Construction of Customized Personas for Decision-Making Cognition Regarding Oral Microbiota Transplantation in Head and Neck Cancer Patients Undergoing Radiotherapy: A Qualitative Study.

Background: Patients with head and neck cancer who are undergoing radiotherapy frequently suffer from oral mucositis and oral microecological disorders, which severely impair their quality of life. Oral microbiota transplantation is an emerging oral microecological intervention that offers a novel approach for reconstructing oral microecological balance and relieving mucositis. However, regarding this innovative therapy, there is a paucity of in-depth research into patients' decision-making cognition, and existing evidence is insufficient to support individualized clinical decision-making guidance. Methods: A descriptive qualitative research design was employed. From July to December 2025, patients diagnosed with head and neck cancer undergoing radiotherapy were recruited from a tertiary hospital in Shanghai via purposive sampling. The data were collected through semi-structured interviews and analyzed using Colaizzi's seven-step analysis method. The user label system was refined and summarized to construct user portraits. These portraits were visualized in the form of WordArt word clouds and character labels. Results: A total of 21 eligible patients with head and neck cancer undergoing radiotherapy participated in the study. The construct of decision-making cognition encompasses five dimensions: treatment prioritization, information needs, health literacy, psychological status, and decision quality. The patients were categorized into four types: proactive participation, passive dependence, weigh carefully, and symptom-driven. These classifications reflect the cognitive characteristics and group differences regarding the Oral Microbiota Transplantation decision-making process among different patients. Conclusions: Patients exhibit considerable variability in their decision-making cognition regarding the innovative OMT therapy. This phenomenon can be categorized into four distinct persona types, which, respectively, reflect unique information processing styles, risk assessments, and behavioral coping strategies when patients encounter novel therapeutic interventions. This typology provides a theoretical foundation for individualized clinical decision support, delineates targets for the formulation of targeted communication strategies, and ultimately enhances patient decision quality and treatment adherence.