Abstract 1369: Cancer-related communication and decision making between patients and their spousal caregivers.
Authors: Li Qiu Ping , Loke Alice Yuen , Yung Jolene Ying King , Mak Yim Wah , Shae Wan Chaw 
Published: August 2014

Abstract
Aims: Patients with cancer and their spousal caregivers face dynamic communication and difficult decision making needs throughout the cancer trajectory. This literature review aims to delineate the current pattern of cancer-related communication (or non-communication) and decision making between patients and their spousal caregivers; and to discuss the support needs of couples on communication and decision making across the cancer trajectory.
Methods: A systematic search was conducted to identity the articles on cancer-related communication and decision making of couples coping with cancer. The search for relevant literature included studies published in English from January 2000 to October 2012. Studies were located using several strategies, including an electronic search, a manual search for the bibliography of related studies, and an author search. The PICO (Population/problem, Intervention/exposure, Comparison, and Outcome) format was applied to guide the identification of the key terms for literature search. The databases searched included MEDLINE, CINAHL, SCI Expanded, Scopus, and PsychINFO. Articles were extracted according to predefined inclusion and exclusion criteria. The PRISMA flow diagram was used to outline the literature search and selection process.
Results: Findings revealed that open and effective communication between couple's coping with cancer facilitated the overall process of decision making, which also led to improved stressful mood, marital relationship, and quality of life of both partners. However, the results also showed that most patients and their spousal caregivers lacked effective communication, which related to both cancer patients and spousal caregivers psycho-sociological distress, created tension in their marital relationship and impaired their quality of life. Patients and their spousal caregivers had vast differences in opinion regarding decision making in treatment and care needs, including medical information on diagnosis, treatment, remission, end of life care, and caregivers’ needs in different cancer stage.
Conclusions: These findings underline the importance of open communication between patients and their spousal caregivers in the study of couples coping with cancer. It is recognized that effective communication within couples may have positive effects on couple's intimacy, decision making, and to improve both the patients and caregiving outcomes. Lack of communication may relate to negative effects on their health care outcomes. Further research is needed to explore interventions that facilitate couples’ communication and address both the patient's and their spouse's needs on decision making throughout the cancer trajectory.
Key words: Cancer; Spousal caregivers; Communication; Decision making
Citation Format: Qiu Ping Li, Alice Yuen Loke, Jolene Ying King Yung, Yim Wah Mak, Wan Chaw Shae. Cancer-related communication and decision making between patients and their spousal caregivers. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1369. doi:10.1158/1538-7445.AM2013-1369