Prognostic Understanding and Quality of Life in Patients With Advanced Lung Cancer: A Multicenter Study

Abstract

Introduction: Communication about the palliative setting remains a barrier for many physicians because they are afraid to harm the patient by giving bad news. We sought to determine whether this a valid concern; the influence of prognostic understanding on patients' quality of life (QoL); and which factors influence this relationship.

Methods: The present multicenter, cross-sectional study used a questionnaire to measure patients' prognostic understanding, QoL, mood, and coping strategy.

Results: We surveyed 125 patients with advanced lung cancer. Prognostic understanding correlated significantly with emotional well-being (r = -0.20; P = .01) and pain (r = 0.43; P = .00) but not with anxiety (r = 0.12, P = .12) or depression (r = 0.05; P = .29). Patients with anxiety (r = -0.23; P = .01) and patients with depressive feelings (r = -0.63; P = .00) experienced poorer QoL. Four in 10 patients reported feelings of anxiety and/or depression. Positive reframing as a coping strategy was associated with a better QoL (r = 0.25; P = .00).

Conclusion: Prognostic understanding was related to poorer emotional well-being and more pain but does not affect mood. Four in 10 patients reported feelings of anxiety and/or depression, which were associated with a poorer QoL. A holistic approach seems necessary when physicians communicate about the palliative setting.

Keywords: Communication; Lung cancer; Palliative care; Prognostic understanding; Quality of life.