title: Use of a decision aid to help caregivers discuss terminal disease status with a family member with cancer: a randomized controlled trial.
abstract: OBJECTIVE
  We tested whether a decision aid explaining how to discuss the approach of death with a family member with cancer would help family caregivers decide to discuss a terminal prognosis.
  
  
  METHODS
  We randomly assigned caregivers of terminally ill patients with cancer to a group that received a video and a companion workbook that showed either how they can discuss the prognosis with their patient (experimental arm) or how cancer pain can be controlled (control arm). At baseline and 1 month, we evaluated the decision to discuss terminal prognosis as the primary outcome. At 0, 1, 3, and 6 months, we assessed the caregivers' decisional conflict and satisfaction as secondary outcomes using a Decision Conflict Scale (DCS).
  
  
  RESULTS
  We found no difference in changes in the decision to discuss terminal prognosis between the two groups. Conflict (P = .003), uncertainty (P = .019), and value clarity (P = .007) subscale scores and total DCS score (P = .008) improved from baseline to 1 month significantly more in the experimental arm than in the control arm. Over 6 months, the significant between-group differences continued for the conflict (P = .031), uncertainty (P = .014), and value clarity (P = .039) subscale scores and total DCS score (P = .040).
  
  
  CONCLUSIONS
  Decision aids can help caregivers, with the aid of trained professionals, to communicate with patients about their terminal illness.
authors: National Cancer Center, Korea. lawyun@snu.ac.kr
authors: Young Ho
authors: YH
authors: Yun
authors: Myung Kyung
authors: MK
authors: Lee
authors: Sohee
authors: S
authors: Park
authors: Jung Lim
authors: JL
authors: Lee
authors: Jeanno
authors: J
authors: Park
authors: Youn Seon
authors: YS
authors: Choi
authors: Yeun Keun
authors: YK
authors: Lim
authors: Sam Yong
authors: SY
authors: Kim
authors: Hyun Sik
authors: HS
authors: Jeong
authors: Jung Hun
authors: JH
authors: Kang
authors: Ho-Suk
authors: HS
authors: Oh
authors: Ji Chan
authors: JC
authors: Park
authors: Si-Young
authors: SY
authors: Kim
authors: Hong Suk
authors: HS
authors: Song
authors: Jungsil
authors: J
authors: Ro
authors: Keun Seok
authors: KS
authors: Lee
authors: Dae Seog
authors: DS
authors: Heo
authors: Young Seon
authors: YS
authors: Hong
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D001364:Awareness; D017028:Caregivers; D003661:Decision Support Techniques; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000523:psychology*; D011379:Prognosis; D011788:Quality of Life; D013727:Terminal Care