Prognostic Awareness in Terminally Ill Cancer Patients: A Narrative Literature Review of the Processes Involved

Abstract

Mariam Chichua,1,2 Davide Mazzoni,1 Eleonora Brivio,2 Gabriella Pravettoni1,2 1Department of Oncology and Hemato-Oncology, University of Milan, Milan, 20122, Italy; 2Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, 20121, ItalyAbstract: High prognostic awareness (PA) is seen by many as a threat to terminal patients’ psychological well-being. Whether this concern is supported by evidence or not is still a matter of discussion, given the heterogeneity of existing findings. This ambiguity points to the importance of considering contextual processes involved in the relationship between high PA and psychological outcomes, as a possible mediator and moderator mechanism. Aiming to capture a holistic image of the relationship between PA and the psychological experiences of patients, we adapted a narrative method to synthesize and discusses patient-related (physical symptoms, coping strategy, spirituality) and external (family support, received medical care) processes as potential explaining mechanisms.Keywords: psycho-oncology, cancer, prognosis, awareness, palliative care, terminal care

Keywords

• psycho-oncology
• cancer
• prognosis
• awareness
• palliative care
• terminal care