Abstract Lung cancer treatment involves complex decision-making processes that require patients to be cognitively and emotionally prepared. While patient-centered communication (PCC) has been associated with improved cancer outcomes, its role in treatment preparedness, particularly among patients with lung cancer, and the influence of literacy remain underexplored. This study explored (1) the level of treatment preparedness among lung cancer patients and examined (2) the association between PCC and preparedness, and (3) whether literacy level moderates or explains this relationship. We conducted a cross-sectional survey among 200 adults who had been diagnosed with lung cancer within the past 3 years. Treatment preparedness was assessed across decision-making, treatment initiation, and engagement. PCC, health literacy, and digital literacy were measured using validated instruments. Logistic regression models examined associations between PCC and high preparedness, adjusting for sociodemographic and clinical factors. Interaction terms tested the moderation effects. Most participants were classified as highly prepared for cancer treatment (83.5%). PCC was strongly associated with high preparedness across all adjusted models (aOR = 48.19, 95% CI: 8.64–268.89, p < 0.001). Health literacy significantly moderated the association between PCC and preparedness ( p = 0.015), indicating that the impact of communication varied by literacy level. Digital literacy was independently associated with preparedness (aOR = 3.40, 95% CI: 1.37–8.45, p = 0.009) but did not moderate the PCC effect. Patient-centered communication is a central predictor of treatment preparedness among lung cancer patients. However, its effectiveness may depend on patients’ literacy. Literacy-sensitive communication strategies and digital support interventions may help ensure that patients with varying health and digital literacy levels are better prepared to understand, initiate, and engage in lung cancer treatment.
Elkefi et al. (2026) studied this question.