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

Publication ,  Journal Article
LeBlanc, TW; Bloom, N; Wolf, SP; Lowman, SG; Pollak, KI; Steinhauser, KE; Ariely, D; Tulsky, JA
Published in: Support Care Cancer
April 2018

PURPOSE: 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. METHODS: 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. RESULTS: 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 options had been presented. CONCLUSIONS: Patients, caregivers, and oncologists have discordant perceptions of the cancer treatment decision-making process, and bring different preferences about how they want to make decisions. These data suggest that oncologists should assess patients' and caregivers' decisional preferences, explicitly signal that a decision needs to be made whenever approaching an important crossroads in treatment and ensure that patients and caregivers understand the full range of presented options.

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Published In

Support Care Cancer

DOI

EISSN

1433-7339

Publication Date

April 2018

Volume

26

Issue

4

Start / End Page

1197 / 1205

Location

Germany

Related Subject Headings

  • Surveys and Questionnaires
  • Pilot Projects
  • Perception
  • Patients
  • Oncology & Carcinogenesis
  • Oncologists
  • Neoplasms
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
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ICMJE
MLA
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LeBlanc, T. W., Bloom, N., Wolf, S. P., Lowman, S. G., Pollak, K. I., Steinhauser, K. E., … Tulsky, J. A. (2018). Triadic treatment decision-making in advanced cancer: a pilot study of the roles and perceptions of patients, caregivers, and oncologists. Support Care Cancer, 26(4), 1197–1205. https://doi.org/10.1007/s00520-017-3942-y
LeBlanc, Thomas W., Nick Bloom, Steven P. Wolf, Sarah G. Lowman, Kathryn I. Pollak, Karen E. Steinhauser, Dan Ariely, and James A. Tulsky. “Triadic treatment decision-making in advanced cancer: a pilot study of the roles and perceptions of patients, caregivers, and oncologists.Support Care Cancer 26, no. 4 (April 2018): 1197–1205. https://doi.org/10.1007/s00520-017-3942-y.
LeBlanc TW, Bloom N, Wolf SP, Lowman SG, Pollak KI, Steinhauser KE, et al. Triadic treatment decision-making in advanced cancer: a pilot study of the roles and perceptions of patients, caregivers, and oncologists. Support Care Cancer. 2018 Apr;26(4):1197–205.
LeBlanc, Thomas W., et al. “Triadic treatment decision-making in advanced cancer: a pilot study of the roles and perceptions of patients, caregivers, and oncologists.Support Care Cancer, vol. 26, no. 4, Apr. 2018, pp. 1197–205. Pubmed, doi:10.1007/s00520-017-3942-y.
LeBlanc TW, Bloom N, Wolf SP, Lowman SG, Pollak KI, Steinhauser KE, Ariely D, Tulsky JA. Triadic treatment decision-making in advanced cancer: a pilot study of the roles and perceptions of patients, caregivers, and oncologists. Support Care Cancer. 2018 Apr;26(4):1197–1205.
Journal cover image

Published In

Support Care Cancer

DOI

EISSN

1433-7339

Publication Date

April 2018

Volume

26

Issue

4

Start / End Page

1197 / 1205

Location

Germany

Related Subject Headings

  • Surveys and Questionnaires
  • Pilot Projects
  • Perception
  • Patients
  • Oncology & Carcinogenesis
  • Oncologists
  • Neoplasms
  • Middle Aged
  • Male
  • Humans