Shin Hye Yoo1, Young Ho Yun2, Kyoung-Nam Kim3, Jung Lim Lee4, Jeanno Park5, Youn Seon Choi6, Yeun Keun Lim7, Samyong Kim8, Hyun Sik Jeong9, Jung Hun Kang10, Ho-Suk Oh11, Ji Chan Park12, Si-Young Kim13, Hong Suk Song14, Keun Seok Lee15, Dae Seog Heo1, Young Seon Hong16. 1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 2. Department of Biomedical Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea. lawyun@snu.ac.kr. 3. Institute of Public Health and Medical Service, Seoul National University Hospital, Seoul, Republic of Korea. 4. Department of Hemato-Oncology, Daegu Fatima Hospital, Daegu, Republic of Korea. 5. Palliative Care and Hospice Center, Bobath Memorial Hospital, Bundang, Seongnam, Republic of Korea. 6. Department of Family Medicine, Korea University Guro Hospital, Seoul, Republic of Korea. 7. Department of Internal Medicine, Kwangju Christian Hospital, Kwangju, Republic of Korea. 8. Division of Hemato-Oncology, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea. 9. Department of Hematology and Oncology, GSAM Hospital, Gunpo, Republic of Korea. 10. Department of Internal Medicine, Postgraduate Medical School, Gyeongsang National University, Jinju, Republic of Korea. 11. Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea. 12. Division of Hemato-Oncology, Department of Internal Medicine, Daejeon St Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea. 13. Departments of Medical Oncology and Hematology, Kyung Hee University Hospital, Seoul, Republic of Korea. 14. Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea. 15. Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. 16. Department of Internal Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Abstract
PURPOSE: The objective of this study was to investigate the impact of caregivers' role preference in decision making on conflicts and psychiatric distresses. METHODS: The responses of 406 caregivers of terminal cancer patients enrolled in a trial determining the efficacy of a decision aid focused on the disclosure of terminal disease status were included in this secondary analysis. The outcomes include the change scores of the Decision Conflict Scale (DCS) and depression and anxiety subscales of the Hospital Anxiety and Depression Scale (HADS) at the 1 and 3 months from baseline. The linear mixed model was employed to discover the impact of caregivers' decisional role preference on the outcomes. FINDINGS: Of the 406, 137 (33.7%) showed an active role preference and 269 (66.3%) showed a passive role preference. In the post hoc analysis of the adjusted differences of change scores between passive caregivers who received decision aid (passive-decision aid) and active caregivers with decision aid (active-decision aid), non-significant differences were observed in the DCS. However, at the 3-month, the change scores of the HADS depression subscale increased by 4.43 (effect size, 0.71) and those of the HADS anxiety subscale increased by 4.14 (effect size, 0.61) in the passive-decision aid group than in active-decision aid group, showing moderate to large difference. CONCLUSIONS: These findings suggest that information might be ethically recommended in a format that is interactive and tailored to how much an individual wishes to be involved in the decision-making process.
PURPOSE: The objective of this study was to investigate the impact of caregivers' role preference in decision making on conflicts and psychiatric distresses. METHODS: The responses of 406 caregivers of terminal cancerpatients enrolled in a trial determining the efficacy of a decision aid focused on the disclosure of terminal disease status were included in this secondary analysis. The outcomes include the change scores of the Decision Conflict Scale (DCS) and depression and anxiety subscales of the Hospital Anxiety and Depression Scale (HADS) at the 1 and 3 months from baseline. The linear mixed model was employed to discover the impact of caregivers' decisional role preference on the outcomes. FINDINGS: Of the 406, 137 (33.7%) showed an active role preference and 269 (66.3%) showed a passive role preference. In the post hoc analysis of the adjusted differences of change scores between passive caregivers who received decision aid (passive-decision aid) and active caregivers with decision aid (active-decision aid), non-significant differences were observed in the DCS. However, at the 3-month, the change scores of the HADS depression subscale increased by 4.43 (effect size, 0.71) and those of the HADS anxiety subscale increased by 4.14 (effect size, 0.61) in the passive-decision aid group than in active-decision aid group, showing moderate to large difference. CONCLUSIONS: These findings suggest that information might be ethically recommended in a format that is interactive and tailored to how much an individual wishes to be involved in the decision-making process.
Entities:
Keywords:
Cancer; Caregiver; Decision aid; Decision making; Decisional role preference; End of life
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