Monday, October 27, 2008

Review of hope & prognosis

Psycho-Oncology recently had a review article looking at sustaining hope when discussing prognosis with terminally ill patients (it came out in July although I just came across it now).   This is a great one for the teaching file - particularly for fellows - and summarizes the patient populations, methods, and major outcomes of all the studies which met the inclusion criteria (essentially any study of patients, caregivers, or health professionals, which involved poor prognosis populations - less than 2 years for the purpose of this review - which looks at the interaction between hope and communication surrounding prognosis/the future).  The studies were predominantly in English-speaking countries.  

If you're looking for dramatic revelations about this there are none here, although the paper's girth underlies the breadth of research in this topic which consistently has shown:  a majority of patients want accurate and realistic prognoses, most identify it as an important topic to discuss, and most terminally ill patients conceive of hope in more ways than just hope for a cure.  Of course that leaves us with an important minority of patients (a few percent to one-third depending on the study) who don't endorse any of that.  

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