Research status and progress on health behavior decision-making in patients with liver cancer_West China Medical Journal

Authors：

JIANG Yujun , GUO Wenxi , LIU Xi ,  WANG Xiaolin

Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China;

Corresponding?author：

WANG Xiaolin, Email: 300696@cqmu.edu.cn

Keywords：

Liver cancer; health behavior decision-making; decision-making need; nursing

DOI：

10.7507/1002-0179.202603019

Video：

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Abstract Full text Figures/Tables Video References Cited by

Health behavior decision-making in patients with liver cancer extends throughout the entire process of disease diagnosis, treatment, and rehabilitation management and is influenced by multiple factors. This review summarizes the research progress in health behavior decision-making in patients with liver cancer, with a particular focus on their participation in decision-making and the current status of health behavior decision-making during disease diagnosis, treatment selection, and health management after interventional therapy. The main influencing factors are summarized in terms of disease-related factors, disease cognition, social support, and educational level. This review aims to provide a reference for clinical healthcare professionals to identify patients’ decision-making needs and implement targeted decision support and health behavior interventions, thereby promoting positive health behavior decision-making and improving patients’ quality of life.

Citation： JIANG Yujun, GUO Wenxi, LIU Xi, WANG Xiaolin. Research status and progress on health behavior decision-making in patients with liver cancer. West China Medical Journal, 2026, 41(9): 1554-1558. doi: 10.7507/1002-0179.202603019 Copy

