Decision Conflict Faced by First-Degree Relatives of Liver Cancer Patients in Liver Cancer Screening: A Cross-Sectional Study in China

Jiawei Zhang, Jin Xia, Ningning Su, Yanfei Wu, Sihan Wang, Xiaoman Tao Department of Hepatobiliary Surgery, Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Jin Xia, Department of Hepatobiliary Surgery, Second Affiliated Hospital of Chongqing Medical University, No. 288, Tianwen Avenue, Nanan District, Chongqing, 400010, People’s Republic of China, Tel +86 15772329636, Email [email protected]: This study aimed to investigate the level of decision conflict regarding liver cancer screening among first-degree relatives (FDRs) of liver cancer patients, and to explore its associations with decision preparation, social support, and health literacy management.Patients and Methods: This cross-sectional study enrolled 172 FDRs of liver cancer patients from a tertiary general hospital in Chongqing, China. Data was collected using the General Information Survey, the Decision Conflict Scale, the Preparation for Decision-Making Scale, the Perceived Social Support Scale, and the Health Literacy Management Scale. Descriptive statistics, one-way analysis of variance (ANOVA), Pearson correlation analysis, and multivariate regression analysis were performed to identify factors influencing decision conflict.Results: The total score of decision conflict was 33.37 (SD = 13.38). Specifically, 40.11% of participants (n = 69) reported clinically significant decision conflict (score ≥ 37.5), and an additional 36.63% (n = 63) reported scores between 25 and 37.5, indicating a tendency toward decisional delay. Multiple linear regression analysis identified the educational level of FDRs and prior liver cancer screening experience as significant determinants. Higher decision conflict scores were associated with lower decision preparation (β = − 0.562, P < 0.001), lower social support (β = − 0.580, P < 0.001), and lower health literacy management (β = − 0.232, P = 0.023). The model accounted for 71.6% of the total variance.Conclusion: FDRs of liver cancer patients experience moderate decision conflict regarding liver cancer screening. To address this issue, the development of structured decision aids incorporating liver cancer screening education and clear risk-benefit information is recommended. Interventions should prioritize enhancing patients’ understanding and preparedness for decision making, particularly among individuals with lower educational attainment or no prior screening experience.Keywords: liver cancer, first-degree relatives, FDRs, liver cancer screening, decision conflict, factor analysis