The impact of caregiver’s role preference on decisional conflicts and psychiatric distresses in decision making to help caregiver’s disclosure of terminal disease status
The objective of this study was to investigate the impact of caregivers’ role preference in decision making on conflicts and psychiatric distresses.
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.
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.
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.
KeywordsDecision making Decision aid Caregiver Decisional role preference Cancer End of life
Financial support for this study was provided in part by a grant from National Cancer Center (Grant Number: 0710420-1) and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant Number: HC13C1391). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.
Compliance with Ethical Standards
All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The institutional review boards of the 13 hospitals and the National Cancer Center approved the protocol (reference: nccncs-08-142). Informed consent was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.
Conflict of interest
The author(s) indicated no potential conflicts of interest.
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