Family involvement in the context of chronic diseases: The role of social support in treatment decision-making for surgical procedures

Abstract

If medical decision-making about complex treatment options (such as surgical procedures) is challenging for patients, family members can provide them with advice and health information. Previous research about family involvement in health communication has largely focused on cancer patients. Thus, it lacks an examination of family involvement in surgery decision-making in the context of non-life-threatening chronic diseases like arthrosis. In particular, we focus on the role of social support for family involvement in these situations. Against this background, we conducted semi-structured qualitative interviews with arthrosis patients and their family members (n = 32 patients; n = 8 relatives). To better understand family involvement in surgery decision-making, three research questions were analyzed: (1) What are the perceived characteristics of the arthroplasty decisional process? (2) Which patterns of family involvement exist with regard to social support? (3) What general circumstances are relevant for family involvement? Our results demonstrate that social support plays an important role in the patterns of family decision-making. Instrumental, emotional, and informational support can indirectly enhance family involvement in decision-making. In addition, relatives are also directly involved in decision-making processes and may instigate the decision. The type of family involvement is influenced by characteristics of the decision-making situation. In addition to personal factors and the relationship with the physician, which is perceived as less supportive, the need for familial decisional support intensifies.