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. 2025 May;42(5):452-458.
doi: 10.1177/10499091241255117. Epub 2024 May 16.

How do Patients With Advanced Cancer and Family Caregivers Accommodate One Another in Decision-Making? Findings From a Qualitative Study in Specialist Palliative Care

Geraldine Foley  1 , Rachel McCauley  1 , Regina McQuillan  2   3   4 , Karen Ryan  2   5   6
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How do Patients With Advanced Cancer and Family Caregivers Accommodate One Another in Decision-Making? Findings From a Qualitative Study in Specialist Palliative Care

Geraldine Foley et al. Am J Hosp Palliat Care. 2025 May.

Abstract

BackgroundPatients with advanced cancer commonly involve family caregivers in decision-making for palliative care. However, how patients with advanced cancer and family caregivers accommodate each other in decision-making is unclear.MethodsA qualitative study in advanced cancer was conducted with 14 patients and 19 family caregivers recruited from two hospices comprising a large regional specialist palliative care service in Ireland. Data comprised semi-structured interviews with participants. The data were analyzed using grounded theory coding procedures.ResultsMost patients preferred to make care decisions with their family caregiver or at least involve their family caregiver in care discussions. Patients engaged in shared decision-making because they felt they benefited from caregiver support. Patients accommodated family caregiver preferences out of concern for that person and because they trusted them. Family caregivers accommodated patient preferences because they wanted to honor the patient's wishes and felt a responsibility to protect patient autonomy when they had a close relationship with the patient. Prior conflict between the patient and family caregiver was a barrier to mutual accommodation. Although concealment was used as a mechanism to support accommodation between the patient and family caregiver, both sought to communicate openly with other family members to negate potential conflict between each other and the wider family.ConclusionPatients with advanced cancer and family caregivers in specialist palliative care support one another by accommodating each other's preferences for patient care. Patients with advanced cancer and family caregivers accommodate one another in decision-making out of a sense of responsibility to one another.

Keywords: advanced cancer; care preferences; decision-making; family caregiver; patient; specialist palliative care.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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References

    1. Dionne-Odom JN, Kent EE, Rocque GB, et al. Family caregiver roles and challenges in assisting cancer patients with treatment decision-making: analysis of data from a national survey. Health Expect. 2023;26(5):1785-2108. - PMC - PubMed
    1. Back AL. Patient-clinician communication issues in palliative care for patients with advanced cancer. J Clin Oncol. 2020;38(9):866-876. - PubMed
    1. Tricou C, Yennu S, Ruer M, et al. Decisional control preferences of patients with advanced cancer receiving palliative care. Palliat Support Care. 2018;16(5):544-551. - PubMed
    1. Dionne-Odom JN, Ejem D, Wells R, et al. How family caregivers of persons with advanced cancer assist with upstream healthcare decision-making: a qualitative study. PLoS One. 2019;14(3):e0212967. - PMC - PubMed
    1. Mulcahy Symmons S, Ryan K, Aoun SM, et al. Decision-making in palliative care – patient and caregiver concordance and discordance: systematic review and narrative synthesis. BMJ Support Palliat Care. 2023;13(4):373-385. - PMC - PubMed