TY - JOUR
T1 - Patient-Caregiver Dyads’ Prognostic Information Preferences and Perceptions in Advanced Cancer
AU - van der Velden, Naomi C. A.
AU - Smets, Ellen M. A.
AU - Hagedoorn, Mariët
AU - Applebaum, Allison J.
AU - Onwuteaka-Philipsen, Bregje D.
AU - van Laarhoven, Hanneke W. M.
AU - Henselmans, Inge
N1 - Funding Information: This work was supported by the Dutch Cancer Society [grant number 11547 ]. The funding source had no role in the conduct of the research or preparation of the article. The authors thank all participating patients, caregivers, and physicians. The authors thank Maartje Meijers, Rania Ali, Laura Streefkerk, and Nora Looze for assisting in this study's data collection. Publisher Copyright: © 2023 The Authors
PY - 2023/5
Y1 - 2023/5
N2 - Context: Prognostic information is considered important for advanced cancer patients and primary informal caregivers to prepare for the end of life. Little is known about discordance in patients’ and caregivers’ prognostic information preferences and prognostic perceptions, while such discordance complicates adaptive dyadic coping, clinical interactions and care plans. Objectives: To investigate the extent of patient-caregiver discordance in prognostic information preferences and perceptions, and the factors associated with discordant prognostic perceptions. Methods: We conducted secondary analyses of a cross-sectional study (PROSPECT, 2019–2021). Advanced cancer patients (median overall survival ≤12 months) from seven Dutch hospitals and caregivers completed structured surveys (n = 412 dyads). Results: Seven percent of patient-caregiver dyads had discordant information preferences regarding the likelihood of cure; 24%–25% had discordant information preferences regarding mortality risk (5/2/1 year). Seventeen percent of dyads had discordant perceptions of the likelihood of cure; 12%–25% had discordant perceptions of mortality risk (5/2/1 year). Dyads with discordant prognostic information preferences (P < 0.05) and dyads in which patients reported better physical functioning (P < 0.01) were significantly more likely to perceive the one-year mortality risk discordantly. Conclusion: Physicians should be sensitive to discordant prognostic information preferences and prognostic perceptions among patient-caregiver dyads in advanced cancer care.
AB - Context: Prognostic information is considered important for advanced cancer patients and primary informal caregivers to prepare for the end of life. Little is known about discordance in patients’ and caregivers’ prognostic information preferences and prognostic perceptions, while such discordance complicates adaptive dyadic coping, clinical interactions and care plans. Objectives: To investigate the extent of patient-caregiver discordance in prognostic information preferences and perceptions, and the factors associated with discordant prognostic perceptions. Methods: We conducted secondary analyses of a cross-sectional study (PROSPECT, 2019–2021). Advanced cancer patients (median overall survival ≤12 months) from seven Dutch hospitals and caregivers completed structured surveys (n = 412 dyads). Results: Seven percent of patient-caregiver dyads had discordant information preferences regarding the likelihood of cure; 24%–25% had discordant information preferences regarding mortality risk (5/2/1 year). Seventeen percent of dyads had discordant perceptions of the likelihood of cure; 12%–25% had discordant perceptions of mortality risk (5/2/1 year). Dyads with discordant prognostic information preferences (P < 0.05) and dyads in which patients reported better physical functioning (P < 0.01) were significantly more likely to perceive the one-year mortality risk discordantly. Conclusion: Physicians should be sensitive to discordant prognostic information preferences and prognostic perceptions among patient-caregiver dyads in advanced cancer care.
KW - Health communication
KW - Informal caregivers
KW - Interpersonal relations
KW - Neoplasm metastases
KW - Prognosis
KW - Truth disclosure
UR - http://www.scopus.com/inward/record.url?scp=85148740877&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85148740877&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36731806
U2 - https://doi.org/10.1016/j.jpainsymman.2023.01.012
DO - https://doi.org/10.1016/j.jpainsymman.2023.01.012
M3 - Article
C2 - 36731806
SN - 0885-3924
VL - 65
SP - 442-455.e2
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 5
ER -