Prognostic Understanding and Quality of Life in Patients With Advanced Lung Cancer: A Multicenter Study

Janssens, Annelies; Derijcke, Sofia; Galdermans, D.; Daenen, Marc; Surmont, Veerle; Droogh, E. De; Lefebure, Anneke; Saenen, Erika; Vandenbroucke, Elke; Morel, Alain; Sadowska, Anna; Meerbeeck, Jan P. van

doi:10.1016/j.cllc.2018.11.011

Cited by 18 publications

(29 citation statements)

References 24 publications

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“…With n = 16 (66.7%) of entries ( Diamond et al, 2014 , 2017 ; El-Jawahri et al, 2014 , 2015 ; Tang et al, 2014 , 2016a,b , 2018 ; Shin et al, 2016 ; Chen et al,2017a,b , 2019 ; Kurita et al, 2018 ; Mack et al, 2018 ; Sato et al, 2018 ; Janssens et al, 2019 ), this was one of the most important components of PA. Often ( n = 11), patients with advanced disease were only considered to have accurate PA if they viewed their disease as incurable ( Diamond et al, 2014 , 2017 ; Tang et al, 2014 , 2016a,b , 2018 ; Chen et al,2017a,b , 2019 ; Sato et al, 2018 ; Janssens et al, 2019 ); other authors ( n = 4) asked patients to rate their chances of recovery in percent (0–100%; El-Jawahri et al, 2014 , 2015 ; Shin et al, 2016 ; Mack et al, 2018 ). All patients who stated 0–10% chances of recovery and/or whose view was concordant with their physician’s assessment were then classified as having adequate PA.…”

Section: Resultsmentioning

confidence: 99%

“…Eight publications (33.3%) dealt with the role of time, i.e., more time passed since diagnosis, and proximity to death were correlated with higher PA ( Liu et al, 2014 ; Tang et al, 2014 , 2016a,b ; Enzinger et al, 2015 ; Chen et al, 2017b , 2019 ; Janssens et al, 2019 ). To the contrary, another publication considered a more advantageous prognosis with an expected positive course as associated with higher PA ( Mack et al, 2018 ).…”

Section: Resultsmentioning

confidence: 99%

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Prognostic Awareness in Advanced Disease: A Review Update and Concept Analysis

et al. 2021

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PurposeAlthough subjective knowledge about the prognosis of an advanced disease is extremely important for coping and treatment planning, the concept of prognostic awareness (PA) remains inconsistently defined. The aims of the scoping review were to synthesize a definition of PA from the most recent literature, describe preconditions, correlates and consequences, and suggest a conceptual model.MethodsBy using scoping review methodology, we searched the Web of Science and PubMed databases, and included publications, reviews, meta-analyses or guidelines on all physical diagnoses, as well as publications offering a conceptual or an operational definition of PA. The data were analyzed by means of content analysis techniques.ResultsOf the 24 included publications, 21 referred exclusively to cancer, one to patients with hip fractures and two to palliative care in general. The deduced definition of PA comprised the following facets: adequate estimation of chances for recovery, knowledge of limited time to live, adequate estimation of life expectancy, knowledge of therapy goals, and knowledge of the course of the disease. Further content analysis results were mapped graphically and in a detailed table.ConclusionThere appears to be a lack of theoretical embedding of PA that in turn influences the methods used for empirical investigation. Drawing on a clear conceptual definition, longitudinal or experimental studies would be desirable.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prognostic Awareness in Advanced Disease: A Review Update and Concept Analysis

et al. 2021

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“…Prior studies have shown an association between accurate patient prognostic understanding and worse patientreported outcomes [11][12][13][14][15]. Data on these associations among caregivers, however, are limited.…”

Section: Discussionmentioning

confidence: 99%

“…Patients and caregivers need to have an accurate understanding of prognosis to help them make informed treatment decisions and prepare for the future [9,10]. However, initial research in this area has shown that accurate prognostic understanding among patients with cancer correlates with worse patient-reported outcomes, including greater depressive and anxiety symptoms and worse quality of life (QoL) [11][12][13][14][15]. Studies have also demonstrated that accurate caregiver prognostic understanding is associated with greater caregiver depressive and anxiety symptoms [13,16].…”

