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Correlates of Perceived Illness Severity and Terminality in Advanced Lung and Prostate Cancer

Journal of Pain and Symptom Management(2025)

Department of Psychology | Department of Medicine

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Abstract
Context While prognostic awareness has been commonly assessed as perceived illness terminality in patients with advanced cancer, both perceptions of illness severity and terminality may be correlated with symptom burden and quality of life. Objectives The present study examined physical and psychological symptoms, quality of life, and smoking status in relation to perceived illness severity and terminality in patients with advanced, inoperable lung and prostate cancer. Methods Patients (N=198) were recruited from hospitals in the midwestern U.S. to complete a one-time survey. Prognostic awareness was assessed in the following categories: “relatively healthy,” “seriously ill but not terminally ill,” or “seriously and terminally ill.” Results Only 12% reported an accurate prognostic awareness (“seriously and terminally ill”) and 66% perceived themselves as “relatively healthy.” Higher levels of anxiety, depressive symptoms, fatigue, and pain, and worse quality of life were associated with a higher likelihood of reporting serious illness, irrespective of perceived illness terminality. Smoking status was unrelated to prognostic awareness. For patients with advanced lung cancer, greater breathlessness was associated with a higher likelihood of reporting serious or terminal illness. Conclusion Our findings suggest that perceiving cancer as serious, not just terminal, is related to symptom burden and quality of life. Results point to the need for interventions to improve prognostic understanding and coping with the disease.
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advanced cancer,prognostic awareness,symptoms,quality of life
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要点】:研究探讨了晚期肺癌和前列腺癌患者对疾病严重性和终端性的感知与症状负担、生活质量的关系,发现疾病严重性的感知与症状负担和生活质量紧密相关,而不仅仅是终端性的感知。

方法】:通过对美国中西部医院中的198名晚期、不可手术的肺癌和前列腺癌患者进行一次性问卷调查,评估了他们的预后意识、身体和心理症状、生活质量以及吸烟状况。

实验】:研究使用的数据集为医院招募的198名患者的问卷调查数据,结果显示仅12%的患者准确认识到自己的预后状况(“严重且终端性疾病”),66%的患者认为自己“相对健康”。疾病严重性感知与焦虑、抑郁症状、疲劳、疼痛的高水平及较差的生活质量相关,而吸烟状况与预后意识无关联。对于晚期肺癌患者,呼吸困难的程度与认为疾病严重或终端的可能性增加相关。