Oral Presentation COSA 2015 ASM

Developing and evaluating practical strategies for oncology clinicians to manage and enhance family caregiver involvement in cancer consultations (#81)

Rebekah Laidsaar-Powell 1 , Phyllis Butow 1 , Fran Boyle 2 , Vikki Entwistle 3 , Ronald Epstein 4 , Julie Claessens 5 , Ilona Juraskova 1
  1. Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW, Australia
  2. Centre for Cancer Care and Research, Mater Hospital, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
  3. University of Aberdeen, Scotland, UK
  4. Centre for Communication and Disparities Research, Department of Family Medicine, University of Rochester, NY, USA
  5. Consumer Representative, CanSpeak, Queensland, Australia

Aims
To date, few strategies have been developed for clinicians to enhance the positive aspects of family caregiver involvement in cancer consultations and provide them with much needed support, whilst also managing the (sometimes) challenging aspects of family attendance at consultations. Clinician strategies are needed as some patients and family caregivers report negative oncologist behaviours including ignoring the family or not adequately identifying/responding to the family’s information needs. Additionally, some oncologists report challenges such as negotiating conflicting patient-family treatment wishes, managing dominant family caregivers, and retaining patient privacy and confidentiality. The aim of this presentation is to describe the development and evaluation of evidence-based, practical strategies for oncology health professionals to manage and enhance family involvement in cancer consultations and decision-making.
Method
Development of strategies was informed by a review of relevant empirical, ethical, legal, and professional publications. Strategies were reviewed by 15 international academic/clinical experts who provided feedback in a focus group or interview. Strategies have been further refined after expert feedback. Further evaluation of the strategies is underway through an online survey using the Delphi consensus approach, where n=200 experts (100 academic experts in medical communication; 100 clinical experts in cancer care) rate their agreement/disagreement with proposed strategies in up to three rounds of surveys.
Results
Fifteen strategies, each with an explanation and worded examples, will be presented. In addition, qualitative (focus group/interviews) and quantitative (Delphi consensus surveys) feedback will be presented including suggested changes to the wording, structure, and content of strategies and proportion of experts who agree/disagree with each strategy.
Conclusions
Development and evaluation of evidence-based, practical strategies has the potential to improve patient’s and family caregiver’s experiences in cancer consultations and also to provide guidance to oncology clinicians who are navigating complex consultations with multiple parties.