Abstract

BackgroundWithout explicit prognostic information, patients may overestimate their life expectancy and make poor choices at the end of life. We sought to design the Japanese version of an information aid (IA) to provide accurate information on prognosis to patients with advanced non–small-cell lung cancer (NSCLC) and to assess the effects of the IA on hope, psychosocial status, and perception of curability.MethodsWe developed the Japanese version of an IA, which provided information on survival and cure rates as well as numerical survival estimates for patients with metastatic NSCLC receiving first-line chemotherapy. We then assessed the pre- and post-intervention effects of the IA on hope, anxiety, and perception of curability and treatment benefits.ResultsA total of 20 (95%) of 21 patients (65% male; median age, 72 years) completed the IA pilot test. Based on the results, scores on the Distress and Impact Thermometer screening tool for adjustment disorders and major depression tended to decrease (from 4.5 to 2.5; P = 0.204), whereas no significant changes were seen in scores for anxiety on the Japanese version of the Support Team Assessment Schedule or in scores on the Hearth Hope Index (from 41.9 to 41.5; p = 0.204). The majority of the patients (16/20, 80%) had high expectations regarding the curative effects of chemotherapy.ConclusionThe Japanese version of the IA appeared to help patients with NSCLC maintain hope, and did not increase their anxiety when they were given explicit prognostic information; however, the IA did not appear to help such patients understand the goal of chemotherapy. Further research is needed to test the findings in a larger sample and measure the outcomes of explicit prognostic information on hope, psychological status, and perception of curability.

Highlights

  • IntroductionPatients may overestimate their life expectancy and make poor choices at the end of life

  • Without explicit prognostic information, patients may overestimate their life expectancy and make poor choices at the end of life

  • 85% of cancerous tumors are histological subtypes of non–small-cell lung cancer (NSCLC), and 50% of patients with NSCLC are treated with palliative chemotherapy [2]

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Summary

Introduction

Patients may overestimate their life expectancy and make poor choices at the end of life. We sought to design the Japanese version of an information aid (IA) to provide accurate information on prognosis to patients with advanced non–small-cell lung cancer (NSCLC) and to assess the effects of the IA on hope, psychosocial status, and perception of curability. 85% of cancerous tumors are histological subtypes of non–small-cell lung cancer (NSCLC), and 50% of patients with NSCLC are treated with palliative chemotherapy [2]. Epidermal growth factor receptor (EGFR) inhibitors have been shown to improve median overall survival; and survival for patients treated with gefitinib, platinum, and pemetrexed or docetaxel is around 3 years [3]. Platinum-based chemotherapy may provide an improved quality of life with an absolute increase of approximately 1.5 months in median survival [5]

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