Use of a Decision Aid to Help Caregivers Discuss Terminal Disease Status With a Family Member With Cancer: A Randomized Controlled Trial

作者：Yun Young Ho^*; Lee Myung Kyung; Park Sohee; Lee Jung Lim; Park Jeanno; Choi Youn Seon; Lim Yeun Keun; Kim Sam Yong; Jeong Hyun Sik; Kang Jung Hun; Oh Ho Suk; Park Ji Chan; Kim Si Young; Song Hong Suk; Ro Jungsil; Lee Keun Seok; Heo Dae Seog; Hong Young Seon

来源：Journal of Clinical Oncology, 2011, 29(36): 4811-4819.

DOI：10.1200/JCO.2011.35.3870

Purpose
We tested whether a decision aid explaining how to discuss the approach of death with a family member with cancer would help family caregivers decide to discuss a terminal prognosis.
Patients and Methods
We randomly assigned caregivers of terminally ill patients with cancer to a group that received a video and a companion workbook that showed either how they can discuss the prognosis with their patient (experimental arm) or how cancer pain can be controlled (control arm). At baseline and 1 month, we evaluated the decision to discuss terminal prognosis as the primary outcome. At 0, 1, 3, and 6 months, we assessed the caregivers' decisional conflict and satisfaction as secondary outcomes using a Decision Conflict Scale (DCS).
Results
We found no difference in changes in the decision to discuss terminal prognosis between the two groups. Conflict (P = .003), uncertainty (P = .019), and value clarity (P = .007) subscale scores and total DCS score (P = .008) improved from baseline to 1 month significantly more in the experimental arm than in the control arm. Over 6 months, the significant between-group differences continued for the conflict (P = .031), uncertainty (P = .014), and value clarity (P = .039) subscale scores and total DCS score (P = .040).
Conclusion
Decision aids can help caregivers, with the aid of trained professionals, to communicate with patients about their terminal illness. J Clin Oncol 29: 4811-4819.

• 出版日期2011-12-20