrating divergent technology-specific psychological pathways and highlighting the potential protective role of OPCC.</div></div><div><h3>Practical implications</h3><div>Our results suggest that enhancing chronic disease patients’ digital health competencies and developing OPCC could effectively counteract cyberchondria in the digital era.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109337"},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video vignettes do not yield higher engagement compared to a written variant in a vignette experiment to test communication in healthcare","authors":"Ellen M.A. Smets ,&nbsp;Leonie N.C. Visser ,&nbsp;Chamoetal Zeidler ,&nbsp;Tanja Henkel ,&nbsp;Julia C.M. van Weert ,&nbsp;Annemiek Linn ,&nbsp;Marij A. Hillen","doi":"10.1016/j.pec.2025.109340","DOIUrl":"10.1016/j.pec.2025.109340","url":null,"abstract":"<div><h3>Objectives</h3><div>Experimental vignette designs are used to systematically test communication strategies in healthcare. To ensure validity, participants of such experiments need to optimally engage with the hypothetical scenario. Researchers have often favored video over written vignettes to maximize engagement, despite a lack of evidence for the superiority of videos. We sought further evidence to substantiate the choice for a vignette modality by testing the impact of video versus written vignette modality on engagement, perceived realism and anxiety among cancer patients and survivors.</div></div><div><h3>Methods</h3><div>We performed an experimental study using video and written vignettes of a hypothetical physician-patient consultation in hematologic oncology. Cancer patients and survivors were recruited through two panels and participated via an online survey. The primary outcome was <em>engagement,</em> assessed using (an adapted version of) the ‘Video Engagement Scale’ short form. Secondary outcomes were perceived realism and state anxiety.</div></div><div><h3>Results</h3><div>Mean engagement score (N = 270) was 3.44 (SD=0.77, potential range 1–5). Neither overall engagement scores, nor scores on the subscales ‘Immersion’ and ‘Emotional impact’ differed between video and written vignettes. No main effects were found for modality on perceived realism or state anxiety. Participant age, gender, and cancer history did not predict engagement, whereas source of recruitment (panel) did (p &lt; .05).</div></div><div><h3>Conclusions</h3><div>Written vignettes appear equally realistic and immersive compared to video vignettes. Future research could establish whether written and video vignettes differentially affect other outcomes and whether innovative virtual reality-based vignette modalities, which enable more interactive experiences, yield higher engagement.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109340"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are bullet points the silver bullet to accessible health information? Cross-sectional analysis of community health information preferences","authors":"Julie Ayre ,&nbsp;Erin Cvejic ,&nbsp;Carissa Bonner ,&nbsp;Danielle M. Muscat ,&nbsp;Gemma Beall ,&nbsp;Debra Letica ,&nbsp;Kirsten J. McCaffery","doi":"10.1016/j.pec.2025.109336","DOIUrl":"10.1016/j.pec.2025.109336","url":null,"abstract":"<div><h3>Objectives</h3><div>This study compared community preferences for original and simplified health texts generated during evaluation of the Health Literacy Editor, a tool that provides objective feedback on use of plain language. The aim was to explore the relationship between Health Literacy Editor use, text characteristics, and health information preferences amongst people with lower levels of education.</div></div><div><h3>Methods</h3><div>Eligible participants were adults living in Australia without an English-language undergraduate degree. Participants viewed text pairs (original; revised) and reported their preference according to: understandability, confusion rating, familiarity with words, trust, actionability, and intentions to share. Logistic regression models explored relationships between outcomes, trial group, and text characteristics (readability, complex language, passive voice, expert health literacy ratings, bullet points).</div></div><div><h3>Results</h3><div>Mean age of the 150 participants was 27.3 years (SD=13.7); 50 % were male; 36 % spoke another language at home. Use of the Health Literacy Editor was not associated with a higher preference for the revised text compared to control (e.g. understandability odds: 1.25, 95 %CI: 0.75–2.09, p = 0.39; confusion rating OR: 0.73, 95 %CI: 0.44–1.21, p = 0.22;). Revised texts that used bullet points were rated more favourably than the original texts (no bullet points), for all parameters (e.g. understandability OR: 2.35, 95 %CI: 1.40–3.97, p = 0.001; confusion rating OR: 0.48, 95 %CI: 0.28–0.83, p = 0.009). Participants rated texts with higher expert ratings (i.e. subjective ratings of plain language) as easier to understand (OR: 1.43, 95 %CI: 1.00–2.06, p = 0.050) and less confusing (OR: 0.66, 95 %CI: 0.46–0.94, p = 0.021) than the original texts.</div></div><div><h3>Conclusion</h3><div>Participants preferred health information that uses bullet points, and stronger plain language ratings. Further research could explore the relevance of bullet points to community acceptability of health information.</div></div><div><h3>Practice implications</h3><div>Findings support use of bullet points and plain language to create texts that are more acceptable to community members.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109336"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive concerns and fertility intentions in cancer survivors: A longitudinal study of decision-making conflict as mediator","authors":"Qingchun Geng ,&nbsp;Mei Kong ,&nbsp;Qingqing Diao ,&nbsp;Yang Li ,&nbsp;Lina Xiong ,&nbsp;Hongwen Ma ,&nbsp;Shuzhen Niu ,&nbsp;Jiping Tan ,&nbsp;Xiaoxiao Hu ,&nbsp;Ruofen Yan ,&nbsp;Yanfei Jin","doi":"10.1016/j.pec.2025.109344","DOIUrl":"10.1016/j.pec.2025.109344","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the impact of reproductive concerns on fertility intentions among cancer survivors of childbearing age and evaluate the mediating role of decision-making conflicts in this relationship.</div></div><div><h3>Methods</h3><div>A prospective longitudinal survey was conducted with 223 cancer patients (aged 18–50) across three regions in China. Assessments using validated scales for fertility intentions, reproductive concerns, and decision-making conflicts were completed at three timepoints: 3, 6, and 9 months post-treatment. A longitudinal path model was constructed using cross-lagged analysis</div></div><div><h3>Results</h3><div>Decision-making conflict significantly mediated the relationship between reproductive concerns and fertility intentions (β = −0.031, 95 % CI = [-0.075, −0.006]). Reproductive concerns predicted increased decision-making conflict (β = 0.347, p &lt; 0.001), which subsequently led to decreased fertility intentions (β = −0.167, p &lt; 0.001). These relationships remained stable across measurement timepoints.</div></div><div><h3>Conclusion</h3><div>Decision-making conflict serves as a key mediator between reproductive concerns and fertility intentions among cancer survivors of childbearing age, suggesting a potential intervention target for enhancing fertility outcomes in this population.</div></div><div><h3>Practice Implications</h3><div>Healthcare providers should address decision-making conflict through structured counseling interventions, particularly in the context of precision medicine where fertility implications of novel therapies may be uncertain. Developing tailored decision support tools could help reduce decision-making conflict and potentially improve alignment between patients’ fertility values and intentions.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"141 ","pages":"Article 109344"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}