Nguyen Thi Quyen, Le Thi Dung, Fan Sheng-Yu, Ke Li-Shan, Pham Thi Viet Huong, Kao Chi-Yin
Phenikaa University Hospital, Hanoi, Vietnam.
Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Psychooncology. 2025 Jun;34(6):e70185. doi: 10.1002/pon.70185.
Hematopoietic stem cell transplantation (HSCT) decisions for patients with hematologic malignancies are deeply intertwined with trust, doctor-patient communication, and interaction with family. Relational autonomy highlights how social relationships and cultural contexts influence patients' decisions, offering a crucial lens to understand this complex process.
To understand the decision-making experience of adult patients with hematologic malignancies in Vietnam regarding HSCT through the lens of relational autonomy.
Convenient and snowball sampling interviewed 22 adult patients diagnosed with hematologic malignancies who had accepted or refused HSCT. Online semi-structured interviews were conducted in Vietnam. Content analysis was applied to identify themes.
Three themes emerged: "coming to identify as a patient," "experiencing the influence of relational networks," and "hoping one's voice will be heard." Trust and communication with healthcare professionals, relationships with family members, and broader social networks were found to critically shape the decision-making process. Patients initiated their consideration of HSCT within a Vietnamese cultural framework while integrating external influences. Social networks profoundly affect patient autonomy, as patients continuously reflected on their views and engaged with others to maintain their final say in decisions. Participants' interpretation of their significant other's experiences supported and maintained their autonomy.
The HSCT decision-making process is shaped by the interplay of patients' personal experiences, trust, socio-cultural relationships, and surrounding support systems. Relational autonomy offers key insights into how patients use social networks and cultural backgrounds to navigate their treatment choices, emphasizing the importance of supportive environments that empower patients to make informed and autonomous decisions.
血液系统恶性肿瘤患者的造血干细胞移植（HSCT）决策与信任、医患沟通以及与家人的互动紧密相连。关系自主性凸显了社会关系和文化背景如何影响患者的决策，为理解这一复杂过程提供了关键视角。
通过关系自主性的视角，了解越南成年血液系统恶性肿瘤患者关于HSCT的决策经历。
采用便利抽样和滚雪球抽样法，对22名已接受或拒绝HSCT的成年血液系统恶性肿瘤确诊患者进行访谈。在越南进行在线半结构化访谈。应用内容分析法确定主题。
出现了三个主题：“开始认同自己为患者”“体验关系网络的影响”以及“希望自己的声音被听到”。发现与医疗保健专业人员的信任和沟通、与家庭成员的关系以及更广泛的社会网络对决策过程具有关键影响。患者在越南文化框架内开始考虑HSCT，同时融入外部影响。社会网络深刻影响患者的自主性，因为患者不断反思自己的观点并与他人互动，以在决策中保持最终话语权。参与者对其重要他人经历的解读支持并维护了他们的自主性。
HSCT决策过程受到患者个人经历、信任、社会文化关系和周围支持系统相互作用的影响。关系自主性为理解患者如何利用社会网络和文化背景来做出治疗选择提供了关键见解，强调了支持性环境的重要性，这种环境能使患者做出明智和自主的决策。
