Decision Aids Help Caregivers Discuss Terminal Illness

Decision aid improves caregivers' decisional conflict and satisfaction over six months

TUESDAY, Nov. 22 (HealthDay News) -- A decision aid, consisting of a video and an accompanying workbook, can help family caregivers discuss terminal disease status with a family member with cancer, according to a study published online Nov. 21 in the Journal of Clinical Oncology.

Young Ho Yun, M.D., Ph.D., from the National Cancer Center in Seoul, Korea, and colleagues examined whether a decision aid, illustrating how to discuss the approach of death with a family member with cancer, assisted caregivers in their decision to discuss a terminal prognosis. Caregivers were randomly assigned to an experimental group, where they were given a video and a companion workbook that showed how to discuss the prognosis with their patient, or to a control group, where they were provided with a video and workbook on how cancer pain can be controlled. The decision to discuss terminal prognosis at baseline and at one month was the primary outcome. The secondary outcome was the caregivers' decisional conflict and satisfaction measured at zero, one, three, and six months, using a Decision Conflict Scale (DCS).

The investigators found that the decision to discuss terminal prognosis did not differ between the two groups. Compared with the control group, the experimental group experienced a significant improvement in conflict, uncertainty, and value clarity subscale scores, and in the total DCS score, from baseline to one month. These differences in the scores persisted over six months.

"Decision aids can help caregivers, with the aid of trained professionals, to communicate with patients about their terminal illness," the authors write.

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