Use of a decision aid to help caregivers discuss terminal disease status with a family member with cancer: A randomized controlled tria

Young Ho Yun, Myung Kyung Lee, Sohee Park, Jung Lim Lee, Jeanno Park, Youn Seon Choi, Yeun Keun Lim, Sam Yong Kim, Hyun Sik Jeong, Jung Hun Kang, Ho Suk Oh, Ji Chan Park, Si Young Kim, Hong Suk Song, Jungsil Ro, Keun Seok Lee, Dae Seog Heo, Young Seon Hong

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Abstract

Purpose: We tested whether a decision aid explaining how to discuss the approach of death with a family member with cancer would help family caregivers decide to discuss a terminal prognosis. Patients and Methods: We randomly assigned caregivers of terminally ill patients with cancer to a group that received a video and a companion workbook that showed either how they can discuss the prognosis with their patient (experimental arm) or how cancer pain can be controlled (control arm). At baseline and 1 month, we evaluated the decision to discuss terminal prognosis as the primary outcome. At 0, 1, 3, and 6 months, we assessed the caregivers' decisional conflict and satisfaction as secondary outcomes using a Decision Conflict Scale (DCS). Results: We found no difference in changes in the decision to discuss terminal prognosis between the two groups. Conflict (P = .003), uncertainty (P = .019), and value clarity (P = .007) subscale scores and total DCS score (P = .008) improved from baseline to 1 month significantly more in the experimental arm than in the control arm. Over 6 months, the significant between-group differences continued for the conflict (P = .031), uncertainty (P = .014), and value clarity (P = .039) subscale scores and total DCS score (P = .040). Conclusion: Decision aids can help caregivers, with the aid of trained professionals, to communicate with patients about their terminal illness.

Original languageEnglish
Pages (from-to)4811-4819
Number of pages9
JournalJournal of Clinical Oncology
Volume29
Issue number36
DOIs
Publication statusPublished - 2011 Dec 20

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Yun, Y. H., Lee, M. K., Park, S., Lee, J. L., Park, J., Choi, Y. S., Lim, Y. K., Kim, S. Y., Jeong, H. S., Kang, J. H., Oh, H. S., Park, J. C., Kim, S. Y., Song, H. S., Ro, J., Lee, K. S., Heo, D. S., & Hong, Y. S. (2011). Use of a decision aid to help caregivers discuss terminal disease status with a family member with cancer: A randomized controlled tria. Journal of Clinical Oncology, 29(36), 4811-4819. https://doi.org/10.1200/JCO.2011.35.3870