LB29
The role of the carer in treatment decision-making
Gill Hubbard, Nicola Illingworth, Neneh Rowa-Dewar, Liz Forbat , Nora Kearney
Cancer Care Research Centre, Stirling, UK
Introduction
The involvement of carers (i.e. individuals who care for a friend, partner, relative or neighbour) is recognised in policy and clinical guidance. Literature about involvement in treatment decision-making tends to focus on patients and clinicians. The absence of carers is problematic because illness management is often done in the context of complex networks of relationships
Aim
To examine the role of the carer in the treatment decision-making process.
Method
The study was a qualitative longitudinal design involving three serial qualitative interviews with 43 patients and carers within the first year following a cancer diagnosis. A descriptive and thematic approach to data analysis was adopted.
Results
Carers are involved in treatment decision-making and contribute to the involvement of patients during, before and after consultations with clinicians. Carers can act as conduits for information from patient to clinician and from clinician to patient. They can also act as facilitators during deliberations, helping patients to consider treatment options.
Conclusion
Our study has highlighted the deficiency of models that fail to acknowledge the role of the carer in the treatment decision-making process. We propose the adoption of a relational approach by including the carer in conceptual frameworks and recommend triadic (patient, carer and professional) models of involvement. Our study suggests that if clinicians aspire to involve patients in treatment decision-making then involving carers will aid this.
