Prognostic Awareness, Preferences for Prognostic Information, and Health-related Quality of Life Among Advanced Cancer Patients in Kenya

Abstract

Background Little is known about prognostic awareness and preferences for prognostic information among patients with advanced cancer in Kenya. This study aims to fill that gap. Methods Outcome variables included a measure of prognostic awareness and preferences for prognostic information. Logistic regressions examined the associations between these variables and patient characteristics including age, years of education, socioeconomic status, and symptom burden. Results A substantial proportion of patients (36%) were unaware of their prognosis and most (69%) did not want to receive additional prognostic information. Patients with greater preferences for receiving prognostic information were older, more educated, of lower socioeconomic status, and reported less symptom burden. Conclusion The high levels of unawareness and preferences against prognostic information provide a challenge for efforts to increase shared decision-making and patient autonomy among historically disenfranchised populations. Greater efforts to educate patients on the value of prognostic awareness should be encouraged.

Informed consent in cancer clinical care: Perspectives of healthcare professionals on information disclosure at a tertiary institution in Uganda

“…This circumstance significantly impacts their support needs and personal relationships, psychological wellbeing, and presents challenges for patients and families during the consenting process. In some cultures, unpleasant facts about the prognosis of disease conditions are unwelcome and are better withheld [6][7][8]. Some patients may feel discomfort talking about death and dying, may have strong emotional responses, and others may be in denial of the diagnosis and prognosis [9].…”