Abstract: Background　The decision to place a peripherally inserted central catheter (PICC) in patients with cancer involves treatment benefits, potential risks, and subsequent maintenance burdens. However, stage-specific experiences during the decisionmaking process have not been systematically explored. Objective　To explore the experiences and problems in the decision-making process of PICC placement among patients with cancer based on patient journey mapping, and summarize nursing support priorities at different stages from the perspective of the American Association of Critical-Care Nurses (AACN) synergy model for patient care. Methods　A descriptive qualitative design was used. Using purposive sampling, patients with cancer who met the eligibility criteria and underwent PICC placement for the first-time were recruited from the Department of Oncology, Department of Hematology, and PICC Maintenance Clinic of Hainan Hospital of PLA General Hospital, from December 2025 to January 2026. Semi-structured interviews were conducted within 1 week after PICC placement. Framework analysis was used to analyze the data and construct a journey map of PICC placement decision-making. Results　A total of 15 patients with cancer were included, and 16 interviews were completed. The PICC placement decision-making journey comprised 3 phases: decision initiation, decision deliberation, and early post-placement adaptation. During the initiation phase, patients had limited knowledge of PICCs, experienced anxiety, helplessness, and concerns about bodily changes, and relied heavily on healthcare professionals when making decisions. During the deliberation phase, patients weighed the benefits, potential risks, and maintenance burden of PICC placement and sought additional information from different sources. During the early post-placement adaptation phase, their attention shifted to catheter maintenance, recognition of abnormal signs, and seeking professional assistance. Some patients reported that maintenance instructions lacked specificity and that their requests for help were not answered promptly. Two participants receiving care outside their home region additionally reported difficulties with travel for catheter maintenance, medical insurance reimbursement, and access to nearby professional services. Conclusion　The PICC placement decision-making journey among patients with cancer is characterized by phase-specific differences in tasks, emotional experiences, behaviors, and pain points. Nurses should tailor decision support and early post-placement care to each phase of the journey and patients' individual needs.