The Role of the Family in Treatment Decision Making by Patients With Cancer

Abstract

The findings suggest that nurses need to be aware of differences of opinion between patients with advanced cancer and their caregivers. Knowledge of family disagreements about treatment decisions can help nurses' efforts to integrate families into decision-making processes in clinical settings to facilitate family communications and improve patients' and caregivers' satisfaction with treatment decisions.

Perspectives of Family Members on Planning End-of-Life Care for Terminally Ill and Frail Older People

“…This amplifies the result of an earlier study revealing that ''previous experiences shape [family] caregivers' attitudes and greatly affects their decision-making behaviors.'' 31 Within the topic of end-of-life care, some other studies have emphasized the importance of previous experiences. 5,12,32e35 Most of the family members perceived the initiation of conversations about death and dying as burdensome.…”

Factors That Impact End-of-Life Decision Making in African Americans With Advanced Cancer

“…We saw few instances of decisional conflict, defined as a state of uncertainty about treatment options 25,26 or a disagreement (ie, between the patient/family and physician, between patient and family/ caregivers, or even between family members) about a course of action. 27 Drought and Koenig, 28 who wrote about the primacy of the medical model in EOL decision making, questioned the concept of "choice" in EOL decision making. That is, although the word choice is frequently used when decision making is discussed, most patients and family members do not have the expertise of the physician or the ability to really consider treatment outcomes over the trajectory of an illness.…”

“…6 Even for racially or ethnically diverse groups making EOL decisions, there is a preference for shared involvement in decision making between patients and physicians. 5,27,29 …”

Discussion networks, physician visits, and non-conventional medicine: Probing the relational correlates of health care utilization

“…This overlap between care regimes implies that people's network tiesdparticularly those with whom adults discuss their healthdmay have a very similar role in enabling the usage of both conventional care and CAM. For instance, the spouses, children, and other "significant others" of cancer patients play a central role in decision-making about treatments, both in the realm of CAM (Ohlen, Balneaves, Bottorf, & Brazier, 2006) and conventional medicine (Zhang & Siminoff, 2003). Furthermore, CAM treatments often require making appointments, securing transportation, and managing other practical details.…”