Differential patient-caregiver opinions of treatment and care for advanced lung cancer patients.

This study examined the differences of opinion between cancer patients and caregivers with regard to treatment and care decisions. 184 advanced lung cancer patients and 171 primary caregivers were recruited as a convenience sample from hospitals in Cleveland, Ohio. A telephone interview was conducted to collect data using a semi-structured questionnaire. Nonparametric tests and regression analysis were performed. The findings showed that patients and caregivers reported significant disagreement on three main issues: trade-off between treatment side effects and benefits; reporting treatment side effects to physicians, and hospice care. Caregivers were more concerned about patient's quality of life and more willing to discuss hospice issues than were patients (p < or = 01). Perceived family disagreement is associated with depression in both patients and caregivers (p < or = 01; R(2)=8%). The study provided empirical evidence for patient-caregiver disagreement about treatment and care decisions and its significant adverse impact on both patients and caregivers.

[1]  M. Brundage,et al.  Cancer patients' attitudes toward treatment options for advanced non-small cell lung cancer: implications for patient education and decision support. , 2001, Patient education and counseling.

[2]  F. Invernizzi,et al.  Chemotherapy vs supportive care in advanced non-small-cell lung cancer. Results of a meta-analysis of the literature. , 1994, Chest.

[3]  Barriers to hospice enrollment among lung cancer patients: A survey of family members and physicians , 2008, Palliative and Supportive Care.

[4]  David A. Hofmann An Overview of the Logic and Rationale of Hierarchical Linear Models , 1997 .

[5]  O. Brodin,et al.  Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials , 1995 .

[6]  L. Degner,et al.  Symptom experiences: perceptual accuracy between advanced-stage cancer patients and family caregivers in the home care setting. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[7]  N. Colabianchi,et al.  Doctor‐patient communication patterns in breast cancer adjuvant therapy discussions , 2000, Health expectations : an international journal of public participation in health care and health policy.

[8]  C. McPherson,et al.  Family caregivers' assessment of symptoms in patients with advanced cancer: concordance with patients and factors affecting accuracy. , 2008, Journal of pain and symptom management.

[9]  J. Holland,et al.  Handbook of psychooncology : psycological care of the patient with cancer , 1989 .

[10]  J. Temel,et al.  Aggressiveness of care in a prospective cohort of patients with advanced NSCLC , 2008, Cancer.

[11]  H. Badr,et al.  Effects of relationship maintenance on psychological distress and dyadic adjustment among couples coping with lung cancer. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[12]  E. Cook,et al.  Relationship between cancer patients' predictions of prognosis and their treatment preferences. , 1998, JAMA.

[13]  S. Yardley,et al.  Receiving a diagnosis of lung cancer: patients' interpretations, perceptions and perspectives , 2001, Palliative medicine.

[14]  L. Siminoff,et al.  Silence and Cancer: Why Do Families and Patients Fail To Communicate? , 2003, Health communication.

[15]  L. Siminoff,et al.  The role of the family in treatment decision making by patients with cancer. , 2003, Oncology nursing forum.

[16]  S Nordlicht,et al.  The family of the cancer patient. , 1982, New York state journal of medicine.

[17]  L. Fallowfield,et al.  Truth may hurt but deceit hurts more: communication in palliative care , 2002, Palliative medicine.

[18]  Carol Thomas,et al.  Companions through cancer: the care given by informal carers in cancer contexts. , 2001, Social science & medicine.

[19]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[20]  A. Donner,et al.  Pathways to distress: the multiple determinants of depression, hopelessness, and the desire for hastened death in metastatic cancer patients. , 2009, Social science & medicine.

[21]  Carol Thomas The place of death of cancer patients: can qualitative data add to known factors? , 2005, Social science & medicine.