由于免疫治疗对于癌症患者来说是一种相对较新的治疗选择，因此在共同决策过程中可能会出现决策冲突。本研究的目的是探讨在免疫治疗联合化疗或靶向治疗下的癌症患者中，身体和心理症状的普遍性和严重程度以及参与共同决策过程中的努力与决策冲突之间的关系。本研究采用横断面调查研究设计，使用SURE版本的决策冲突量表来筛查癌症患者的决策冲突状态。同时，还评估了人口统计学和临床特征、身体症状和心理困扰以及参与共同决策过程中的努力等潜在因素与决策冲突的相关性。共调查了117名患者，体力状况良好、睡眠障碍、食欲不振和疼痛症状的患病率较高，严重程度为中度。瘙痒、皮疹、皮肤干燥和腹泻症状的患病率较低，严重程度为轻度。65.8%的患者报告存在不确定性，且属于轻度到中度。此外，97.4%的患者在共同决策过程中付出了一定的努力，平均努力程度为中等（均值：5.56±2.02）。64.1%的患者确定免疫治疗是最佳选择。年龄、不确定性和参与共同决策过程中的努力是与决策冲突相关的主要因素。我们观察到年龄较大的患者（年龄≥65岁）、不确定性程度较高和在共同决策过程中付出较少努力的患者报告了较高水平的决策冲突。未来的研究应该探讨年龄较大的患者对免疫治疗的决策需求。应设计干预措施来减少癌症患者的不确定性，并提高他们对免疫治疗的理解，以便他们在共同决策过程中付出更多努力。 © 2023. Springer Nature Limited.

Decisional conflict might occur during shared decision-making (SDM) because immunotherapy is a rather novel treatment option for patients with cancer. To explore the prevalence and severity of physical and psychological symptoms and the effort invested in SDM in relation to decisional conflict among patients with cancer undergoing immunotherapy combined with chemotherapy or targeted therapy. This was a cross-sectional survey study. The SURE version of the Decisional Conflict Scale was used to screen cancer patients' decisional conflict status. Demographic or clinical characteristics, physical symptoms and psychological distress; efforts invested in the SDM process were also assessed as potential factors related to decisional conflict. One hundred seventeen patients surveyed, the prevalence of fatigue (79.5%), sleep disturbance (78.6%), poor appetite (67.5%), and pain (58.1%) symptoms were high and the severity was at moderate levels. The prevalence of pruritus (40.2%), rash (34.2%), dry skin (41.9%), and diarrhea (17.1%) symptoms were low and the severity was at mild levels. 65.8% of patients reported uncertainty, with mild to moderate levels. Furthermore, 97.4% of the patients made some effort in SDM, and the effort level was moderate (mean: 5.56 ± 2.02). 64.1% of patients were certain that immunotherapy was the best option. Age, uncertainty, and effort in the SDM process were major factors related to decisional conflict. We observed that older patients (age: ≥ 65) and those with higher uncertainty levels and less effort in SDM reported higher levels of decisional conflict. Future studies should explore older patients' decisional related needs of immunotherapy. Interventions should be designed to reduce the uncertainty experienced by patients with cancer and enhance their understanding of immunotherapy to enable them to take more effort in the SDM process.© 2023. Springer Nature Limited.