{"doi":"10.3389/fonc.2025.1644925","title":"Psychosocial barriers and cultural contexts in chemotherapy decision-making: a qualitative study of advanced lung cancer patients in China","abstract":"<jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>Shared Decision-Making (SDM) was developed within Western healthcare systems, which are characterized by cultural norms of individualism and low power distance, as a “patient-centered” medical decision-making model. Its applicability remains underexplored in collectivist societies like China, where family-centered decision-making and respect for authority shape medical encounters. Chemotherapy remains a cornerstone in the management of advanced lung cancer; however, the varied risk-benefit profiles of different therapeutic regimens often lead to decisional dilemmas and significant psychological burden in patients. This study investigates the chemotherapy decision-making experiences of advanced lung cancer patients in China to identify cultural barriers and inform the development of globally relevant SDM frameworks.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>This study employs Colaizzi’s phenomenological approach and Hofstede’s cultural dimensions theory as the foundational theoretical framework. We conducted semi-structured interviews with 14 lung cancer patients and thematically analyzed the data through iterative coding and member validation. A purposive sample of 14 advanced lung cancer patients receiving chemotherapy was recruited from a tertiary hospital in Jiangxi Province, China.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>From the face-to-face conversations between patients and nursing staff, four main themes and 13 sub-themes were identified: Disease Treatment and Decision-making; Treatment Burden and Decision Conflict; Lifestyle Adjustment and Support Needs; Psychological Experience and Emotional Response.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>Lung cancer patients face information barriers in the decision-making process and show high needs for decision-making assistance, psychological support, and social recognition. Healthcare professionals need to strengthen professional information support and communication, enhance patients’ enthusiasm for participating in decision-making, and pay attention to their intrinsic needs.</jats:p>\n                  </jats:sec>","journal":"Frontiers in Oncology","year":2025,"id":621989,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":106134,"name":"Jun Zhang","orcid":"0000-0002-1289-0624","position":1,"is_corresponding":false},{"id":254415,"name":"Mengying Hu","orcid":"0000-0002-0358-6014","position":2,"is_corresponding":false},{"id":645055,"name":"Jiaojiao Xu","orcid":"0000-0002-7036-5131","position":3,"is_corresponding":false},{"id":1606433,"name":"Qiongqiong Ai","orcid":null,"position":4,"is_corresponding":false},{"id":1606434,"name":"Hequn Wei","orcid":null,"position":5,"is_corresponding":false},{"id":162267,"name":"Jiao Yu","orcid":null,"position":6,"is_corresponding":false},{"id":1606435,"name":"Haiping Ma","orcid":null,"position":7,"is_corresponding":false},{"id":321521,"name":"Qing Wang","orcid":"0000-0003-1679-0169","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Psychosocial barriers and cultural contexts in chemotherapy decision-making: a qualitative study of advanced lung cancer patients in China","abstract":"<jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>Shared Decision-Making (SDM) was developed within Western healthcare systems, which are characterized by cultural norms of individualism and low power distance, as a “patient-centered” medical decision-making model. Its applicability remains underexplored in collectivist societies like China, where family-centered decision-making and respect for authority shape medical encounters. Chemotherapy remains a cornerstone in the management of advanced lung cancer; however, the varied risk-benefit profiles of different therapeutic regimens often lead to decisional dilemmas and significant psychological burden in patients. This study investigates the chemotherapy decision-making experiences of advanced lung cancer patients in China to identify cultural barriers and inform the development of globally relevant SDM frameworks.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>This study employs Colaizzi’s phenomenological approach and Hofstede’s cultural dimensions theory as the foundational theoretical framework. We conducted semi-structured interviews with 14 lung cancer patients and thematically analyzed the data through iterative coding and member validation. A purposive sample of 14 advanced lung cancer patients receiving chemotherapy was recruited from a tertiary hospital in Jiangxi Province, China.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>From the face-to-face conversations between patients and nursing staff, four main themes and 13 sub-themes were identified: Disease Treatment and Decision-making; Treatment Burden and Decision Conflict; Lifestyle Adjustment and Support Needs; Psychological Experience and Emotional Response.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>Lung cancer patients face information barriers in the decision-making process and show high needs for decision-making assistance, psychological support, and social recognition. Healthcare professionals need to strengthen professional information support and communication, enhance patients’ enthusiasm for participating in decision-making, and pay attention to their intrinsic needs.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"41476590","pmcid":"PMC12747944","openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://public-pages-files-2025.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1644925/pdf","host_type":"publisher"},{"url":"https://www.frontiersin.org/articles/10.3389/fonc.2025.1644925/full","host_type":"publisher"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12747944/","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12747944","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12747944?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":[],"mesh_terms":[],"keywords":["Lung cancer","Chemotherapy","decision-making","Qualitative Research","Traditional Chinese Medicine (Tcm)","Semi-structured Interview","Treatment Process"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T17:41:58.191765Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}