Illness Awareness of Patients in Hospice: Psychological Evaluation and Perception of Family Members and Medical Staff

Abstract

Despite the fact that patients in hospice were in the terminal phase of disease, 30% of patients had no diagnosis awareness, and an even higher percentage of patients (62%) who had no prognosis awareness.

Is therapeutic non-disclosure still possible? A study on the awareness of cancer diagnosis in China

“…Some of the patients may not know they have cancer, some of them, knowing the diagnosis, "play along", as if they did not know [19]. So far there is no standardized questionnaire, and using semi-structured clinical interviews is the most common method [20,21]. We interviewed both patients and their accompanying relatives in order to strengthen the accuracy of the findings.…”

Patients’ understanding of treatment goals and disease course and their relationship with optimism, hope, and quality of life: a preliminary study among advanced breast cancer outpatients before receiving palliative treatment

“…To assess the awareness of the prognosis and perception of the goals of therapy, we adapted and modified the following two self-report items, just as was done in previous studies with patients with advanced cancer [14,15]. To assess perceptions of the goals of therapy, we asked the patients the following question: BWhat is the purpose of your treatment?^Patients were categorized into the Baccurate awareness^group if they used terms including Breduce my pain/symptom management or extend my lifetime,^but if they used Bto recover from my cancer/illness^or BI do not know,^the patients were classified into the Binaccurate awareness^category.…”

“…However, the prevalence of disease prognosis and perception of treatment purpose were inconsistent in these studies. For instance, the study by Andruccioli et al [14] evaluated the awareness of patients regarding their prognosis, and the findings of this study showed that 62 % of cancer patients were not aware of the progression of their disease. More recently, a study that was conducted in South Korea reported that approximately 90 % of the incurable cancer patients had an unrealistic expectation about their disease progression during chemotherapy [15].…”

What is Your Understanding of Your Illness? A Communication Tool to Explore Patients’ Perspectives of Living with Advanced Illness

“…24,25 However, in this study we found that many patients with lifelimiting illness do not discuss their illness in terms of prognosis. [26][27][28] We also found differences among disease groups in discussions of symptoms and causality. Some subjects with COPD and CHF mentioned symptoms and functional limitations associated with their illness.…”