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

摘要： 目的：分析妇科恶性肿瘤化疗患者参与中心静脉置管共享决策的阻碍及促进因素，旨在为临床护理实施共享决策，提高患者参与共享决策的积极性及满意度提供参考。方法：采用目的抽样法，选取 2024 年 10 月至 2025 年 2 月接受静脉化疗的 16 例妇 科恶性肿瘤患者为研究对象，采用质性研究中的现象学研究方法进行半结构式访谈。使用 Colaizzi 7 步分析法对访谈资料进行分析整理。结果：阻碍因素包括患者因素、决策过程因素、决策支持水平因素，其中决策自我效能低、健康素养不足、信息沟通障碍、决策偏好缺失、家庭支持不足、医疗资源限制阻碍患者参与共享决策。促进因素包括患者赋能共享决策、决策过程优化、优质的家庭与社会支持。结论：妇科恶性肿瘤化疗患者参与中心静脉置管决策受个人、医患互动及支持系统等多层面因素综合影响，临床实践中应关注患者决策心理与信息需求，通过结构化沟通主动探寻其偏好，并整合家庭与社区资源，构建“以患者为中心”的共享决策支持路径，提升决策质量与患者满意度。

关键词: 妇科恶性肿瘤患者, 化疗, 中心静脉置管, 共享决策