4.6 Article

Physicians' perspectives on family caregivers' roles in elderly cancer patients' therapies: a qualitative, interview-based study

Journal

SUPPORTIVE CARE IN CANCER
Volume 31, Issue 7, Pages -

Publisher

SPRINGER
DOI: 10.1007/s00520-023-07857-6

Keywords

Family caregivers; Clinical communication; Therapy decision-making

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This study explores physicians' perspectives on the roles and involvement of family caregivers in consultations and therapy decision-making for elderly cancer patients in Germany. The findings indicate that although physicians recognize the importance of family caregivers in providing information, supporting the patient, and contributing to the treatment decision, they rarely involve them closely in consultations.
PurposeClinical communication and facilitating informed and sound medical decisions become challenging as patients age and suffer from age-associated impairments. Family caregivers are perceived as essential actors in addressing these challenges. Here, we explore physicians' perspectives on family caregivers' roles and their involvement in consultations and therapy decision-making situations of elderly cancer patients.MethodsWe examined 38 semi-structured interviews with physicians from different specialities (oncologists, non-oncology specialists, and general practitioners) in Germany who treated elderly cancer patients. Data were analyzed using reflexive thematic analysis.ResultsWe identified five general and distinct perspectives on the involvement of family caregivers in the therapy process. Family caregivers are seen as (1) translators of medical information; (2) providers of support for the patient; (3) providers of information about the patient; (4) stakeholders with relevant points of view regarding the treatment decision; or (5) individuals who have a disruptive influence on the consultation. The interviewed physicians rarely involved family caregivers closely in consultations.ConclusionsAlthough physicians frequently attribute supportive roles to family caregivers, they rarely include them in consultations. Previous studies have found that a triadic setting is often better suited to agreeing upon a patient-centered and needs-based treatment decision for older cancer patients. We infer that physicians too rarely recognize the potential importance of family caregivers. Educators should further integrate family caregiver involvement and its implications in general medical education and professional training.

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