Dijkman Bea L, Luttik Marie Louise, Van der Wal-Huisman Hanneke, Paans Wolter, van Leeuwen Barbara L
Research Group Nursing Diagnostics, Hanze University of Applied Sciences Groningen, P.O.Box 3109, 9701, DC, Groningen, the Netherlands; Department of Surgery, Groningen University, University Medical Center Groningen, PO box 30.001, 9700, RB, Groningen, the Netherlands.
Research Group Nursing Diagnostics, Hanze University of Applied Sciences Groningen, P.O.Box 3109, 9701, DC, Groningen, the Netherlands.
J Geriatr Oncol. 2022 May;13(4):391-397. doi: 10.1016/j.jgo.2021.11.003. Epub 2021 Nov 12.
Many older patients with cancer depend on their family members for care and support and involve their family members in treatment decision-making in different stages of the cancer trajectory. Although family involvement is advocated in person-centered care, little is known about family involvement in decision-making specifically for older patients, and evidence-based strategies are scarce. The aim of this scoping review is to provide deeper understanding of factors influencing family involvement in treatment decision-making for older patients with cancer. Four databases were searched for quantitative-, qualitative- and mixed-method empirical studies describing factors influencing family involvement in treatment decision-making for older patients with cancer: PubMed, EMBASE, CINAHL and PsycINFO. Three independent researchers reviewed the papers for eligibility and quality and contributed to the data extraction and analysis. Twenty-seven papers were included, sixteen quantitative studies, nine qualitative studies and two mixed-method studies. Five categories of factors influencing family involvement emerged: 1) patient characteristics, 2) family member characteristics, 3) family system characteristics, 4) physician's role and 5) cultural influences. These factors affect the level of family control in decision-making, treatment choice, decision agreement, and levels of stress and coping strategies of patients and family members. This review reveals a complex interplay of factors influencing family involvement in treatment decision-making for older patients with cancer that is rooted in characteristics of the family system. The findings underscore the need for development and implementation of evidence-based strategies for family involvement in treatment decision-making as part of patient-centered care for older patients with cancer.
许多老年癌症患者依靠家庭成员提供护理和支持，并让家庭成员参与癌症病程不同阶段的治疗决策。尽管在以患者为中心的护理中提倡家庭参与，但对于家庭在老年患者治疗决策中的具体参与情况知之甚少，且缺乏循证策略。本范围综述的目的是更深入地了解影响家庭参与老年癌症患者治疗决策的因素。检索了四个数据库，以查找描述影响家庭参与老年癌症患者治疗决策因素的定量、定性和混合方法实证研究：PubMed、EMBASE、CINAHL和PsycINFO。三位独立研究人员对论文的资格和质量进行了审查，并参与了数据提取和分析。纳入了27篇论文，其中16篇定量研究、9篇定性研究和2篇混合方法研究。出现了影响家庭参与的五类因素：1）患者特征，2）家庭成员特征，3）家庭系统特征，4）医生的角色，5）文化影响。这些因素影响家庭在决策、治疗选择、决策一致性以及患者和家庭成员的压力水平及应对策略方面的控制程度。本综述揭示了影响家庭参与老年癌症患者治疗决策的因素之间复杂的相互作用，这种相互作用植根于家庭系统的特征。研究结果强调，需要制定和实施循证策略，让家庭参与治疗决策，作为老年癌症患者以患者为中心护理的一部分。
