Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making
Abstract Background Family caregivers play an increasing role in cancer treatment decision‐making. We examined bias reported by family caregivers in the support they and their patient received from their healthcare team when making these decisions, including associations with distress. Methods Analy...
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.5182 |
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| author | J. Nicholas Dionne‐Odom Katherine A. Ornstein Andres Azuero Erin R. Harrell Shena Gazaway Kristen Allen Watts Deborah Ejem Avery C. Bechthold Kyungmi Lee Frank Puga Ellen Miller‐Sonet Grant R. Williams Erin E. Kent |
| author_facet | J. Nicholas Dionne‐Odom Katherine A. Ornstein Andres Azuero Erin R. Harrell Shena Gazaway Kristen Allen Watts Deborah Ejem Avery C. Bechthold Kyungmi Lee Frank Puga Ellen Miller‐Sonet Grant R. Williams Erin E. Kent |
| author_sort | J. Nicholas Dionne‐Odom |
| collection | DOAJ |
| description | Abstract Background Family caregivers play an increasing role in cancer treatment decision‐making. We examined bias reported by family caregivers in the support they and their patient received from their healthcare team when making these decisions, including associations with distress. Methods Analysis of 2021 national survey data of family caregivers of patients with cancer (N = 2703). Bias experienced in decision support was assessed with the item: “Have you felt that the support you and the person with cancer have received for making cancer‐related decisions by your doctor or healthcare team has been negatively affected by any of the following?” Check‐all‐that‐apply response options included: age, race, language, education, political affiliation, body weight, insurance type or lack of insurance, income, religion, sexual orientation, and gender/sex. Chi‐square and regression analyses assessed associations between bias and caregiver distress (GAD‐2, PHQ‐2). Results Of 2703 caregiver respondents, 47.4% (n = 1281) reported experiencing ≥1 bias(es) when receiving decision support for making cancer‐related decisions. Bias was more prevalent among younger caregivers, males, transwomen/men or gender non‐conforming caregivers, racial/ethnic minorities, and those providing care over a longer time period. The odds of having high anxiety (GAD‐2 scores ≥ 3) were 2.1 times higher for caregivers experiencing one type of bias (adjusted OR, 2.1; 95% CI, 1.6–2.8) and 4.2 times higher for caregivers experiencing ≥2 biases (adjusted OR, 4.2; 95% CI, 3.4–5.3) compared to none. Similar results were found for high depression scores (PHQ‐2 scores ≥ 3). Conclusions Nearly half of caregivers involved in their care recipients' cancer‐related decisions report bias in decision support received from the healthcare team. Experiencing bias was strongly associated with high psychological distress. |
| format | Article |
| id | doaj-art-67be81ed6b3c45ef859296c534a169e1 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-67be81ed6b3c45ef859296c534a169e12024-11-25T07:56:32ZengWileyCancer Medicine2045-76342023-02-011233567357610.1002/cam4.5182Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐makingJ. Nicholas Dionne‐Odom0Katherine A. Ornstein1Andres Azuero2Erin R. Harrell3Shena Gazaway4Kristen Allen Watts5Deborah Ejem6Avery C. Bechthold7Kyungmi Lee8Frank Puga9Ellen Miller‐Sonet10Grant R. Williams11Erin E. Kent12School of Nursing University of Alabama at Birmingham Birmingham Alabama USADepartment of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai New York New York USASchool of Nursing University of Alabama at Birmingham Birmingham Alabama USADepartment of Psychology University of Alabama Tuscaloosa Alabama USASchool of Nursing University of Alabama at Birmingham Birmingham Alabama USADivision of Preventive Medicine School of Medicine University of Alabama at Birmingham Birmingham Alabama USASchool of Nursing University of Alabama at Birmingham Birmingham Alabama USASchool of Nursing University of Alabama at Birmingham Birmingham Alabama USASchool of Nursing University of Alabama at Birmingham Birmingham Alabama USASchool of Nursing University of Alabama at Birmingham Birmingham Alabama USACancerCare New York New York USADivision of Hematology‐Oncology School of Medicine University of Alabama at Birmingham Birmingham Alabama USAGillings School of Global Public Health University of North Carolina Chapel Hill Chapel Hill North Carolina USAAbstract Background Family caregivers play an increasing role in cancer treatment decision‐making. We examined bias reported by family caregivers in the support they and their patient received from their healthcare team when making these decisions, including associations with distress. Methods Analysis of 2021 national survey data of family caregivers of patients with cancer (N = 2703). Bias experienced in decision support was assessed with the item: “Have you felt that the support you and the person with cancer have received for making cancer‐related decisions by your doctor or healthcare team has been negatively affected by any of the following?” Check‐all‐that‐apply response options included: age, race, language, education, political affiliation, body weight, insurance type or lack of insurance, income, religion, sexual orientation, and gender/sex. Chi‐square and regression analyses assessed associations between bias and caregiver distress (GAD‐2, PHQ‐2). Results Of 2703 caregiver respondents, 47.4% (n = 1281) reported experiencing ≥1 bias(es) when receiving decision support for making cancer‐related decisions. Bias was more prevalent among younger caregivers, males, transwomen/men or gender non‐conforming caregivers, racial/ethnic minorities, and those providing care over a longer time period. The odds of having high anxiety (GAD‐2 scores ≥ 3) were 2.1 times higher for caregivers experiencing one type of bias (adjusted OR, 2.1; 95% CI, 1.6–2.8) and 4.2 times higher for caregivers experiencing ≥2 biases (adjusted OR, 4.2; 95% CI, 3.4–5.3) compared to none. Similar results were found for high depression scores (PHQ‐2 scores ≥ 3). Conclusions Nearly half of caregivers involved in their care recipients' cancer‐related decisions report bias in decision support received from the healthcare team. Experiencing bias was strongly associated with high psychological distress.https://doi.org/10.1002/cam4.5182biascancerdecision‐makingdiscriminationfamily caregiver |
| spellingShingle | J. Nicholas Dionne‐Odom Katherine A. Ornstein Andres Azuero Erin R. Harrell Shena Gazaway Kristen Allen Watts Deborah Ejem Avery C. Bechthold Kyungmi Lee Frank Puga Ellen Miller‐Sonet Grant R. Williams Erin E. Kent Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making Cancer Medicine bias cancer decision‐making discrimination family caregiver |
| title | Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making |
| title_full | Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making |
| title_fullStr | Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making |
| title_full_unstemmed | Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making |
| title_short | Bias reported by family caregivers in support received when assisting patients with cancer‐related decision‐making |
| title_sort | bias reported by family caregivers in support received when assisting patients with cancer related decision making |
| topic | bias cancer decision‐making discrimination family caregiver |
| url | https://doi.org/10.1002/cam4.5182 |
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