ArticleCancer medicine2023
Prognostic awareness and its association with health outcomes in the last year of life.
Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 15 citations in OpenAlex.
- Shifting sands: How parents engage with the idea of their child's death.Palliative & supportive care · 2026Article
- Determining patient-oncologist cancer treatment intent concordance using systematic screening in a supportive care center.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Prognostic awareness in family caregivers of patients with terminal illness: a scoping review.BMJ open · 2025Article
- Prognostic beliefs in patients with cancer receiving outpatient palliative care.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- How patients with advanced cancer conceptualize prognosis: A phenomenological qualitative inquiry.Palliative medicine · 2023Article
- Prognostic awareness and its association with health outcomes in the last year of life.Cancer medicine · 2023Article
- The relationship between hope, medical expenditure and survival among advanced cancer patients.Frontiers in psychology · 2023Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle research has examined changes in prognostic awareness (PA) in the last year of life and the extent PA change was associated with anxiety, depression, and spiritual well-being among metastatic cancer patients.
methodsTwo surveys were administered in the last year of life to 176 conveniently sampled Singaporean patients with stage 4 solid cancers. PA was assessed by asking patients whether they were aware that their treatments were unlikely to cure their cancer. Multivariable linear regression models were used to investigate the association of PA change with anxiety, depression, and spiritual well-being.
resultsThe proportion of patients with accurate PA increased (39.2%-45.5%; p < 0.05) from the second-last assessment to the last assessment before death. Those with inaccurate PA decreased (26.1%-20.4%; p < 0.05) while a third of patients remained uncertain at both assessments (34.7% and 34.1%). Compared to patients with inaccurate PA at both assessments, patients who reported accurate PA at both assessments reported worsened anxiety (β = 2.08), depression (β = 3.87), and spiritual well-being (β = -4.45) while patients who reported being uncertain about their prognosis at both assessments reported worsened spiritual well-being (β = - 6.30) at the last assessment before death (p < 0.05 for all).
conclusionsInterventions should dually focus on decreasing prognostic uncertainty at the end-of-life while minimising the psychological and spiritual sequelae associated with being prognostically aware. More research is needed to clarify the causes of prognostic uncertainty.
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