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Chemotherapy treatment decision-making experiences of older adults with cancer, their family members, oncologists and family physicians: a mixed methods study
- Source :
- Supportive Care in Cancer
- Publisher :
- Springer Nature
-
Abstract
- Purpose Although comorbidities, frailty, and functional impairment are common in older adults (OA) with cancer, little is known about how these factors are considered during the treatment decision-making process by OAs, their families, and health care providers. Our aim was to better understand the treatment decision process from all these perspectives. Methods A mixed methods multi-perspective longitudinal study using semi-structured interviews and surveys with 29 OAs aged ≥70 years with advanced prostate, breast, colorectal, or lung cancer, 24 of their family members,13 oncologists, and 15 family physicians was conducted. The sample was stratified on age (70–79 and 80+). All interviews were analyzed using thematic analysis. Results There was no difference in the treatment decision-making experience based on age. Most OAs felt that they should have the final say in the treatment decision, but strongly valued their oncologists’ opinion. “Trust in my oncologist” and “chemotherapy as the last resort to prolong life” were the most important reasons to accept treatment. Families indicated a need to improve communication between them, the patient and the specialist, particularly around goals of treatment. Comorbidity and potential side-effects did not play a major role in the treatment decision-making for patients, families, or oncologists. Family physicians reported no involvement in decisions but desired to be more involved. Conclusion This first study using multiple perspectives showed neither frailty nor comorbidity played a role in the treatment decision-making process. Efforts to improve communication were identified as an opportunity that may enhance quality of care. Condensed abstract In a mixed methods study multiple perspective study with older adults with cancer, their family members, their oncologist and their family physician we explored the treatment decision making process and found that most older adults were satisfied with their decision. Comorbidity, functional status and frailty did not impact the older adult’s or their family members’ decision. Electronic supplementary material The online version of this article (doi:10.1007/s00520-016-3476-8) contains supplementary material, which is available to authorized users.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Pain medicine
Decision Making
Comorbidity
03 medical and health sciences
0302 clinical medicine
Neoplasms
Health care
medicine
Humans
Family
030212 general & internal medicine
Longitudinal Studies
Aged
Aged, 80 and over
Oncologists
Chemotherapy
business.industry
Nursing research
Communication
Age Factors
Cancer
Physicians, Family
Functional status
medicine.disease
3. Good health
Geriatric oncology
Oncology
030220 oncology & carcinogenesis
Family medicine
Mixed methods study
Original Article
Female
Treatment decision making
business
Subjects
Details
- Language :
- English
- ISSN :
- 09414355
- Volume :
- 25
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Supportive Care in Cancer
- Accession number :
- edsair.doi.dedup.....94ca843be866af113c06742cded2193d
- Full Text :
- https://doi.org/10.1007/s00520-016-3476-8