Caregivers’ role in cancer treatment decision-making and its association with patient involvement and satisfaction: An observational study from a single tertiary cancer hospital in South India

Background: In India, cancer care often involves family members guiding treatment decisions, which may limit patient autonomy and satisfaction. Shared decision-making remains underutilized, underscoring the need to understand caregiver roles in patient involvement and satisfaction. Objectives: The primary objective was to assess caregiver roles in cancer treatment decision-making and their association with patient involvement and satisfaction. The secondary objective was to evaluate the association between patient and caregiver demographics and treatment intent (curative vs. palliative) on caregiver roles and patient involvement. Materials and Methods: A cross-sectional study was conducted at the Department of Oncology, GVN Riverside Hospital, Tiruchirappalli, South India, between May and August 2024. A total of 300 eligible patient–caregiver dyads were consecutively recruited. Data were collected through structured questionnaires and analyzed using descriptive statistics and Chi-square tests. Results: Most patients were female ( n = 227, 75.7%) and married ( n = 232, 77.3%), while caregivers were predominantly male ( n = 164, 54.7%). Spouses were most often shared decision makers ( n = 75, 62.0%), whereas sons and daughters served as shared ( n = 53, 45.7%) or primary ( n = 42, 36.2%) decision makers. Caregiver marital status and co-residence were associated with caregiver roles. Caregiver roles were not associated with patient satisfaction, whereas treatment intent was significantly associated with caregiver role ( P < 0.001). Conclusion: Caregivers of patients receiving curative treatment were often shared decision makers, whereas those in palliative care assumed primary roles. Promoting culturally sensitive shared decision-making may strengthen patient autonomy in oncology care.