Family involvement in cancer treatment decision-making: A qualitative study of patient, family, and clinician attitudes and experiences. Issue 7 (July 2016)

• Record Type: Journal Article
• Authors: Laidsaar-Powell, Rebekah; Butow, Phyllis; Bu, Stella; Charles, Cathy; Gafni, Amiram; Fisher, Alana; Juraskova, Ilona
• Is Part Of: Patient education and counseling. Volume 99:Issue 7(2016)
• Page Start: 1146
• Page End: 1155
• Publication Date: 2016-07
• Subjects: Cancer -- Family caregivers -- Communication -- Decision-making -- Triadic -- Qualitative; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2016.01.014
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Family are often involved in decision-making- researching treatments, asking questions, being a sounding board. Family involvement in decision-making may start before, and continue after, the consultation. Family influence over the decision varies on a spectrum from passive to dominant. While family needs were considered important, the needs and preferences of the patient were paramount for most. Many factors may influence level of family involvement- patient, family, cultural, relationship, decisional. Abstract: Objective: Little is known about how family are involved in cancer treatment decision-making. This study aimed to qualitatively explore Australian oncology clinicians', patients', and family members' attitudes towards, and experiences of, family involvement in decision-making. Methods: Semi-structured interviews were conducted with 30 cancer patients, 33 family members, 10 oncology nurses and 11 oncologists. Framework analysis methods were used. Results: Three main themes were uncovered: (i) how family are involved in the decision-making process: specific behaviours of family across 5 (extended) decision-making stages; (ii) attitudes towards family involvement in the decision-making process: balancing patient authority with the rights of the family; and (iii) factors influencing family involvement: patient, family, cultural, relationship, and decision. Conclusion: This study highlighted many specific behaviours of family throughout the decision-making process, the complex participant attitudes toward retaining patient authority whilst including the family, and insight into influencing factors. These findings will inform a conceptual framework describing family involvement in decision-making. Practice implications: Clinicians could ascertain participant preferences and remain open to the varying forms of family involvement in decision-making. Given the important role of family in the decision-making process, family inclusive consultation strategies are needed.