Rebekah Laidsaar-Powell1, Phyllis Butow2, Cathy Charles3, Amiram Gafni3, Vikki Entwistle4, Ronald Epstein5, Ilona Juraskova2. 1. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia. Electronic address: rebekah.laidsaar-powell@sydney.edu.au. 2. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia. 3. Department of Clinical Epidemiology and Biostatistics and Centre for Health and Policy Analysis (CHEPA), McMaster University, Hamilton, Ontario, Canada. 4. Health Services Research Unit, University of Aberdeen, Aberdeen, Scotland, UK. 5. Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Abstract
OBJECTIVE: Family caregivers are regularly involved in cancer consultations and treatment decision-making (DM). Yet there is limited conceptual description of caregiver influence/involvement in DM. To address this, an empirically-grounded conceptual framework of triadic DM (TRIO Framework) and corresponding graphical aid (TRIO Triangle) were developed. METHODS: Jabareen's model for conceptual framework development informed multiple phases of development/validation, incorporation of empirical research and theory, and iterative revisions by an expert advisory group. RESULTS: Findings coalesced into six empirically-grounded conceptual insights: i) Caregiver influence over a decision is variable amongst different groups; ii) Caregiver influence is variable within the one triad over time; iii) Caregivers are involved in various ways in the wider DM process; iv) DM is not only amongst three, but can occur among wider social networks; v) Many factors may affect the form and extent of caregiver involvement in DM; vi) Caregiver influence over, and involvement in, DM is linked to their everyday involvement in illness care/management. CONCLUSION: The TRIO Framework/Triangle may serve as a useful guide for future empirical, ethical and/or theoretical work. PRACTICE IMPLICATIONS: This Framework can deepen clinicians's and researcher's understanding of the diverse and varying scope of caregiver involvement and influence in DM.
OBJECTIVE: Family caregivers are regularly involved in cancer consultations and treatment decision-making (DM). Yet there is limited conceptual description of caregiver influence/involvement in DM. To address this, an empirically-grounded conceptual framework of triadic DM (TRIO Framework) and corresponding graphical aid (TRIO Triangle) were developed. METHODS: Jabareen's model for conceptual framework development informed multiple phases of development/validation, incorporation of empirical research and theory, and iterative revisions by an expert advisory group. RESULTS: Findings coalesced into six empirically-grounded conceptual insights: i) Caregiver influence over a decision is variable amongst different groups; ii) Caregiver influence is variable within the one triad over time; iii) Caregivers are involved in various ways in the wider DM process; iv) DM is not only amongst three, but can occur among wider social networks; v) Many factors may affect the form and extent of caregiver involvement in DM; vi) Caregiver influence over, and involvement in, DM is linked to their everyday involvement in illness care/management. CONCLUSION: The TRIO Framework/Triangle may serve as a useful guide for future empirical, ethical and/or theoretical work. PRACTICE IMPLICATIONS: This Framework can deepen clinicians's and researcher's understanding of the diverse and varying scope of caregiver involvement and influence in DM.
Authors: Lee A Kehoe; Huiwen Xu; Paul Duberstein; Kah Poh Loh; Eva Culakova; Beverly Canin; Arti Hurria; William Dale; Megan Wells; Nikesha Gilmore; Amber S Kleckner; Jennifer Lund; Charles Kamen; Marie Flannery; Mike Hoerger; Judith O Hopkins; Jane Jijun Liu; Jodi Geer; Ron Epstein; Supriya G Mohile Journal: J Am Geriatr Soc Date: 2019-03-29 Impact factor: 5.562