Immunotherapy Decision-Making Experiences of Patients With Cancer and Their Family Caregivers: A Qualitative Study

Patients with cancer and their families anticipate that innovative treatment options such as immunotherapy may improve survival and quality of life. Qualitative interviews have rarely been used to examine the immunotherapy-related decision-making experiences of cancer patients and their family caregivers.

This study was developed to explore the factors and reasons influencing the decisions of patients with cancer and their family caregivers to accept immunotherapy.

Between October 2019 and January 2021, data were collected using in-depth interviews that were conducted face-to-face in a semistructured format and audio-recorded. Content analysis was performed, and the Consolidated Criteria for Reporting Qualitative Research checklist was applied.

Fifteen patients with cancer in Taiwan who had received immunotherapy and 17 family caregivers were enrolled as participants. Three main themes were common among the considerations of patients and caregivers with regard to their decision-making to undergo immunotherapy. These included (a) putting decisions in the hands of health professionals, (b) the value of life surpasses all other considerations, and (c) practical considerations such as treatment side effects, financial burden, and the effects of immunotherapy.

The immunotherapy decision-making experiences of patients with cancer and their family caregivers in Taiwan were explored in this study. The generally low level of medical expertise identified among the participants emphasizes the importance of fostering a shared approach to immunotherapy decision-making. Also, oncology nurses should prioritize the inherent worth of patients and the emotions of their family caregivers to bolster their confidence and sense of self-worth. Notably, experiencing severe side effects with previous treatments was found to be a strong predictor of immunotherapy choice, highlighting the critical importance of regular assessment of patients' immunotherapy experiences in clinical practice. Also, financial concerns were confirmed as an important factor affecting patient-centered care. Thus, when needed, additional financial support should be provided.