Illness and prognostic understanding in patients with hematologic malignancies
Tamryn F Gray1, Jennifer S Temel2, Areej El-Jawahri2
1Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Blood Reviews
|April 15, 2020
Summary
Patients with blood cancers need to understand their illness and prognosis for informed decisions. Research on this topic in hematologic malignancies is growing, highlighting patient needs and care improvement strategies.
Area of Science:
- Hematology
- Oncology
- Psychosocial Oncology
Background:
- Accurate illness and prognostic understanding is crucial for patients with hematologic malignancies to make informed treatment decisions.
- While studied in solid tumors, data on understanding in hematologic malignancies is expanding, revealing unique challenges like unpredictable trajectories and intensive therapies.
- Hematologic malignancies present complex prognoses, often with potential for cure even in advanced stages, necessitating clear patient comprehension.
Purpose of the Study:
- To review current literature on illness and prognostic understanding in hematologic malignancies.
- To identify patient-specific factors, including desire for information, misperceptions, and psychological outcomes related to prognostic understanding.
- To explore barriers to understanding and draw insights from solid tumor research to identify gaps in hematologic malignancy research.
Main Methods:
- Systematic review of existing literature on illness and prognostic understanding in hematologic malignancies.
- Analysis of patient desire for information, prognostic misperceptions, and psychological associations.
- Comparison with literature on solid tumors to identify research gaps.
Main Results:
- Literature highlights varied patient desire for prognostic information and prevalence of prognostic misperceptions.
- Patient prognostic understanding is linked to psychological outcomes, with barriers to comprehension identified.
- Gaps exist in understanding the longitudinal relationship between prognostic understanding, distress, and coping in hematologic malignancies.
Conclusions:
- Effective communication, adaptive coping strategies, and integrated palliative care can enhance prognostic understanding.
- Further research is needed to explore the dynamic interplay between prognostic understanding, psychological distress, and coping mechanisms.
- Improving prognostic understanding is vital for enhancing quality of life and care for patients with hematologic malignancies.
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