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The association of prognostic awareness with quality of life, spiritual well-being, psychological distress, and pain severity in patients with advanced cancer: Results from the APPROACH Study in Indonesia

Published online by Cambridge University Press:  07 March 2024

Rudi Putranto ,
Hamzah Shatri ,
Cosphiadi Irawan ,
Soehartati Gondhowiardjo ,
Eric Finkelstein ,
Chetna Malhotra Open the ORCID record for Chetna Malhotra [Opens in a new window] ,
Semra Ozdemir ,
Irene Teo  and
Grace Meijuan Yang Open the ORCID record for Grace Meijuan Yang [Opens in a new window]
Rudi Putranto
Affiliation:
Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Hamzah Shatri*
Affiliation:
Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Cosphiadi Irawan
Affiliation:
Department of Internal Medicine, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Soehartati Gondhowiardjo
Affiliation:
Department of Radiotherapy, Comprehensive Cancer Center, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
Eric Finkelstein
Affiliation:
Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Chetna Malhotra
Affiliation:
Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Semra Ozdemir
Affiliation:
Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Irene Teo
Affiliation:
Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore Division of Supportive and Palliative Care, National Cancer Centre, Singapore
Grace Meijuan Yang
Affiliation:
Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore Division of Supportive and Palliative Care, National Cancer Centre, Singapore
*
Corresponding author: Hamzah Shatri; Email: [email protected]
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Abstract

Background and objectives

Advanced cancer patients’ understanding of their illness is key for making informed treatment decisions. Despite the known importance of patients’ awareness of their disease prognosis, it is debatable whether this awareness is positively, negatively, or not associated with clinical and psychological outcomes among patients with advanced cancer. This paper aims to determine the prevalence of and factors associated with prognostic awareness and its association with quality of life (QoL), spiritual well-being, pain control, and psychological distress in patients with advanced cancer in Indonesia.

Methods

This cross-sectional questionnaire-based survey was part of a multicountry study titled “Asian Patient Perspectives Regarding Oncology Awareness, Care and Health (APPROACH).” Patients were asked what they knew about their cancer and treatment. QoL and spiritual well-being were measured using the Functional Assessment of Cancer Therapy – General (FACT-G) and Functional Assessment of Chronic Illness Therapy – Spiritual Well-being (FACIT-Sp) questionnaire. Psychological distress experienced by patients was recorded via the Hospital Anxiety and Depression Scale. Pain severity was also assessed. Data from 160 patients were analyzed using descriptive statistics and multivariable regression models.

Results

Of the 160 patients who participated, 55 (34.4%) were unaware of their cancer stage. Those who were aware of their stage of cancer were younger than those who were not aware (45.7 years vs 50.4 years, p = .015). There was no significant difference in spiritual well-being and other domains of QoL between those who were aware and those who were not aware of their advanced cancer stage. There was also no significant difference in anxiety depression or pain severity, even after adjustment for demographic and clinical characteristics.

Significant of results

Given the high prevalence of patients who wrongly thought their cancer was curable, more could be done to improve disease and prognostic understanding among patients with advanced cancer in Indonesia. Those who were aware of their advanced cancer stage did not have a poorer QoL, nor did they have more anxiety or depression than those who were unaware. This finding suggests that concerns about the negative impact of prognostic disclosure may be unfounded.

Keywords

Advanced cancerprognostic awarenessanxietydepressionquality of lifespiritual well-beingpain severity
Type
Original Article
Information
Palliative & Supportive Care , First View , pp. 1 - 7
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Copyright
© The Author(s), 2024. Published by Cambridge University Press.

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