Current status and influencing factors of decision-making readiness among lung cancer patients during chemotherapy: a cross-sectional study based on CSM model

Objective This study aimed to investigate the current status of decision - making readiness (DMR) among lung cancer patients during chemotherapy and to explore its influencing factors, with the goal of informing targeted clinical interventions. Methods A cross-sectional survey was conducted among 461 lung cancer patients during chemotherapy at a tertiary oncology hospital in China. Data were collected using the Decision Readiness Scale (C-PrepDM), Decisional Conflict Scale (DCS), and the Patient Participation in Treatment Decision-Making Attitude Questionnaire, along with demographic and clinical information. Hierarchical multiple regression analysis was performed to identify significant predictors of DMR. Results The overall level of DMR was moderate among the participants. Hierarchical regression revealed that economic status, place of residence, decisional conflict, and decision participation attitude were significant predictors (P < 0.05). Patients with higher income and those residing in rural or township areas showed better DMR. A positive attitude toward participation in decision-making was positively correlated with DMR (r = 0.382, P < 0.001), while decisional conflict was negatively correlated (r=–0.164, P < 0.001). Conclusion DMR in lung cancer patients during chemotherapy is influenced by both socioeconomic and psychosocial factors. Enhancing patient education, promoting active decision participation, and reducing decisional conflict through tailored communication strategies may strengthen patients’ readiness to engage in their treatment planning. Future multi-center and longitudinal studies are needed to further validate these findings.