Decision-making among adolescents and young adults with cancer (AYA) is often complex, ongoing, and multifaceted, involving caregiver and oncology provider perspectives. Engagement in decision-making against the backdrop of normative developmental processes of acquiring autonomy and gaining independence contributes to the complexity of decision-making. Semi-structured qualitative interviews from 11 AYA and caregiver dyads and eight oncology providers examined decision-making processes with specific attention to the role of shared decision-making, cognitive and emotional processes, and coping with the decision-making experience. Five decision-making patterns were identified, with collaborative decision-making and AYA-driven decisions most commonly described. Utilizing hypothesis coding, AYA and caregivers explained how cognitive (i.e., pros/cons) and emotional (i.e., shock and fear of missing out) processes influenced cancer-related decisions. Coping strategies provided clarity and respite when engaged in decision-making. Our findings illuminate important implications for how to best support decision-making among AYA and caregivers, including the role oncology providers can play during decision-making.

患有癌症 (AYA) 的青少年和年轻成人的决策通常是复杂的、持续的和多方面的，涉及护理人员和肿瘤学提供者的观点。在获得自主权和获得独立性的规范发展过程的背景下参与决策会导致决策的复杂性。来自 11 名 AYA 和护理人员二人组以及 8 名肿瘤学提供者的半结构化定性访谈检查了决策过程，特别关注共享决策、认知和情感过程的作用，以及应对决策经验。确定了五种决策模式，包括协作决策和AYA 驱动的决策最常被描述。利用假设编码，AYA 和护理人员解释了认知（即利弊）和情感（即震惊和害怕错过）过程如何影响与癌症相关的决定。在参与决策时，应对策略提供了清晰和喘息的机会。我们的研究结果阐明了如何最好地支持 AYA 和护理人员之间的决策制定的重要意义，包括肿瘤学提供者在决策制定过程中可以发挥的作用。