Caregiver-Reported Roles in Treatment Decision Making in Advanced Cancer and Associated Caregiving Burden and Psychological Distress: A Longitudinal Study

Semra Ozdemir, Sean Ng, Isha Chaudhry, Irene Teo, Chetna Malhotra and Eric Andrew Finkelstein
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Semra Ozdemir: Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Sean Ng: Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Isha Chaudhry: Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Irene Teo: Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Chetna Malhotra: Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Eric Andrew Finkelstein: Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore

Medical Decision Making, 2023, vol. 43, issue 2, 191-202

Abstract: Objective To longitudinally examine caregiver-reported treatment decision-making roles and to investigate the associations of these roles with caregiver burden, caregiving esteem, caregiver anxiety, and depression. Methods 281 caregivers of patients with stage IV solid cancers were recruited from outpatient clinics in Singapore. Caregivers were eligible if they were aged ≥21 y, primary informal caregiver, and involved in treatment decision making. We used 3 y of longitudinal data. The decision-making roles were grouped into 4 categories: no family involvement, patient/physician-led, joint, and family-led/alone decision making. Mixed-effects linear regressions were used to assess associations between decision-making roles and caregiver outcomes. Results On average, 72% of caregivers reported family involvement in decision making. Compared with baseline, a higher proportion of caregivers at the 36-mo follow-up reported no family involvement (from 23% to 34%, P = 0.05) and patient/physician-led decision making (from 22% to 34%, P = 0.02), while a lower proportion reported family-led/alone (from 19% to 7%, P = 0.01) decision making. Compared with family-led/alone decision making, caregivers reporting no family involvement reported lower impact on finances (−0.15 [−0.28, −0.01], P = 0.03) while caregivers who reported patient/physician-led decision making reported lower impact on schedule and health (−0.12 [−0.20, −0.03], P = 0.01), and finances (−0.15 [−0.28, −0.03], P = 0.02), and lower anxiety (−0.69 [−1.17, −0.22], P

Keywords: caregiving; treatment decision making; anxiety; depression (search for similar items in EconPapers)
Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:43:y:2023:i:2:p:191-202

DOI: 10.1177/0272989X221125408

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