Communicating about the end of life : the path of prognostic awareness

Article indépendant

D'ANDRIA URSOLEO, Jacopo | BOTTUSSI, Alice | EPSTEIN, Andrew S. | AGOSTA, Viviana Teresa | MONACO, Fabrizio | ROSA, William E.

Patients with cancer are surviving longer, and therefore have more time both living as well as for end-of-life (EOL) planning (Bergenholtz et al. Reference Bergenholtz, Missel and Timm2020). Major concerns for dying patients relate to issues such as dealing with pain and other distressing symptoms, as well as the loss of autonomy, agency, and functional independence (Steinhauser et al. Reference Steinhauser, Christakis and Clipp2000). Lack of control over the future is another common cause of anxiety and related suffering (Jackson and Emanuel Reference Jackson, Emanuel and O’Malley2024). Consequently, accurate prognostic understanding can enhance informed shared decision-making, improve quality of life and mood, and give patients the time and opportunity to make longer-term decisions for themselves, and arrangements for family members and caregivers (Jackson and Emanuel Reference Jackson, Emanuel and O’Malley2024). Unfortunately, fewer than 20% of cancer patients reports accurate prognostic awareness (PA) over the course of their illness, highlighting the need for a better focus on communicating prognostic information early and effectively (Loucka et al. Reference Loucka, Vlcková and Tucková2021). Furthermore, due to the inherently challenging nature of these discussions, clinicians still find it difficult to engage in conversations about serious news, prognosis, goals of care, and dying and death (Hancock et al. Reference Hancock, Clayton and Parker2007; Schenker Reference Schenker2024; Smith and Longo Reference Smith and Longo2012). These hurdles can be more easily overcome by enhancing the skills and confidence of clinicians through effective communication strategies (Parry et al. Reference Parry, Land and Seymour2014). [Début de l'éditorial]

http://dx.doi.org/10.1017/S147895152400169X

Voir la revue «Palliative & Supportive Care, 23»

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