The role of relatives of prostate cancer patients in decision-making conversations during hospital consultations – a qualitative study

Relatives often participate in medical decision-making, yet they often feel neglected. Research shows that active involvement of relatives in patient care, aligning with their abilities and needs, enhances patient safety, compliance, and overall experiences for both patients and relatives. Despite this, the role of relatives in Shared Decision-Making remains underexplored. This study focuses on consultations in hospital settings with prostate cancer patients, aiming to explore the perceptions of relatives, patients, physicians and nurses about the role of relatives in medical decision-making.

Results
The interviews indicate that relatives play an important role in consultations, becoming the patient's ambassador, described by several patients and relatives as "support", "secretary" or "nanny". They become the patient's “ears” and “voice”. It is stressful for the relative to be given these roles, in addition to the emotional aspect of worrying about the situation.

Introduction
Relatives often participate in medical decision-making, yet they often feel neglected. Research shows that active involvement of relatives in patient care, aligning with their abilities and needs, enhances patient safety, compliance, and overall experiences for both patients and relatives. Despite this, the role of relatives in Shared Decision-Making remains underexplored. This study focuses on consultations in hospital settings with prostate cancer patients, aiming to explore the perceptions of relatives, patients, physicians and nurses about the role of relatives in medical decision-making.

Methods
Twenty semi-structured individual interviews were conducted with patients and their relatives in autumn 2023, all selected through purposive sampling. Field notes from 12 consultations informed the interview guides. All interviews capture decision-making moments during consultations, using a hermeneutic-phenomenological approach to understand informants' lived experiences regarding the role of relatives. Content analysis focuses on themes relating to informants' experiences.

Results
The interviews indicate that relatives play an important role in consultations, becoming the patient's ambassador, described by several patients and relatives as "support", "secretary" or "nanny". They become the patient's “ears” and “voice”. It is stressful for the relative to be given these roles, in addition to the emotional aspect of worrying about the situation.

Discussion
On the one hand, relatives serve as a valuable resource, and on the other hand, they have needs that require care during the course of their loved one's illness. Clinicians and nurses need be aware of this dynamic in their interactions during consultations. Forthcoming focus group interviews with physicians and nurses, as part of the study, will provide additional insights into the significant aspects of the role of relatives.

Conclusion
The results include valuable perspectives that can help physicians and nurses in decision-making conversations involving relatives, also extending beyond conditions such as prostate cancer.