Associations among prognostic understanding, quality of life, and mood in patients with advanced cancer
Version of Record online: 10 OCT 2013
© 2013 American Cancer Society
Volume 120, Issue 2, pages 278–285, 15 January 2014
How to Cite
El-Jawahri, A., Traeger, L., Park, E. R., Greer, J. A., Pirl, W. F., Lennes, I. T., Jackson, V. A., Gallagher, E. R. and Temel, J. S. (2014), Associations among prognostic understanding, quality of life, and mood in patients with advanced cancer. Cancer, 120: 278–285. doi: 10.1002/cncr.28369
- Issue online: 7 JAN 2014
- Version of Record online: 10 OCT 2013
- Manuscript Accepted: 15 AUG 2013
- Manuscript Revised: 5 AUG 2013
- Manuscript Received: 21 MAY 2013
- supportive care;
- prognostic understanding;
- quality of life;
- advanced cancer;
- illness understanding
Patients' perception of their prognosis has an impact on their decisions about medical care. However, the relations between prognostic understanding and quality of life (QoL) and mood are unknown. The objectives of this study were to assess perceptions of prognosis and preferences for prognostic information among patients with advanced cancer and to explore the associations of prognostic understanding with QoL and mood.
Fifty patients were assessed within 6 to 12 weeks of initiating chemotherapy for advanced gastrointestinal cancers. A 13-item questionnaire was used to assess patients' information preferences, perceptions of their prognosis and goal of therapy, and communication about end-of-life care. The Functional Assessment of Cancer Therapy-General and the Hospital Anxiety and Depression Scale were used to assess QoL and mood, respectively.
Fifty of 62 (80%) consecutive, eligible patients were enrolled. Thirty-eight of 50 patients (75%) wanted to know as many details as possible about their cancer diagnosis and treatment. However, 25 of 50 patients (50%) stated that the goal of therapy was to “cure their cancer,” and only 10 of 49 patients (22%) reported having a discussion about end-of-life preferences with their oncologist. Patients who acknowledged their illness as terminal reported lower QoL (P = .005) and higher anxiety (P = .003) compared with those who did not perceive themselves as being terminally ill.
Although patients desired detailed information about their illness, half incorrectly perceived their cancer as curable. Accurate prognostic understanding was associated with lower QoL and worse anxiety. Interventions to improve patients' prognostic understanding while providing adequate psychosocial support are warranted. Cancer 2014;120:278–285. © 2013 American Cancer Society.