Will I or my loved one die? Concordant awareness between terminal cancer patients and their caregivers is associated with lower patient anxiety and caregiver burden

Abstract

Objective: The aims of this study were to investigate the association between patients' awareness of their terminal illness and the levels of anxiety and depression, whether the concordance between the patients' and caregivers' belief about the patient's terminal illness was associated with patient's anxiety and depression, and with the caregiver burden.Method: The study recruited 31 terminally ill patients with cancer along with their caregivers from a Palliative Care Unit. All data about patients and caregivers' awareness of the illness, patients' depression and anxiety, and caregiver burden were collected.Results: Patients aware of their short-term prognosis of death showed lower levels of anxiety than the unaware ones, especially women. Aware patients with concordant caregivers showed lower levels of anxiety but not of depression.Caregivers concordant with the patients' awareness presented lower levels of strain and burden. Finally, terminal patients who had an adult child caregiver were less likely to be aware of their terminal condition.Conclusions: It appears that illness awareness and the caregiver's concordance with the patient's belief on the terminal condition are associated with lower anxiety, especially in women, and a reduced burden for caregivers.

Associations of prognostic‐awareness‐transition patterns with emotional distress and quality of life during terminally ill cancer patients' last 6 months of life

“…These findings are in line with longitudinal studies 8,9,11,12 indicating that advanced/terminal cancer patients with inaccurate or worsening prognostic understanding improve in psychological well-being 8,12 and QOL. 9,11 However, these results conflict with findings from some studies in a systematic review (of primarily cross-sectional studies) 6 and two cross-sectional studies 26,27 in that accurate prognostic awareness improved cancer patients' emotional well-being. This difference may be attributed to the diverse study designs and services received.…”

“…A cross‐sectional study cannot detect differences in emotional distress in relation to the timing of prognostic understanding. Additionally, palliative care received by study subjects 26,27 may help patients in coping with the negative emotional reactions (e.g., depressive symptoms) 28 toward prognostic awareness. The conflicting results illustrate the complex relationship between prognostic awareness and patients' psychological well‐being as concluded in a systematic review 6 .…”

Timely integration of palliative care into cancer care

“…Lai et al show in this issue in a study among 31 terminally ill cancer patients that their awareness of prognosis is associated with less anxiety. Moreover, caregivers' concordance with the patient's prognostic awareness was also associated with better outcomes (Lai et al, 2021).…”