AbstractObjective The aim of this study is to investigate the potential profile of decision-making conflicts in early-stage non-small cell lung cancer (NSCLC) patients, and to explore the mediating role of financial toxicity between psychological resilience and decision-making conflicts. Methods A cross-sectional survey was conducted to analyze 310 patients with early-stage NSCLC who visited a tertiary Grade A oncology hospital in Beijing, China from August 2023 to April 2024. General information questionnaires, the Cancer Specific Resilience Scale (RS-SC), the Decision Conflict Scale (DCS), and the COST-PROM were collected. Results Decision conflict among early-stage NSCLC patients was classified into three subgroups: 44.5% of patients exhibited low decision conflict (mean score 10.97 ± 1.73), 30.3% exhibited moderate decision conflict (mean score 18.21 ± 2.89), and 25.2% exhibited high decision conflict (mean score 23.90 ± 3.31). Independent factors associated with decision conflict included lower education level, lower monthly income, unemployment, and participation in the New Rural Cooperative Medical Insurance (all P β = -0.162, P = 0.004), as was the indirect effect through financial toxicity (β = -0.041, P = 0.017). Financial toxicity accounted for 18.1% of the total mediation effect. Conclusions Early-stage NSCLC experience varying degrees of decision conflict. Financial toxicity plays a partial mediating role between psychological resilience and decision conflict. Interventions aimed at reducing financial toxicity may improve psychological resilience and reduce decision conflict in these patients.
Liu et al. (Sun,) studied this question.