Samenvatting

Presentation at conference about methods and result scoping review into factors influencing family involvement in treatment decision making for older patients with cancer. Presenter is Bea Dijkman. Other names where involved in the research and approved the presentation.Background and purposeMany older cancer patients depend on their family members for care and support, and have their family members involved in treatment decision making in different stages of the cancer trajectory. Although family involvement is advocated in person centred care, little is known about family involvement in decision making for this specific group of older patients and evidence based strategies are scarce. The aim of this scoping review is to get a deeper understanding of factors influencing family involvement in the treatment decision making for older cancer patients.MethodsFour databases were searched for quantitative-, qualitative- and mixed method empirical studies describing factors influencing family involvement in treatment decision making for older cancer patients: PubMed, EMBASE, CINAHL and PsycINFO. ResultsTwenty-seven papers were included, 16 quantitative studies, nine qualitative studies and two mixed methods studies. Factors influencing family involvement were divided in five categories: 1. patient characteristics; 2. family member characteristics; 3. family system characteristics; 4. physician’s role and 5. cultural influences. These factors have an effect on the level of family control in decision making; treatment choice; decisional agreement; and levels of stress and coping strategies of patients and family members. Conclusions and implicationsThe review reveals a complex interplay of factors influencing family involvement in treatment decision making for older cancer patients. It shows that family involvement in decision making is rooted in characteristics of the family system. Physicians and nurses can influence family involvement in treatment decisions which seems to have a positive effect on patients and their family members. The findings underscore the need for developing and implementing evidence based strategies for family involvement in treatment decision making as part of patient centered care for older cancer patients.