1.	Rumgay H, Arnold M, Ferlay J, et al. Global burden of primary liver cancer in 2020 and predictions to 2040[J]. J Hepatol, 2022, 77(6): 1598-1606.
2.	謝雅瑞. 基于健康行為過程取向模型原發性肝癌切除術患者出院計劃方案的構建與應用[D]. 廣州: 南方醫科大學, 2023.
3.	余偉, 黃長山, 王謙, 等. 術前改善 ICGR15 對肝癌術后并發癥及近期肝功能的影響[J]. 中國普通外科雜志, 2021, 30(8): 949-954.
4.	Kim MS, Kang M, Park J, et al. Nurses’ comfort care of transarterial chemoembolization patients based on their perceptions around postembolization syndrome and symptom interference[J]. Nurs Open, 2023, 10(5): 2877-2885.
5.	W?rns MA, Burns D, Paskow M, et al. Patient experience of hepatocellular carcinoma and their treatment goals: an international qualitative study and patient journey map[J]. Adv Ther, 2024, 41(9): 3598-3614.
6.	Punnett G, Eastwood C, Green L, et al. A systematic review of the effectiveness of decision making interventions on increasing perceptions of shared decision making occurring in advanced cancer consultations[J]. Patient Educ Couns, 2024, 123: 108235.
7.	Ritaccio G, Barritt Iv AS, Conklin JL, et al. Scoping review of values elicitation tools for treatment decisions in hepatocellular carcinoma[J]. BMC Gastroenterol, 2024, 24(1): 90.
8.	Liao YL, Wang TJ, Su CW, et al. Efficacy of a decision support intervention on decisional conflict related to hepatocellular cancer treatment: a randomized controlled trial[J]. Clin Nurs Res, 2023, 32(1): 233-243.
9.	繆愛云. 我國癌癥病人就醫延遲現狀研究的文獻分析[J]. 循證護理, 2021, 7(3): 382-385.
10.	Zheng J, Wang S, Xia L, et al. Hepatocellular carcinoma: signaling pathways and therapeutic advances[J]. Signal Transduct Target Ther, 2025, 10(1): 35.
11.	Wolf E, Rich NE, Marrero JA, et al. Use of hepatocellular carcinoma surveillance in patients with cirrhosis: a systematic review and meta-analysis[J]. Hepatology, 2021, 73(2): 713-725.
12.	石菊芳, 曹夢迪, 嚴鑫鑫, 等. 肝癌篩查在我國人群中的可及性: 一項探索性分析[J]. 中華流行病學雜志, 2022, 43(6): 906-914.
13.	Feng GH, Liu M, Chen YS, et al. Knowledge, attitudes, and practices of liver cancer screening among high-risk populations in China[J]. BMC Public Health, 2025, 25(1): 2346.
14.	Moon AM, Richardson D, Lupu GV, et al. Exploring the role of patient preferences in hepatocellular carcinoma treatment decisions: a qualitative study[J]. MDM Policy Pract, 2025, 10(1): 23814683251340055.
15.	Singh JA, Sloan JA, Atherton PJ, et al. Preferred roles in treatment decision making among patients with cancer: a pooled analysis of studies using the Control Preferences Scale[J]. Am J Manag Care, 2010, 16(9): 688-696.
16.	朱行策, 劉智勇, 董鐘昕, 等. 我國慢性病患者決策參與影響因素質性研究的系統評價[J]. 護理學雜志, 2022, 37(9): 10-16.
17.	王思潼, 葉志霞, 李蕓蕓, 等. 中文版決策自我效能量表在原發性肝癌患者治療決策中的信效度檢驗[J]. 解放軍護理雜志, 2021, 38(1): 37-40, 64.
18.	王思潼, 葉志霞, 潘澤亞, 等. 原發性肝癌患者治療決策輔助平臺設計[J]. 解放軍醫院管理雜志, 2021, 28(2): 129-133.
19.	劉紹平, 羅漢傳, 林書瀚, 等. 中晚期肝細胞癌介入及系統治療的現狀與研究進展[J]. 國際腫瘤學雜志, 2023, 50(12): 758-762.
20.	胡茂娟, 嚴穎琦, 吳琛, 等. 肝癌術后患者心理彈性水平調查及與生存質量、應對方式和創傷后成長的相關性分析[J]. 現代生物醫學進展, 2021, 21(20): 3888-3892.
21.	武慧娟, 崔菲. 原發性肝癌介入治療患者習得性無助感調查、影響因素及護理對策分析[J]. 臨床研究, 2024, 32(8): 184-187.
22.	Pathomjaruwat T, Matchim Y, Armer JM. Health-related quality of life in Thai patients with hepatocellular carcinoma and its influencing factors: a cross-sectional study[J]. Belitung Nurs J, 2025, 11(4): 370-383.
23.	Tsumura S, Shimose S, Niizeki T, et al. Telephone follow-up contributes to improving adherence and treatment duration in patients with hepatocellular carcinoma treated with lenvatinib[J]. J Gastroenterol Hepatol, 2023, 38(7): 1140-1147.
