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

Yun, Young Ho; Lee, Myung Kyung; Park, Sohee; Lee, Jung Lim; Park, Jeanno; Choi, Youn Seon; Lim, Young-Jae; Kim, Sam Yong; Jeong, Hakyung; Kang, Jung Hun; Oh, Ho Suk; Park, Kang Hyun; Kim, Sang Yong; Song, Hong Suk; Ro, Jungsil; Lee, Keun Seok; Heo, Dae Seog; Hong, Young Seon

doi:10.1200/jco.2011.35.3870

Cited by 44 publications

(86 citation statements)

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“…Our findings indicate that terminally ill cancer patients’ prognostic awareness generally remained unchanged (probabilities of remaining in the original state were 45.5%–92.9%), especially accurate prognostic awareness, consistent with reports that prognostic awareness remained accurate over time for the majority of terminally ill cancer patients. Prognostic awareness was mostly stable for our participants in state 4 (accurate prognostic awareness).…”

Section: Discussionsupporting

confidence: 89%

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Transitions in Prognostic Awareness Among Terminally Ill Cancer Patients in Their Last 6 Months of Life Examined by Multi-State Markov Modeling

et al. 2017

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Terminally ill Taiwanese cancer patients' prognostic awareness generally remained stable, with a tendency toward developing higher states of awareness. Health care professionals should appropriately assess patients' readiness for prognostic information and respect patients' reluctance to confront their poor prognosis if they are not ready to know, but sensitively coach them to cultivate their accurate prognostic awareness, provide desired and understandable prognostic information for those who are ready to know, and give direct and honest prognostic information to clarify any misunderstandings for those with inaccurate awareness, thus ensuring that they develop accurate and realistic prognostic knowledge in time to make end-of-life care decisions.

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Section: Discussionsupporting

confidence: 89%

“…Few studies measured changes in cancer patients' prognostic awareness until their death or last month of life [11][12][13]. Some explored individual-level changes in prognostic awareness [9,10,12,15,17,18], but none investigated transition probabilities in distinct states of prognostic awareness between consecutive time points.…”

Section: Introductionmentioning

confidence: 99%

Transitions in Prognostic Awareness Among Terminally Ill Cancer Patients in Their Last 6 Months of Life Examined by Multi-State Markov Modeling

et al. 2017

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“…In a large high-quality (GRADE A) study by Yun et al, 51 a booklet assisting family members with the decision about disclosure of terminal status to Korean patients with cancer offered no change in the decision to discuss a terminal prognosis, but a significant decrease in decisional conflict ( P = .008) and caregiver depression ( P = .007) occurred. Further, both benefits were sustained at 6 months ( P = .03 and P = .008, respectively).…”

Section: Resultsmentioning

confidence: 99%

Tools to Promote Shared Decision Making in Serious Illness

et al. 2015

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IMPORTANCE-Serious illness impairs function and threatens survival. Patients facing serious illness value shared decision making, yet few decision aids address the needs of this population.OBJECTIVE-To perform a systematic review of evidence about decision aids and other exportable tools that promote shared decision making in serious illness, thereby (1) identifying tools relevant to the treatment decisions of seriously ill patients and their caregivers, (2) evaluating the quality of evidence for these tools, and (3) summarizing their effect on outcomes and accessibility for clinicians.

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“…In RCTs based on TTM and CBT, our research team has showed that target goals could be improved by simultaneous stage-matched exercise and diet intervention [39], Health Navigation for cancer-related fatigue [40], and decision aids to help family caregivers discuss terminal disease status [41]. …”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial of physical activity, dietary habit, and distress management with the Leadership and Coaching for Health (LEACH) program for disease-free cancer survivors

et al. 2017

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BackgroundWe aimed to evaluate the potential benefits of the Leadership and Coaching for Health (LEACH) program on physical activity (PA), dietary habits, and distress management in cancer survivors.MethodsWe randomly assigned 248 cancer survivors with an allocation ratio of two-to-one to the LEACH program (LP) group, coached by long-term survivors, or the usual care (UC) group. At baseline, 3, 6, and 12 months, we used PA scores, the intake of vegetables and fruits (VF), and the Post Traumatic Growth Inventory (PTGI) as primary outcomes and, for secondary outcomes, the Ten Rules for Highly Effective Health Behavior adhered to and quality of life (QOL), the Hospital Anxiety and Depression Scale (HADS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).ResultsFor primary outcomes, the two groups did not significantly differ in PA scores or VF intake but differed marginally in PTGI. For secondary outcomes, the LP group showed a significantly greater improvement in the HADS anxiety score, the social functioning score, and the appetite loss and financial difficulties scores of the EORTC QLQ-C30 scales from baseline to 3 months. From baseline to 12 months, the LP group showed a significantly greater decrease in the EORTC QLQ-C30 fatigue score and a significantly greater increase in the number of the Ten Rules for Highly Effective Health Behavior.ConclusionOur findings indicate that the LEACH program, coached by long-term survivors, can provide effective management of the QOL of cancer survivors but not of their PA or dietary habits.Trial registrationClinical trial information can be found for the following: NCT01527409 (the date when the trial was registered: February 2012).Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3290-9) contains supplementary material, which is available to authorized users.

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

Abstract: Decision aids can help caregivers, with the aid of trained professionals, to communicate with patients about their terminal illness.

Cited by 44 publications

References 29 publications

Transitions in Prognostic Awareness Among Terminally Ill Cancer Patients in Their Last 6 Months of Life Examined by Multi-State Markov Modeling

Transitions in Prognostic Awareness Among Terminally Ill Cancer Patients in Their Last 6 Months of Life Examined by Multi-State Markov Modeling

Tools to Promote Shared Decision Making in Serious Illness

A randomized controlled trial of physical activity, dietary habit, and distress management with the Leadership and Coaching for Health (LEACH) program for disease-free cancer survivors

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