Section: Introductionmentioning

confidence: 99%

Caregiver–Oncologist Prognostic Concordance, Caregiver Mastery, and Caregiver Psychological Health and Quality of Life

et al. 2021

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Background Caregivers of adults with cancer often report a different understanding of the patient's prognosis than the oncologist. We examine the associations of caregiver–oncologist prognostic concordance with caregiver depressive symptoms, distress, and quality of life (QoL). We also explore whether these relationships differed by caregiver environment mastery, an individual's sense of control, and effectiveness in managing life situations. Materials and Methods We used data from a national geriatric assessment cluster‐randomized trial (URCC 13070) that recruited patients aged 70 years and older with incurable cancer considering any line of cancer treatment at community oncology practices, their caregivers, and their oncologists. At enrollment, caregivers and oncologists estimated the patient's prognosis (0–6 months, 7–12 months, 1–2 years, 2–5 years, and >5 years; identical responses were concordant). Caregivers completed the Ryff's environmental mastery at enrollment. At 4–6 weeks, caregivers completed the Patient Health Questionnaire‐2 (depressive symptoms), distress thermometer, and 12‐Item Short‐Form Health Survey (quality of life [QoL]). We used generalized estimating equations in models adjusted for covariates. We then assessed the moderation effect of caregiver mastery. Results Of 411 caregiver–oncologist dyads (mean age = 66.5 years), 369 provided responses and 28% were concordant. Prognostic concordance was associated with greater caregiver depressive symptoms (β = 0.30; p = .04) but not distress or QoL. A significant moderation effect for caregiver depressive symptoms was found between concordance and mastery (p = .01). Specifically, among caregivers with low mastery (below median), concordance was associated with greater depressive symptoms (β = 0.68; p = .003). Conclusions Caregiver–oncologist prognostic concordance was associated with caregiver depressive symptoms. We found a novel moderating effect of caregiver mastery on the relationship between concordance and caregiver depressive symptoms. Implications for Practice Caregiver–oncologist prognostic concordance is associated with greater caregiver depressive symptoms, particularly in those with low caregiver mastery. When discussing prognosis with caregivers, physicians should be aware that prognostic understanding may affect caregiver psychological health and should assess their depressive symptoms. In addition, while promoting accurate prognostic understanding, physicians should also identify strengths and build resilience among caregivers.

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“…The interval between initial diagnosis and the interview was very long: almost 7 years on average. Prognostic awareness seems to increase from the diagnosis onwards, 40 but how prognostic acceptance proceeds in parallel, remains to be investigated.…”

Section: Discussionmentioning

confidence: 99%

Perspectives of patients with multiple myeloma on accepting their prognosis—A qualitative interview study

et al. 2020

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Objective Prognostic awareness is essential for making treatment decisions in malignant diseases. Being confronted with a poor prognosis, however, can affect patients' mental health. Therefore, it is important to study coping in the context of malignant diseases. Acceptance is an adaptive coping strategy associated with less psychological distress. This study sought to explore the facilitators and barriers for prognostic acceptance in a sample in which both hope and uncertainty regarding prognosis are pronounced: multiple myeloma patients. Methods In a German university hospital, 20 multiple myeloma patients participated in semistructured interviews. Following thematic content analysis by Kuckartz, the interview transcripts were coded for facilitators and barriers for prognostic acceptance. Additionally, patients completed questionnaires on prognostic awareness and sociodemographic characteristics. Results Patients described the following facilitators for prognostic acceptance: social support, positive thinking, focusing on the Here and Now, proactive confrontation, having little to no symptoms, and being there for others. The indicated barriers were distressing physical symptoms and restricted functioning, social distress, and additional distress from other areas of life. Conclusions Patients reported a variety of factors—related to the social realm, symptom burden, and specific attitudes—that help or hinder them in accepting their prognosis. Oncologists and psycho‐oncologists may support prognostic acceptance by encouraging patients to both actively deal with realistic information as well as enjoy pleasant and meaningful moments in the present during which the disease and its prognosis recedes into the background.

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Prognostic Understanding and Quality of Life in Patients With Advanced Lung Cancer: A Multicenter Study

Cited by 18 publications

References 24 publications

Prognostic Awareness in Advanced Disease: A Review Update and Concept Analysis

Prognostic Awareness in Advanced Disease: A Review Update and Concept Analysis

Caregiver–Oncologist Prognostic Concordance, Caregiver Mastery, and Caregiver Psychological Health and Quality of Life

Perspectives of patients with multiple myeloma on accepting their prognosis—A qualitative interview study

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