24.	Serper M, Parikh ND, Thiele G, et al. Patient-reported outcomes in HCC: a scoping review by the Practice Metrics Committee of the American Association for the study of liver diseases[J]. Hepatology, 2022, 76(1): 251-274.
25.	周小英, 張雯, 張巖, 等. 原發性肝癌介入手術病人自我管理效能感的影響因素分析[J]. 護理研究, 2022, 36(10): 1857-1860.
26.	劉桐, 孟郭瑞, 馬世輝, 等. 乙型肝炎相關性肝癌抗病毒治療研究進展[J]. 中華轉移性腫瘤雜志, 2024, 7(4): 399-403.
27.	張昌英, 劉進, 何妙芬, 等. 全人健康視角下癌癥患者需求特點分析及對醫務社工介入的啟示——以上海市 M 醫院為例[J]. 現代醫院, 2023, 23(3): 464-467, 471.
28.	陳化. 知情同意臨床實踐的倫理隱憂及其消解[J]. 醫學與哲學, 2024, 45(20): 11-16.
29.	Pietrzykowski T, Smilowska K. The reality of informed consent: empirical studies on patient comprehension-systematic review[J]. Trials, 2021, 22(1): 57.
30.	程洋, 蒲叢珊, 伊靜, 等. 肝癌患者 TACE 術后恐懼疾病進展與社會支持和心理彈性的調查研究[J]. 重慶醫學, 2020, 49(11): 1846-1849, 1854.
31.	Wang S, Lu Q, Ye Z, et al. Effects of a smartphone application named “shared decision making assistant” for informed patients with primary liver cancer in decision-making in China: a quasi-experimental study[J]. BMC Med Inform Decis Mak, 2022, 22(1): 145.
32.	Liu S, Xie Y, Li T, et al. Social support, quality of life, and financial toxicity among patients with hepatocellular carcinoma[J]. J Hepatocell Carcinoma, 2025, 12: 1711-1723.
33.	陳麗容. 肝癌經導管肝動脈化療栓塞術后病人自我護理能力的研究進展[J]. 全科護理, 2023, 21(10): 1361-1364.
34.	唐遠清, 高碧瑤, 韓曄. 國內外健康教育核心信息的理念及其實踐[J]. 中國健康教育, 2023, 39(6): 483-487, 508.
35.	Kelly D, Fernández-Ortega P, Arjona ET, et al. The role of nursing in the management of patients with renal and hepatic cancers: a systematic literature review[J]. Eur J Oncol Nurs, 2021, 55: 102043.
36.	Fernando A, Tokell M, Ishak Y, et al. Mental health needs in cancer - a call for change[J]. Future Healthc J, 2023, 10(2): 112-116.
37.	Chang WH, Lai AG. Cumulative burden of psychiatric disorders and self-harm across 26 adult cancers[J]. Nat Med, 2022, 28(4): 860-870.
38.	孫青, 李國宏, 金曉靈, 等. 肝癌行免疫治療患者延續護理需求的質性研究[J]. 護理學雜志, 2024, 39(16): 34-37, 46.
39.	朱利君, 谷坤坤, 廖小娟. 正念接納承諾理論指導下心理干預對原發性肝癌介入治療患者的影響[J]. 齊魯護理雜志, 2023, 29(5): 21-24.
40.	劉威, 胡婷婷. 早期積極心理干預對晚期肝癌患者癌因性疲乏及生活質量的影響[J]. 臨床醫學工程, 2022, 29(12): 1731-1732.
41.	Grignoli N, Manoni G, Gianini J, et al. Clinical decision fatigue: a systematic and scoping review with meta-synthesis[J]. Fam Med Community Health, 2025, 13(1): e003033.
42.	Lopez-Fernandez O, Aguilar Castillo CP, Horrillo B, et al. The implementation of shared decision-making using patient decision aid tools to select breast cancer treatment options: a systematic review in the time of minimum quality standards[J]. Healthcare (Basel), 2025, 13(7): 748.
43.	Ter Stege JA, Woerdeman LAE, Hahn DEE, et al. The impact of an online patient decision aid for women with breast cancer considering immediate breast reconstruction: study protocol of a multicenter randomized controlled trial[J]. BMC Med Inform Decis Mak, 2019, 19(1): 165.
44.	Robertson EG, Wakefield CE, Cohn RJ, et al. Piloting a parent and patient decision aid to support clinical trial decision making in childhood cancer[J]. Psychooncology, 2019, 28(7): 1520-1529.
45.	王思潼. 移動醫療下原發性肝癌患者治療決策輔助平臺的構建與應用研究[D]. 上海: 中國人民解放軍海軍軍醫大學, 2021.
46.	馬蘭花. 階梯護理決策輔助對提高肝癌患者腸內營養依從性的作用[J]. 青海醫藥雜志, 2021, 51(1): 29-32.
47.	房鈺, 郝媛媛, 張晨, 等. 癌癥患者決策疲勞的研究進展及護理啟示[J]. 中華護理雜志, 2024, 59(8): 941-946.

