Discussion About Life Expectancy and Functional Prognosis in Family Members of Cancer Patients.

Abstract

Prognostic information is crucial for end-of-life decision-making. While survival predictions are common, the impact on family members remains unclear. There is also a need to understand the role of discussions about functional prognosis. This study aimed to explore (1) the frequency of discussion about life expectancy and functional prognosis in family members and (2) the impact of the discussion on family outcomes. This pre-planned analysis of a nationwide post-bereavement survey examined communication regarding life expectancy and functional prognosis. The study included bereaved family members of cancer patients who died in palliative care units between May and January of 2024. Complicated grief, depression, and unfinished business were measured using validated scales. It compared outcomes between those with and without these discussions. Of the 988 questionnaires sent, 582 were analyzed. Regarding discussions with clinicians, 85.7% of family members discussed life expectancy, while 68.0% of family members discussed functional prognosis. Family members experienced better scores on measures of grief and depression. All subscales of "unfinished business" showed better outcomes in the groups that had these discussions. Discussions about life expectancy were more prevalent than discussions about functional prognosis for family members. These discussions were linked to reduced grief, depression and unfinished business for family members.