Exploring the communication of oncologists, patients and family members in cancer consultations: development and application of a coding system capturing family‐relevant behaviours (KINcode)

Laidsaar-Powell, Rebekah; Butow, Phyllis; Bu, Stella; Dear, Rachel; Fisher, Alana; Coll, Joseph R.; Juraskova, Ilona

doi:10.1002/pon.4003

Cited by 28 publications

(28 citation statements)

References 35 publications

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“…It has been rigorously developed, informed by our own program of research [4,13,33]; as well as a comprehensive review of other relevant empirical, conceptual, ethical, and legal publications, and iterative feedback from an advisory group of experts in ethics, medical oncology, psychology, and theory development. These strong empirical foundations underpinning the TRIO Framework enhance the validity and clinical relevance of the TRIO Framework, with several empirical examples derived from our interview [4] and consultation transcript [13] studies used to test the Framework's effectiveness in depicting the real behaviours and dynamics occurring during triadic DM.…”

Section: Discussionmentioning

confidence: 99%

“…Relevant data from qualitative interviews with oncology clinicians, patients, and family caregivers [4] and interaction analyses of triadic consultation audiotapes [13], were also appraised. …”

Section: Phases 1-2mentioning

confidence: 99%

“…However it is clear that a family caregiver could not fit along this unidimensional line. Our [4,13] and others' [e.g. 4,13,16,17] empirical work points to the fact that, in many cases, a family caregiver is influential in the DM process, and their influence over a decision can similarly rest on a spectrum from passive, to shared, to dominant.…”

Section: Family Caregiver Influence: Development Of the Trio Trianglementioning

confidence: 99%

“…An important empirical finding within the evidence base [4,13,16,17] was the variability of family caregiver influence among triads. For example, in some cases the family caregiver was very passive and did not influence the decision whilst the patient and clinician shared the decision; in other triads, the family caregiver assumed a dominant role in DM while the patient and clinician had limited input.…”

Section: Concept 1: Family Caregiver Influence Over a Decision Is Varmentioning

confidence: 99%

“…Interaction analyses of audio/video-taped medical consultations similarly highlight that family caregivers are often actively involved in consultation communication [e.g. 2,13], and DM [13][14][15]; and also reveal that family caregiver involvement in DM is variable both across consultations and among different triads [13]. Family caregiver involvement in DM can vary on a spectrum from passive to dominant [4,16,17] and the form/extent of involvement may be influenced by contextual factors such as the patient's age, gender, health status, cultural background and relationship with the family caregiver [11,18].…”

Section: Introductionmentioning

confidence: 99%

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The TRIO Framework: Conceptual insights into family caregiver involvement and influence throughout cancer treatment decision-making

Laidsaar-Powell

Butow

Charles

et al. 2017

Patient Education and Counseling

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Dedication:This paper is dedicated to the memory of our colleague, the late Professor Cathy Charles, who made a major contribution to the TRIO conceptual framework.2 Highlights  Empirically-grounded conceptual Framework of DM with a corresponding graphical aid  Focuses on the form and extent of family caregiver involvement in/influence over DM  Presents six conceptual insights derived from empirical evidence and DM theory  May serve as a useful guide for future empirical, ethical and/or theoretical work AbstractObjective: Family caregivers are regularly involved in cancer consultations and treatment decisionmaking (DM). Yet there is limited conceptual description of caregiver influence/involvement in DM.To address this, an empirically-grounded conceptual framework of triadic DM (TRIO Framework) and corresponding graphical aid (TRIO Triangle) were developed.Methods: Jabareen's model for conceptual framework development informed multiple phases of development/validation, incorporation of empirical research and theory, and iterative revisions by an expert advisory group. Results:Findings coalesced into six empirically-grounded conceptual insights: i) Caregiver influence over a decision is variable amongst different groups; ii) Caregiver influence is variable within the one triad over time; iii) Caregivers are involved in various ways in the wider DM process; iv) DM is not only amongst three, but can occur among wider social networks; v) Many factors may affect the form and extent of caregiver involvement in DM; vi) Caregiver influence over, and involvement in, DM is linked to their everyday involvement in illness care/management. Conclusion:The TRIO Framework/Triangle may serve as a useful guide for future empirical, ethical and/or theoretical work.Practice Implications: This Framework can deepen clinicians's and researcher's understanding of the diverse and varying scope of caregiver involvement and influence in DM.

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Section: Discussionmentioning

confidence: 99%

Section: Phases 1-2mentioning

confidence: 99%

Section: Family Caregiver Influence: Development Of the Trio Trianglementioning

confidence: 99%

Section: Concept 1: Family Caregiver Influence Over a Decision Is Varmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The TRIO Framework: Conceptual insights into family caregiver involvement and influence throughout cancer treatment decision-making

Laidsaar-Powell

Butow

Charles

et al. 2017

Patient Education and Counseling

Self Cite

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Caregiver, patient, and nurse visit communication patterns in cancer home hospice

Reblin

Clayton

et al. 2017

Psycho-Oncology

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Objective Few studies have examined the triadic communication between patients, spouse caregivers, and nurses in the home hospice setting. Thus, little is known about the types of communication patterns that unfold. The goals of the study were to, first, identify common patterns of communication in nurse-patient-caregiver home hospice visits and, second, to identify nurse, caregiver-patient dyad, and visit characteristics that predict visit communication patterns. Method Nurses (N = 58) and hospice cancer patient and spouse caregiver dyads (N = 101; 202 individuals) were recruited from 10 hospice agencies. Nurses audio recorded visits to patient/caregiver homes from study enrollment until patient death. All patient, caregiver, and nurse utterances from the audio recordings were coded using an adapted Roter interaction analysis system. Using identified codes, cluster analysis was conducted to identify communication patterns within hospice visits. Logistic regression was used with demographic variables to predict visit communication patterns. Results Six visit communication patterns were identified and were defined largely by 2 dimensions: (1) either the patient, the caregiver, or the patient and caregiver dyad interacting with the nurse and (2) the relatively high or low expression of distress during the visit. Time until death significantly predicted several clusters. Conclusion This study leads the way in outlining triadic communication patterns in cancer home hospice visits. Our findings have implications for nursing education, letting future nurses know what to expect, and lays the foundation for future research to determine effectiveness and interventions to improve health care communication.

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Patients' and oncologists' views on family involvement in goals of care conversations

2018

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Exploring the communication of oncologists, patients and family members in cancer consultations: development and application of a coding system capturing family‐relevant behaviours (KINcode)

Cited by 28 publications

References 35 publications

The TRIO Framework: Conceptual insights into family caregiver involvement and influence throughout cancer treatment decision-making

The TRIO Framework: Conceptual insights into family caregiver involvement and influence throughout cancer treatment decision-making

Caregiver, patient, and nurse visit communication patterns in cancer home hospice

Patients' and oncologists' views on family involvement in goals of care conversations

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