1. Rumgay H, Arnold M, Ferlay J, et al. Global burden of primary liver cancer in 2020 and predictions to 2040[J]. J Hepatol, 2022, 77(6): 1598-1606.
2. 謝雅瑞. 基于健康行為過程取向模型原發性肝癌切除術患者出院計劃方案的構建與應用[D]. 廣州: 南方醫科大學, 2023.
3. 余偉, 黃長山, 王謙, 等. 術前改善 ICGR15 對肝癌術后并發癥及近期肝功能的影響[J]. 中國普通外科雜志, 2021, 30(8): 949-954.
4. Kim MS, Kang M, Park J, et al. Nurses’ comfort care of transarterial chemoembolization patients based on their perceptions around postembolization syndrome and symptom interference[J]. Nurs Open, 2023, 10(5): 2877-2885.
5. W?rns MA, Burns D, Paskow M, et al. Patient experience of hepatocellular carcinoma and their treatment goals: an international qualitative study and patient journey map[J]. Adv Ther, 2024, 41(9): 3598-3614.
6. Punnett G, Eastwood C, Green L, et al. A systematic review of the effectiveness of decision making interventions on increasing perceptions of shared decision making occurring in advanced cancer consultations[J]. Patient Educ Couns, 2024, 123: 108235.
7. Ritaccio G, Barritt Iv AS, Conklin JL, et al. Scoping review of values elicitation tools for treatment decisions in hepatocellular carcinoma[J]. BMC Gastroenterol, 2024, 24(1): 90.
8. Liao YL, Wang TJ, Su CW, et al. Efficacy of a decision support intervention on decisional conflict related to hepatocellular cancer treatment: a randomized controlled trial[J]. Clin Nurs Res, 2023, 32(1): 233-243.
9. 繆愛云. 我國癌癥病人就醫延遲現狀研究的文獻分析[J]. 循證護理, 2021, 7(3): 382-385.
10. Zheng J, Wang S, Xia L, et al. Hepatocellular carcinoma: signaling pathways and therapeutic advances[J]. Signal Transduct Target Ther, 2025, 10(1): 35.
11. Wolf E, Rich NE, Marrero JA, et al. Use of hepatocellular carcinoma surveillance in patients with cirrhosis: a systematic review and meta-analysis[J]. Hepatology, 2021, 73(2): 713-725.
12. 石菊芳, 曹夢迪, 嚴鑫鑫, 等. 肝癌篩查在我國人群中的可及性: 一項探索性分析[J]. 中華流行病學雜志, 2022, 43(6): 906-914.
13. Feng GH, Liu M, Chen YS, et al. Knowledge, attitudes, and practices of liver cancer screening among high-risk populations in China[J]. BMC Public Health, 2025, 25(1): 2346.
14. Moon AM, Richardson D, Lupu GV, et al. Exploring the role of patient preferences in hepatocellular carcinoma treatment decisions: a qualitative study[J]. MDM Policy Pract, 2025, 10(1): 23814683251340055.
15. Singh JA, Sloan JA, Atherton PJ, et al. Preferred roles in treatment decision making among patients with cancer: a pooled analysis of studies using the Control Preferences Scale[J]. Am J Manag Care, 2010, 16(9): 688-696.
16. 朱行策, 劉智勇, 董鐘昕, 等. 我國慢性病患者決策參與影響因素質性研究的系統評價[J]. 護理學雜志, 2022, 37(9): 10-16.
17. 王思潼, 葉志霞, 李蕓蕓, 等. 中文版決策自我效能量表在原發性肝癌患者治療決策中的信效度檢驗[J]. 解放軍護理雜志, 2021, 38(1): 37-40, 64.
18. 王思潼, 葉志霞, 潘澤亞, 等. 原發性肝癌患者治療決策輔助平臺設計[J]. 解放軍醫院管理雜志, 2021, 28(2): 129-133.
19. 劉紹平, 羅漢傳, 林書瀚, 等. 中晚期肝細胞癌介入及系統治療的現狀與研究進展[J]. 國際腫瘤學雜志, 2023, 50(12): 758-762.
20. 胡茂娟, 嚴穎琦, 吳琛, 等. 肝癌術后患者心理彈性水平調查及與生存質量、應對方式和創傷后成長的相關性分析[J]. 現代生物醫學進展, 2021, 21(20): 3888-3892.
21. 武慧娟, 崔菲. 原發性肝癌介入治療患者習得性無助感調查、影響因素及護理對策分析[J]. 臨床研究, 2024, 32(8): 184-187.
22. Pathomjaruwat T, Matchim Y, Armer JM. Health-related quality of life in Thai patients with hepatocellular carcinoma and its influencing factors: a cross-sectional study[J]. Belitung Nurs J, 2025, 11(4): 370-383.
23. Tsumura S, Shimose S, Niizeki T, et al. Telephone follow-up contributes to improving adherence and treatment duration in patients with hepatocellular carcinoma treated with lenvatinib[J]. J Gastroenterol Hepatol, 2023, 38(7): 1140-1147.
