Use of a Decision Aid to Help Caregivers Discuss Terminal Disease Status With a Family Member With Cancer: A Randomized Controlled Trial
- Affiliated Author(s)
- 송홍석
- Alternative Author(s)
- Song, Hong Suk
- Journal Title
- Journal of Clinical Oncology
- ISSN
- 0732-183X
- Issued Date
- 2011
- 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.
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