Awareness of Disease Status Among Patients With Cancer: An Integrative Review.
Catherine S Finlayson, William E Rosa, Shiyon Mathew and 3 others
PMID 36728162WHAT IT FOUND
Awareness of disease status in cancer patients is inconsistent and poorly defined across studies.
While it often leads to less aggressive end-of-life care, its impact on quality of life is mixed. Clinicians should prioritize transparent, iterative communication rather than assuming a single assessment captures patient understanding.
Key findings
01Patients with greater awareness of their incurable disease were less likely to choose aggressive end-of-life care, more likely to sign do-not-resuscitate orders, and less likely to use intensive care.
02The impact of awareness on quality of life is unclear, with studies split evenly between positive, negative, and no significant effects.
03Awareness is heavily influenced by context, including provider communication styles, organizational culture, and whether information is shared directly with the patient or filtered through family members.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only English-language articles were included, limiting the understanding of cultural variations in awareness. The search stopped in January 2020, so it does not reflect changes during the pandemic. Most included studies measured awareness from the healthcare provider's perspective, not the patient's. The concept of 'awareness' was defined and measured inconsistently across the 69 studies, making direct comparisons difficult.
Declared interests
None reported.
The easy way to misread this
Do not assume that a patient who has been 'informed' of their diagnosis automatically has accurate awareness of their prognosis or curability. The review shows that understanding is dynamic and often discordant, particularly regarding treatment intent. A single conversation is rarely sufficient.