Mechanisms Influencing Neoadjuvant Treatment Decision‐Making in Patients With Locally Advanced Gastric Cancer: An Analysis Based on the Ottawa Decision Support Framework

OBJECTIVE: To explore the current status of patient involvement in neoadjuvant treatment decision-making among individuals with locally advanced gastric cancer, and to further identify the factors influencing their level of participation. METHODS: This cross-sectional study included patients with locally advanced gastric cancer and was conducted between July 2023 and April 2024 at two hospitals in Guangzhou, China. Data were collected using the Questionnaire of Cancer Patients' Decision-Making Regarding Treatment, the Decisional Conflict Scale, the Health Literacy Management Scale, the Fear of Progression Questionnaire-Short Form, and the Perceived Social Support Scale. Univariate analyzes and multivariable logistic regression were performed to identify factors associated with patient participation in neoadjuvant treatment decision-making. RESULTS: Patients with a positive attitude toward participating in neoadjuvant therapy decision-making also demonstrated higher actual participation levels (χ² = 47.05, p < 0.001). Binary logistic regression analysis identified several factors influencing decision-making attitudes in patients with locally advanced gastric cancer, including being a worker or self-employed, decisional conflict, health literacy (willingness to improve health), and fear of disease progression. Additionally, factors influencing the actual level of participation in decision-making included having a college education, being employed in government or public institutions, a per capita monthly household income of 5,001-10,000 CNY (≈700-1,400 USD), decisional conflict, health literacy (willingness to improve health), and social support (family support). CONCLUSIONS: The decision-making participation of patients with locally advanced gastric cancer is influenced by multiple factors, highlighting the need for comprehensive interventions tailored to these influences.