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.
RCT Entities:
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.
Authors: C Adrian Austin; Dinushika Mohottige; Rebecca L Sudore; Alexander K Smith; Laura C Hanson Journal: JAMA Intern Med Date: 2015-07 Impact factor: 21.873
Authors: Rebecca E Ryan; Michael Connolly; Natalie K Bradford; Simon Henderson; Anthony Herbert; Lina Schonfeld; Jeanine Young; Josephine I Bothroyd; Amanda Henderson Journal: Cochrane Database Syst Rev Date: 2022-07-08
Authors: Nicole DePasquale; Patti L Ephraim; Jessica Ameling; Lapricia Lewis-Boyér; Deidra C Crews; Raquel C Greer; Hamid Rabb; Neil R Powe; Bernard G Jaar; Luis Gimenez; Priscilla Auguste; Mollie Jenckes; L Ebony Boulware Journal: BMC Nephrol Date: 2013-01-14 Impact factor: 2.388