JMIR Publications

ABSTRACT

Background:

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is employed as a preventive and therapeutic measure for abdominal metastasis following gastric cancer (GC) surgery. The determination of whether to administer HIPEC to GC patients typically occurs during the surgical procedure. As a result, family members frequently assume the role of surrogate decision-makers. The intricate nature of this process can exert an impact on the treatment decisions made on behalf of the patients.

Objective:

This study aimed to explore the real experience and influencing factors of family caregivers for surrogate decision-making regarding intraperitoneal HIPEC in patients with GC.

Methods:

The study adopted a qualitative approach using semistructured interviews, 15 family caregivers of patients with GC in a top-three hospital in Guangxi Province were selected as research objects through purposive sampling method. Participants were asked to comment on their experience of surrogate decision-making for HIPEC process, including motivations, difficulties, and decision-making methods. Colaizzi seven-step method was used to analyze and summarize the themes.

Results:

We extracted four themes as follows: (1) decision-information sources (decision-making information came from medical-care personnel, decision-making information came from the Internet, and decision-making information came from acquaintances); (2) barriers to decision making (financial burden and effects and side effects of treatment); (3) motivation in decision making (positive health beliefs and surrogate decision makers perceived responsibility); and (4) decision-making participation mode (doctor-led passive decision making and doctor–family sharing decision making).

Conclusions:

Hyperthermic intraperitoneal chemotherapy decision making by family caregivers of patients with GC is primarily passive decision making, and many obstacles and motivations are encountered in the process. Medical staff should share information and encourage and guide family caregivers to participate in the decision-making process through decision assistance or decision support. Clinical Trial: This study was a survey study, approved by the Ethics Committee of the First Affiliated Hospital of Guangxi Medical University (2024-E055-01).