ArticleAsia-Pacific journal of oncology nursing2026
The "good cancer" paradox: Decisional conflict and unmet support needs in patients with thyroid cancer facing surgical decisions-A mixed-methods study.
Article in Asia-Pacific journal of oncology nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To assess decisional conflict levels and predictors among patients with differentiated thyroid cancer (DTC) choosing between open and endoscopic thyroidectomy, and to explore their decision-making experiences and decisional support needs. Methods: A convergent parallel mixed-methods design guided by the Ottawa Decision Support Framework was employed at three tertiary hospitals in China (June 2024-June 2025). The quantitative strand surveyed 696 patients using the Decisional Conflict Scale (DCS) and Control Preferences Scale. The qualitative strand comprised semi-structured interviews with 22 purposively sampled patients, analyzed using reflexive thematic analysis. Data were integrated through joint display and meta-inference. Results: Over half of participants (57.9%) experienced clinically significant decisional conflict (DCS > 37.5). Lower income ( Conclusions: Patients with DTC experience substantial decisional conflict when choosing between surgical approaches. Decision support interventions, particularly nurse-led decision coaching, should address socioeconomic barriers, assess decisional readiness beyond stated preferences, and validate patients' concerns rather than inadvertently dismissing them through prognostic reassurance.
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