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Prognostic awareness in advanced cancer: an integrative literature review
  1. Sara Mone1 and
  2. Helen Kerr2
  1. 1 Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, Belfast, UK
  2. 2 School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
  1. Correspondence to Dr Helen Kerr, School of Nursing and Midwifery, Queen's University Belfast, Belfast BT7 1NN, UK; h.kerr{at}


Individuals with advanced cancer who have accurate prognostic awareness are reported to make more informed decisions about their plan of care. Despite this, it is reported that individuals do not always have accurate prognostic awareness with the rationale for this discordance unclear. The primary aim of the integrative literature review was to identify if there is concordance between actual prognosis and accurate prognostic awareness in individuals with advanced cancer. The secondary aim was to identify the rationale for any discordance between actual prognosis and prognostic awareness in individuals with advanced cancer. This is an integrative literature review using a systematic approach. Literature searches were undertaken in March 2018 in four databases; CINAHL, MEDLINE, PsycINFO and Cochrane Library. Searches were limited to between 2008 and 2018 and those written in the English language. Database searches were supplemented with papers from reference lists of included papers and grey literature. Two reviewers independently completed the literature search and independently reviewed the papers. Fourteen eligible research papers were identified. The majority of individuals with advanced cancer in the included studies did not have accurate prognostic awareness. When identified, the rationale for discordance relates to the individual not being communicated accurate prognostic information, not being able to recall prognostic conversations or prognosis being discussed in vague terms. As individuals with advanced cancer with accurate prognostic awareness make more informed decisions at a crucial time in their life trajectory, it is imperative that healthcare professionals are equipped to effectively deliver accurate prognostic information, ensuring understanding is assessed.

  • prognosis
  • cancer
  • communication
  • clinical decisions

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  • Contributors SM designed the focus of the literature review, was the lead in the review process and in writing the manuscript. HK was a major contributor in the literature review process, in writing the manuscript and providing critical input. Both authors revised and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.