{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:56:22Z","timestamp":1791262582152,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Discontinuation of treatment by cancer patients is a complex decision driven by many factors that are not yet fully understood. Using a qualitative approach is the best way to explore this complexity in greater depth. Therefore, this study aimed to explore and synthesize the factors that influence the decision\u2010making of cancer patients regarding withdrawal from treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a qualitative systematic review and meta\u2010synthesis, conducted using the six\u2010step meta\u2010synthesis method developed by Sandelowski and Barroso in 2007. Initially, a comprehensive systematic search was conducted in PubMed, Web of Science, Scopus, and CINAHL to identify relevant studies published between 2000 and 2024 according to our inclusion criteria. Subsequently, conventional content analysis was used to analyze the data extracted from qualitative studies. Initially, 348 studies were retrieved, and after screening, 18 studies were included in the meta\u2010synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 177 primary codes, one main theme, two categories (endogenous and exogenous factors), and eight sub\u2010categories were extracted through the meta\u2010synthesis process. The factors affecting withdrawal from treatment were: \u201cfinancial and insurance challenges,\u201d \u201cthe communication role of the healthcare team,\u201d \u201ccultural and social factors,\u201d \u201cspiritual and religious beliefs,\u201d \u201cfamily functioning,\u201d \u201cpersonal attributes,\u201d \u201cthe role of emotions,\u201d and \u201cmedication side effects.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The decision to withdraw from treatment is a multifaceted process influenced by personal values, clinical considerations, and social dynamics. A deeper understanding of these factors enables healthcare providers, especially nurses, to design better support programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72219","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T04:20:39Z","timestamp":1789791639000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Why Do Cancer Patients Decide to Withdraw Their Treatment? A Systematic Review and Meta\u2010Synthesis"],"prefix":"10.1002","volume":"15","author":[{"given":"Faezeh","family":"Abadi","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Nursing, School of Nursing and Midwifery Fasa University of Medical Sciences  Fasa Fars Iran"},{"name":"Department of Medical and Surgical Nursing, School of Nursing and Midwifery Kerman University of Medical Sciences  Kerman Kerman Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1906-4146","authenticated-orcid":false,"given":"Esmat","family":"Nouhi","sequence":"additional","affiliation":[{"name":"Nursing Research Centre Kerman University of Medical Sciences  Kerman Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7990-662X","authenticated-orcid":false,"given":"Mostafa","family":"Bijani","sequence":"additional","affiliation":[{"name":"Department of Medical\u2010Surgical Nursing, School of Nursing Fasa University of Medical Sciences  Fasa Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6456-6586","authenticated-orcid":false,"given":"Camelia","family":"Rohani","sequence":"additional","affiliation":[{"name":"Independent Researcher  Stockholm Sweden"},{"name":"Department of Community Health Nursing, School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-023-01132-5"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.09.075"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-024-08975-5"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.1744"},{"key":"e_1_2_13_7_1","volume-title":"National Cancer Control Programmes: Policies and Managerial Guidelines","author":"Organization WH","year":"2002"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0831"},{"key":"e_1_2_13_9_1","volume-title":"The ICN Code of Ethics","author":"ICo N","year":"2012"},{"key":"e_1_2_13_10_1","unstructured":"J.Lennon \u201cPatients Who Decide to Forgo Breast Cancer Treatment: Perspectives and Experiences of Cancer Professionals \u201d2023 University of East London."},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.10.025"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.obhdp.2016.05.003"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-015-1231-8"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3571"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216315583032"},{"key":"e_1_2_13_16_1","first-page":"106","volume-title":"Understanding Ethics for Nursing Students","author":"Ellis P.","year":"2017"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-8-45"},{"issue":"3","key":"e_1_2_13_18_1","first-page":"695","article-title":"Meta\u2010Synthesis of Qualitative Research: The Challenges and Opportunities","volume":"38","author":"Mohammed M. 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