Triadic treatment decision-making in advanced cancer: a pilot study of the roles and perceptions of patients, caregivers, and oncologists

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Thomas W LeBlancJames A Tulsky

Abstract

The research on cancer treatment decision-making focuses on dyads; the full "triad" of patients, oncologists, and caregivers remains largely unstudied. We investigated how all members of this triad perceive and experience decisions related to treatment for advanced cancer. At an academic cancer center, we enrolled adult patients with advanced gastrointestinal or hematological malignancies, their caregivers, and their oncologists. Triad members completed a semi-structured qualitative interview and a survey measuring decisional conflict and perceived influence of the other triad members on treatment decisions. Seventeen patients, 14 caregivers, and 10 oncologists completed the study. Patients and caregivers reported little decisional regret and voiced high satisfaction with their decisions, but levels of decisional conflict were high. We found sizeable disagreement among triad members' perceptions and preferences. For example, patients and oncologists disagreed about the caregiver's influence on the decision 56% of the time. In addition, many patients and caregivers preferred to defer to their oncologist about treatment decisions, felt like no true decision existed, and disagreed with their oncologist about how many treatment opt...Continue Reading

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Citations

Jul 10, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Ashley Odai-AfoteyTara Sanft
Jan 5, 2020·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Amy W AnPaul R Duberstein
Jun 12, 2020·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Hélène ElidorFrance Légaré
Oct 1, 2020·Journal of Palliative Medicine·Tamryn F GrayAreej El-Jawahri
Oct 23, 2020·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Hélène ElidorFrance Légaré
Nov 23, 2019·Seminars in Oncology Nursing·J Nicholas Dionne-OdomAbby R Rosenberg
Feb 20, 2021·Scandinavian Journal of Caring Sciences·Trine A GregersenJette Ammentorp
May 21, 2021·European Journal of Oncology Nursing : the Official Journal of European Oncology Nursing Society·Louise Gribben, Cherith J Semple
Aug 14, 2021·Patient Education and Counseling·James A TulskyKathryn I Pollak

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