Abstract
Background
Gastrostomy tube placement is the preferred modality for long-term nutritional management in individuals with oral feeding disorders. However, acceptance of this intervention is often impeded by reluctance to discontinue oral feeding, concerns about increased caregiver burden, and apprehension regarding life prolongation with diminished quality of life. These factors may generate decisional conflict, negatively affecting patients' physical and psychological well-being and treatment outcomes. In this study, we aimed to explore the facilitators and barriers influencing gastrostomy-related decision-making among patients with cancer and dysphagia, providing a theoretical and empirical basis for developing culturally tailored decision aids and structured communication pathways.Methods
A qualitative descriptive design was employed. In-depth one-on-one interviews were conducted with 18 patients with cancer and dysphagia who had engaged in gastrostomy decision-making at two tertiary hospitals in Fujian Province, China. The transcripts were coded using NVivo and analyzed using conventional content analysis.Results
Three overarching themes with seven subthemes were identified. Theme 1 included decision-making motivation, which comprised three subthemes: disease perception and survival needs, supportive communication from healthcare providers, and support from family members and peers. Theme 2 included decision-making challenges, which included two subthemes: emotional-rational dissonance and insufficient decision-making information. Theme 3 comprised decision-making optimization and included two subthemes: enhancing the transparency of gastrostomy-related information and improving the efficacy of healthcare provider-patient communication.Conclusions
Effective healthcare provider-patient communication and support from family members and peers emerged as key facilitators of decision-making regarding gastrostomy tube placement, whereas emotional-rational conflicts and informational deficits constituted major barriers. Future efforts should focus on developing culturally tailored, multimodal decision aids integrating paper and digital formats, establishing structured communication pathways that integrate these tools, and strengthening family-peer support while ensuring that autonomous decisions are aligned with patient values.Clinical trial number
Not applicable.