Korean J Fam Med.  2020 Mar;41(2):91-97. 10.4082/kjfm.18.0113.

Effect of Prognosis Awareness on the Survival and Quality of Life of Terminally Ill Cancer Patients: A Prospective Cohort Study

• Lee H
• Ko HJ
• Kim AS
• Kim SM
• Moon H
• Choi HI

• KMID: 2501852
• DOI: http://doi.org/10.4082/kjfm.18.0113

Abstract

Background
Physicians and caregivers are conflicted over whether to inform patients that their disease is terminal. Studies examining the effect of awareness of prognosis on the survival and quality of life of terminally ill cancer patients report conflicting results. This study aimed to assess the effects of prognosis awareness on the survival time and psychological health of terminally ill cancer patients.
Methods
Patients in the hospice wards of two general hospitals were asked to complete a questionnaire. All were mentally alert and could express themselves clearly. Awareness of prognosis was defined as knowing both the diagnosis and exact prognosis. Survival time was defined as the time from hospital admission to death. Multiple psychological examinations were conducted to verify the effect of prognosis awareness on psychological health.
Results
Of the 98 subjects who met the inclusion criteria, 65 (66.3%) were aware of their terminal status. The patients’ awareness was significantly related to survival time after adjusting for clinical variables with a hazard ratio of 1.70 (95% confidence interval [CI], 1.01–2.86). Furthermore, the unaware group had a higher risk of cognitive impairment (Mini-Mental State Examination <24; adjusted odds ratio [aOR], 3.65; 95% CI, 1.26–10.59) and a poorer quality of life (physical component summary of the Short Form 36-item Health Survey <20; aOR, 3.61; 95% CI, 1.12– 11.60) than the aware group.
Conclusion
Knowledge of the exact prognosis might have a positive effect on the survival and quality of life of terminally ill cancer patients.

Keyword

Awareness; Hospices; Life Expectancy; Prognosis; Quality of Life