Cancer Patients with Venous Access Device Status and Influencing Factors of Path Analysis Decision Conflicts.

Objective: The study aims to investigate the status of decision-making and the influencing factors of venous access devices in cancer patients and to explore their action path. Methods: A retrospective analysis was conducted on the clinical data of 360 inpatients in the oncology department from July 2022 to October 2022 in Hebei, Shandong, and Shanxi provinces. The patients were assessed with a general information questionnaire, decision conflict scale, general self-efficacy scale, patient version of doctor-patient decision-making questionnaire, and medical version of social support scale. Further analysis was conducted on the influencing factors of decision conflict on cancer patients' status and access to venous access devices. Results: A total of 345 valid questionnaires were acquired, showing the total score of decision-making conflict regarding venous access devices in cancer patients to be 34.72 ± 12.13. A total of 245 patients exhibited decision-making conflict, with a high level in 119 patients. A negative correlation was found between the total score of decision-making conflict with that of self-efficacy, doctor-patient joint decision-making, and social support (r = 0.766, -0.816, -0.74, P < .001). The joint decision-making between doctor and patient directly negatively affected decision-making conflict (ß = -0.587, P < .001). Self-efficacy was found to exert a direct positive and negative predictive effect on the doctor-patient joint decision-making and decision-making conflict, respectively (ß = 0.415, 0.277, P < .001). Social support can contribute to decision-making conflict in a direct or indirect way through multiple modulations of self-efficacy and joint decision-making between doctors and patients (ß = -0.296, -0.237, -0.185, P < .001). Conclusion: Decisional conflicts are existing among cancer patients in intravenous access device selection, the degree of joint decisional involvement of doctors and patients makes a negative predictive effect on intravenous access device selection, and self-efficacy and social support exert direct or indirect effects. Accordingly, enhancing patients' self-efficacy and improving patients' social support from multiple perspectives could contribute to decision-making of intravenous access devices for cancer patients, which could be achieved by developing decision support programs to elevate decision quality, block related paths early, and reduce the level of patients' decision conflicts.