Do Caregivers of Asian Patients with Advanced Cancer Help or Hinder Patient Understanding of Illness and Involvement in Decision Making?

Purpose It is unclear whether caregivers help or hinder patients’ involvement in decision making and understanding of illness. We thus investigated the extent to which caregivers’ preferred level of patient involvement in decision making and understanding of treatment goals are associated with those of patients. Methods We used survey data from 229 patients with metastatic cancer and their family caregivers living in Singapore spanning 2 y prior to the patient’s death. We used mixed-effects regressions to investigate the associations between 1) caregiver-preferred level of patient involvement ( t -1 ) and patient preferred and perceived level of involvement in decision making at subsequent assessments ( t 1 ) and 2) patient and caregiver understanding of treatment goals at the same assessments ( t 1 ). Results Caregivers who preferred higher levels of patient involvement in decision making at t −1 were more likely to have patients who also preferred higher levels of involvement (odds ratio [OR] = 1.19; P = 0.03) and who perceived experiencing higher levels of involvement in decision making (OR = 1.24; P