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The trajectory of prognostic cognition in patients with advanced cancer: is the traditional advance care planning
Takaaki Hasegawa1, Toru Okuyama2,3, Tatsuo Akechi1,2
1Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan.
Japanese Journal of Clinical Oncology
|February 9, 2024
Summary
Most advanced cancer patients want to know their prognosis, but many lack accurate awareness or acceptance. This impacts advance care planning and end-of-life care decisions.
Area of Science:
- Oncology
- Palliative Care
- Medical Communication
Background:
- Patients with advanced cancer often desire prognostic information, influencing their understanding of illness.
- Prognostic cognition, encompassing awareness and acceptance, is shaped by patient-oncologist discussions and coping strategies.
- Poor prognostic awareness and limited acceptance are common, hindering advance care planning.
Purpose of the Study:
- To examine the role of prognostic cognition in advanced cancer care.
- To identify factors influencing prognostic awareness and acceptance.
- To highlight the need for improved decision-making support for end-of-life care.
Main Methods:
- The study reviews existing literature on prognostic cognition in advanced cancer patients.
- It analyzes the impact of patient-oncologist communication on prognostic awareness and acceptance.
- It discusses the relationship between prognostic cognition and advance care planning.
Main Results:
- Nearly half of advanced cancer patients exhibit poor prognostic awareness.
- Few patients achieve prognostic acceptance, creating barriers to advance care planning.
- Prognostic cognition significantly influences patient preferences for future treatment and care.
Conclusions:
- Effective advance care planning requires oncologists to assess patients' prognostic cognition and readiness.
- Enhanced communication skills, empathy, and compassion are crucial for goal-concordant end-of-life care.
- Further research is needed to develop decision-making support for high-quality, goal-concordant care.
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