title: Family involvement in cancer treatment decision-making: A qualitative study of patient, family, and clinician attitudes and experiences.
abstract: Little is known about how family are involved in cancer treatment decision-making. This study aimed to qualitatively explore Australian oncology clinicians', patients', and family members' attitudes towards, and experiences of, family involvement in decision-making.
  
  
  
  Semi-structured interviews were conducted with 30 cancer patients, 33 family members, 10 oncology nurses and 11 oncologists. Framework analysis methods were used.
  
  
  
  Three main themes were uncovered: (i) how family are involved in the decision-making process: specific behaviours of family across 5 (extended) decision-making stages; (ii) attitudes towards family involvement in the decision-making process: balancing patient authority with the rights of the family; and (iii) factors influencing family involvement: patient, family, cultural, relationship, and decision.
  
  
  
  This study highlighted many specific behaviours of family throughout the decision-making process, the complex participant attitudes toward retaining patient authority whilst including the family, and insight into influencing factors. These findings will inform a conceptual framework describing family involvement in decision-making.
  
  
  
  Clinicians could ascertain participant preferences and remain open to the varying forms of family involvement in decision-making. Given the important role of family in the decision-making process, family inclusive consultation strategies are needed.
authors.affiliation: Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia. Electronic address: rebekah.laidsaar-powell@sydney.edu.au.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Laidsaar-Powell
authors.affiliation: Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Butow
authors.affiliation: Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia.
authors.forename: Stella
authors.initials: S
authors.lastname: Bu
authors.affiliation: Department of Clinical Epidemiology and Biostatistics and Centre for Health and Policy Analysis (CHEPA), McMaster University, Hamilton, Ontario, Canada.
authors.forename: Cathy
authors.initials: C
authors.lastname: Charles
authors.affiliation: Department of Clinical Epidemiology and Biostatistics and Centre for Health and Policy Analysis (CHEPA), McMaster University, Hamilton, Ontario, Canada.
authors.forename: Amiram
authors.initials: A
authors.lastname: Gafni
authors.affiliation: Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia.
authors.forename: Alana
authors.initials: A
authors.lastname: Fisher
authors.affiliation: Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia.
authors.forename: Ilona
authors.initials: I
authors.lastname: Juraskova
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001315:Australia; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010358:Patient Participation; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D036301:Qualitative Research
keywords: Cancer; Communication; Decision-making; Family caregivers; Qualitative; Triadic