关键词: 妇科恶性肿瘤患者, 化疗, 中心静脉置管, 共享决策

Abstract: Objective: To analyze the barriers and facilitators of shared decision-making regarding central venous catheterization in patients undergoing chemotherapy for gynecological malignancies, aiming to provide a reference for the implementation of shared decision-making in clinical nursing and to enhance patients' willingness to participate and satisfaction with the shared decision-making process. Methods: Using purposive sampling, 16 patients with gynecological malignancies undergoing intravenous chemotherapy from October 2024 to February 2025 were selected as participants. Semi-structured interviews were conducted using a phenomenological approach within qualitative research. The interview data were analyzed and organized using the Colaizzi's 7-step analysis method. Results: Barriers to participation in shared decision-making included patient-related factors, decision process factors, and decision support level factors, namely low decision self-efficacy, inadequate health literacy, information communication obstacles, lack of decision preference, insufficient family support, and limited medical resources. Facilitators included patient empowerment in shared decision-making, optimization of the decision-making process, and strong family and social support. Conclusion: The participation of patients with gynecological malignancies undergoing chemotherapy in decision-making regarding central venous catheterization is influenced by multiple factors, including individual, patient-clinician interaction, and support system levels. In clinical practice, attention should be paid to patients' decision-making psychology and information needs. Structured communication should be employed to actively elicit their preferences, and family and community resources should be integrated to establish a patient-centered shared decision-making support pathway, thereby enhancing decision quality and patient satisfaction. 

Key words: Patients with gynecological malignancies, Chemotherapy, Central venous catheterization, Shared decision-making