{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:06:47Z","timestamp":1782846407026,"version":"3.54.5"},"reference-count":50,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Cancer"],"abstract":"\n Background<\/jats:title>\n Hyperthermic intraperitoneal chemotherapy (HIPEC) has been integrated into the management of gastric cancer (GC) as a combined approach for addressing peritoneal metastasis, serving both prophylactic and therapeutic roles following GC surgery. The pivotal decision regarding HIPEC administration typically arises intraoperatively, creating a complex clinical scenario where family caregivers must act as surrogate decision-makers under substantial time constraints. This decision-making process proves particularly challenging due to limited understanding of the procedure\u2019s risk-benefit profile and long-term outcomes among nonmedical surrogates, challenges often exacerbated by the acute stress of the surgical environment.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This qualitative study aims to explore how family caregivers of patients with GC navigate the HIPEC decision-making process, specifically examining the facilitators, challenges, and the role of information acquisition that shape the shared decision-making mode.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This study adopted a qualitative approach using semistructured interviews; 15 family caregivers of patients with GC in a major tertiary hospital in Guangxi Province were selected as research objects through a purposive sampling method. Participants were asked to comment on their experience of surrogate decision-making for the HIPEC process. The Colaizzi 7-step method was used to analyze and summarize the themes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The mean age of the 15 participants was 39.8\u00a0(SD 13.29, range 20-68) years, and all patients were on average aged 56.7 (SD 10.78, range 36-74) years. The relationship to the patient was distributed as follows: 33% (5\/15) spouses, 60% (9\/15) children, and 6% (1\/15) other relatives. Four major themes emerged from the data analysis: (1) shared decision-making participation mode (doctor-led passive decision-making and doctor-family shared decision-making); (2) decision-information sources (decision-making information came from medical-care personnel, decision-making information came from the internet, and decision-making information came from acquaintances); (3) challenges in the decision-making process (financial burden and anticipated therapeutic efficacy); and (4) facilitator in the decision-making process (positive health beliefs and cultural dimensions of perceived responsibility: a Confucian perspective).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n HIPEC decision-making by family caregivers of patients with GC was primarily passive decision-making, and many obstacles and facilitators were encountered in the process. Medical staff should share information and encourage and guide family caregivers to participate in the decision-making process through decision assistance or decision support.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/80471","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T12:05:08Z","timestamp":1768824308000},"page":"e80471","source":"Crossref","is-referenced-by-count":0,"title":["Surrogate Decision-Making by Family Caregivers for Hyperthermic Intraperitoneal Chemotherapy in Gastric Cancer: Qualitative Study in a High-Volume Chinese 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