Decision‐Making Readiness and Its Influencing Factors Among Lung Cancer Patients Receiving Chemotherapy: A Cross‐Sectional Study

BACKGROUND: Decision-making readiness is essential for effective patient participation in treatment decisions, especially for lung cancer patients receiving chemotherapy who face repeated complicated treatment choices. However, existing research investigating their level of decision-making readiness and its associated influencing factors remains inadequate. AIMS: This study aimed to investigate the level of decision-making readiness among hospitalized lung cancer patients undergoing chemotherapy, and further explore the influencing factors of their decision-making readiness. MATERIALS AND METHODS: A cross-sectional observational design was adopted. A total of 452 hospitalized lung cancer patients receiving chemotherapy were recruited using convenience sampling. Data were collected via multiple questionnaires: the Chinese Version of the Preparation for Decision Making Scale, Decisional Conflict Scale, Patient Attitude Toward Treatment Decision-Making Scale, Decision Regret Scale, and a self-designed questionnaire covering sociodemographic and clinical characteristics. Descriptive statistics, correlation analysis, and hierarchical multiple linear regression were applied for data analysis. RESULTS: The median score of participants' decision-making readiness was 62.00 (56.00, 70.00), representing a moderate overall readiness level. Correlation analysis demonstrated that decision-making readiness was positively associated with patients' willingness to participate in treatment decision-making and negatively associated with decisional conflict. Hierarchical regression revealed that demographic variables could explain 9.2% of the total variance of decision-making readiness, and the inclusion of decisional conflict and decision participation attitude raised the explanatory power to 31.1%. Economic status, residential location, decisional conflict and participation attitude were identified as significant predictive factors of decision-making readiness. DISCUSSION: Lung cancer patients undergoing chemotherapy only possess moderate decision-making readiness. Compared with demographic characteristics, psychosocial factors (decisional conflict and decision participation attitude) exert a stronger impact on patients' decision-making readiness. These findings also support the applicability of the Common Sense Model of Self-Regulation in the field of cancer treatment decision-making research. CONCLUSION: Targeted nursing decision-support interventions are urgently needed to assess and elevate lung cancer patients' decision-making readiness, which can further promote the practice of patient-centered treatment decision-making.