24. Serper M, Parikh ND, Thiele G, et al. Patient-reported outcomes in HCC: a scoping review by the Practice Metrics Committee of the American Association for the study of liver diseases[J]. Hepatology, 2022, 76(1): 251-274.
25. 周小英, 張雯, 張巖, 等. 原發性肝癌介入手術病人自我管理效能感的影響因素分析[J]. 護理研究, 2022, 36(10): 1857-1860.
26. 劉桐, 孟郭瑞, 馬世輝, 等. 乙型肝炎相關性肝癌抗病毒治療研究進展[J]. 中華轉移性腫瘤雜志, 2024, 7(4): 399-403.
27. 張昌英, 劉進, 何妙芬, 等. 全人健康視角下癌癥患者需求特點分析及對醫務社工介入的啟示——以上海市 M 醫院為例[J]. 現代醫院, 2023, 23(3): 464-467, 471.
28. 陳化. 知情同意臨床實踐的倫理隱憂及其消解[J]. 醫學與哲學, 2024, 45(20): 11-16.
29. Pietrzykowski T, Smilowska K. The reality of informed consent: empirical studies on patient comprehension-systematic review[J]. Trials, 2021, 22(1): 57.
30. 程洋, 蒲叢珊, 伊靜, 等. 肝癌患者 TACE 術后恐懼疾病進展與社會支持和心理彈性的調查研究[J]. 重慶醫學, 2020, 49(11): 1846-1849, 1854.
31. Wang S, Lu Q, Ye Z, et al. Effects of a smartphone application named “shared decision making assistant” for informed patients with primary liver cancer in decision-making in China: a quasi-experimental study[J]. BMC Med Inform Decis Mak, 2022, 22(1): 145.
32. Liu S, Xie Y, Li T, et al. Social support, quality of life, and financial toxicity among patients with hepatocellular carcinoma[J]. J Hepatocell Carcinoma, 2025, 12: 1711-1723.
33. 陳麗容. 肝癌經導管肝動脈化療栓塞術后病人自我護理能力的研究進展[J]. 全科護理, 2023, 21(10): 1361-1364.
34. 唐遠清, 高碧瑤, 韓曄. 國內外健康教育核心信息的理念及其實踐[J]. 中國健康教育, 2023, 39(6): 483-487, 508.
35. Kelly D, Fernández-Ortega P, Arjona ET, et al. The role of nursing in the management of patients with renal and hepatic cancers: a systematic literature review[J]. Eur J Oncol Nurs, 2021, 55: 102043.
36. Fernando A, Tokell M, Ishak Y, et al. Mental health needs in cancer - a call for change[J]. Future Healthc J, 2023, 10(2): 112-116.
37. Chang WH, Lai AG. Cumulative burden of psychiatric disorders and self-harm across 26 adult cancers[J]. Nat Med, 2022, 28(4): 860-870.
38. 孫青, 李國宏, 金曉靈, 等. 肝癌行免疫治療患者延續護理需求的質性研究[J]. 護理學雜志, 2024, 39(16): 34-37, 46.
39. 朱利君, 谷坤坤, 廖小娟. 正念接納承諾理論指導下心理干預對原發性肝癌介入治療患者的影響[J]. 齊魯護理雜志, 2023, 29(5): 21-24.
40. 劉威, 胡婷婷. 早期積極心理干預對晚期肝癌患者癌因性疲乏及生活質量的影響[J]. 臨床醫學工程, 2022, 29(12): 1731-1732.
41. Grignoli N, Manoni G, Gianini J, et al. Clinical decision fatigue: a systematic and scoping review with meta-synthesis[J]. Fam Med Community Health, 2025, 13(1): e003033.
42. Lopez-Fernandez O, Aguilar Castillo CP, Horrillo B, et al. The implementation of shared decision-making using patient decision aid tools to select breast cancer treatment options: a systematic review in the time of minimum quality standards[J]. Healthcare (Basel), 2025, 13(7): 748.
43. Ter Stege JA, Woerdeman LAE, Hahn DEE, et al. The impact of an online patient decision aid for women with breast cancer considering immediate breast reconstruction: study protocol of a multicenter randomized controlled trial[J]. BMC Med Inform Decis Mak, 2019, 19(1): 165.
44. Robertson EG, Wakefield CE, Cohn RJ, et al. Piloting a parent and patient decision aid to support clinical trial decision making in childhood cancer[J]. Psychooncology, 2019, 28(7): 1520-1529.
45. 王思潼. 移動醫療下原發性肝癌患者治療決策輔助平臺的構建與應用研究[D]. 上海: 中國人民解放軍海軍軍醫大學, 2021.
46. 馬蘭花. 階梯護理決策輔助對提高肝癌患者腸內營養依從性的作用[J]. 青海醫藥雜志, 2021, 51(1): 29-32.
47. 房鈺, 郝媛媛, 張晨, 等. 癌癥患者決策疲勞的研究進展及護理啟示[J]. 中華護理雜志, 2024, 59(8): 941-946.

West China Medical Journal

Research status and progress on health behavior decision-making in patients with liver cancer

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