The role of social networks in prognostic understanding of older adults with advanced cancer.
Veronica Yu, Sule Yilmaz, Jorie Freitag and 8 others
PMID 36270857WHAT IT FOUND
Older adults with advanced cancer reported clearer prognostic understanding when network members asked questions, accompanied them to appointments, and talked openly about fears and end-of-life.
Well-wishes alone often made patients fear burdening others.
Key findings
01Patients who had network members involved in appointments, asking questions, checking records, and engaging in treatment conversations tended to have clearer prognostic understanding.
02Emotional support that stayed at well-wishes often left patients afraid to burden others, while support that included discussions of fears and end-of-life care was associated with clearer prognostic understanding.
03Most patients trusted healthcare professionals, but less than half included any healthcare professional in their social network map, and many had not discussed prognosis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a secondary analysis of a pilot with a very small sample. Participants were mostly white and male, so findings may not generalize to other groups. Patients had to read and understand spoken English and have decision capacity verified by an oncologist, so results may not apply to patients who cannot consent or communicate in English. The authors selected cases for detailed comparison, so those cases may not represent all patients. The study describes patients' reports and associations, not whether changing a network improves understanding.
Declared interests
The paper lists NIH extramural and non-U.S. government research support. The supplied text gives no additional disclosure statement.
The easy way to misread this
Do not conclude that building a patient's social network will improve prognostic understanding. This is a small qualitative pilot that describes patients' reports and selected cases, not a tested intervention.