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Cancer Prognostic Awareness: Relations to Patient and Caregiver Quality of Life and Care Preferences

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dc.contributor.authorKrueger, E.
dc.contributor.authorMosher, C.E.
dc.contributor.authorLewson, A.
dc.contributor.authorHickman, S.E.
dc.contributor.authorWu, W.
dc.contributor.authorPrigerson, H.G.
dc.date.accessioned2025-10-09T19:48:12Z
dc.date.issued2025-06-10
dc.description.abstractCONTEXT: Patients who are prognostically aware are more likely to receive end-of-life care consistent with their values. However, prognostic awareness has shown mixed associations with patients' quality-of-life (QoL) outcomes. Theory suggests that acceptance of cancer may moderate relationships between prognostic awareness and outcomes of QoL and end-of-life treatment preferences. Patients' degree of prognostic awareness and illness acceptance may also impact their family caregivers' QoL and end-of-life treatment preferences for the patient. OBJECTIVES: To examine the potential moderating role of patient acceptance of cancer in the relationships between patient prognostic awareness and both patient and caregiver QoL and end-of-life treatment preferences. METHODS: A cross-sectional, secondary analysis was conducted using data from patients with advanced cancer (n=243) and their caregivers (n=87) in the multi-institutional Coping with Cancer-II cohort study. Patient physical, psychological, and existential QoL were examined in a moderation path analysis. Caregiver physical and psychological QoL were examined in separate linear regression analyses. Patient and caregiver end-of-life treatment preferences were examined in multiple logistic regression moderation models. RESULTS: No significant moderations were found. Greater patient illness acceptance was associated with better patient QoL outcomes and caregiver psychological QoL but was unrelated to end-of-life treatment preferences. Greater patient prognostic awareness was associated with worse patient physical QoL and both patients' and caregivers' preference for comfort care. CONCLUSION: Increasing patients' prognostic awareness and cancer acceptance may improve values-consistent end-of-life care and patient and caregiver QoL outcomes. Findings support timely conversations to promote prognostic awareness and further testing of acceptance-based interventions in advanced cancer.en_US
dc.description.embargo2026-06-10
dc.identifier.citationKrueger E, Mosher CE, Lewson A, Hickman SE, Wu W, Prigerson HG. Cancer Prognostic Awareness: Relations to Patient and Caregiver Quality of Life and Care Preferences. Journal of pain and symptom management. 2025;70(3):313-323.e3. doi: 10.1016/j.jpainsymman.2025.06.002. PMID: 40505995.en_US
dc.identifier.urihttps://hdl.handle.net/1813/117964
dc.language.isoen_US
dc.publisherElsevieren_US
dc.relation.doihttps://doi.org/10.1016/j.jpainsymman.2025.06.002en_US
dc.relation.ispartofseriesJournal of pain and symptom managementen_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectWCM Library Coordinated Depositen_US
dc.subjectHumansen_US
dc.subjectQuality of Life/psychologyen_US
dc.subjectCaregivers/psychologyen_US
dc.subjectMaleen_US
dc.subjectFemaleen_US
dc.subjectNeoplasms/psychology/diagnosis/therapyen_US
dc.subjectMiddle Ageden_US
dc.subjectCross-Sectional Studiesen_US
dc.subjectPrognosisen_US
dc.subjectAgeden_US
dc.subjectTerminal Care/psychologyen_US
dc.subjectPatient Preference/psychologyen_US
dc.subjectAwarenessen_US
dc.subjectAdulten_US
dc.subjectHealth Knowledge, Attitudes, Practiceen_US
dc.subjectAged, 80 and overen_US
dc.subjectAdvanced canceren_US
dc.subjectcaregiveren_US
dc.subjectend-of-life treatment preferenceen_US
dc.subjectillness acceptanceen_US
dc.subjectprognostic awarenessen_US
dc.subjectquality of lifeen_US
dc.titleCancer Prognostic Awareness: Relations to Patient and Caregiver Quality of Life and Care Preferencesen_US
dc.typearticleen_US
schema.issueNumber70(3)en_US

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