Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia.
Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, New South Wales, Australia.
Patient Educ Couns. 2017 Nov;100(11):2035-2046. doi: 10.1016/j.pec.2017.05.014. Epub 2017 May 5.
Family caregivers are regularly involved in cancer consultations and treatment decision-making (DM). Yet there is limited conceptual description of caregiver influence/involvement in DM. To address this, an empirically-grounded conceptual framework of triadic DM (TRIO Framework) and corresponding graphical aid (TRIO Triangle) were developed.
Jabareen's model for conceptual framework development informed multiple phases of development/validation, incorporation of empirical research and theory, and iterative revisions by an expert advisory group.
Findings coalesced into six empirically-grounded conceptual insights: i) Caregiver influence over a decision is variable amongst different groups; ii) Caregiver influence is variable within the one triad over time; iii) Caregivers are involved in various ways in the wider DM process; iv) DM is not only amongst three, but can occur among wider social networks; v) Many factors may affect the form and extent of caregiver involvement in DM; vi) Caregiver influence over, and involvement in, DM is linked to their everyday involvement in illness care/management.
The TRIO Framework/Triangle may serve as a useful guide for future empirical, ethical and/or theoretical work.
This Framework can deepen clinicians's and researcher's understanding of the diverse and varying scope of caregiver involvement and influence in DM.
癌症患者的家属经常参与癌症咨询和治疗决策(DM)。然而,对于家属在 DM 中的影响/参与程度,目前仅有有限的概念描述。为了解决这个问题,我们开发了一个基于实证的三方 DM 概念框架(TRIO 框架)和相应的图形辅助工具(TRIO 三角形)。
Jabareen 的概念框架开发模型为多个开发/验证阶段提供了信息,包括纳入实证研究和理论,以及专家咨询小组的迭代修订。
研究结果凝聚成六个基于实证的概念见解:i)在不同群体中,家属对决策的影响是可变的;ii)在同一三方中,家属的影响随时间而变化;iii)家属以各种方式参与更广泛的 DM 过程;iv)DM 不仅发生在三方之间,也可能发生在更广泛的社交网络中;v)许多因素可能影响家属参与 DM 的形式和程度;vi)家属对 DM 的影响和参与与其在日常疾病护理/管理中的参与程度有关。
TRIO 框架/三角形可以作为未来实证、伦理和/或理论工作的有用指南。
该框架可以加深临床医生和研究人员对家属在 DM 中参与和影响的多样性和变化范围的理解。