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Review
Prognostic disclosure and quality of life in palliative care: a systematic review
  1. Sanhapan Wattanapisit1,2,
  2. Richard Wagland1 and
  3. Katherine Hunt1
  1. 1 School of Health Sciences, University of Southampton, Southampton, UK
  2. 2 Palliative Care Unit, Thasala Hospital, Thasala, Nakhon Si Thammarat, Thailand
  1. Correspondence to Dr Sanhapan Wattanapisit, School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK; th.sanhapan{at}gmail.com

Abstract

Introduction Prognostic disclosure is an important component of communication in palliative care. Disclosing information on poor prognosis may affect quality of life (QoL) of palliative care patients. However, the effects of prognostic disclosure on QoL across different cultures and countries are unclear.

Objective To review the effects of prognostic disclosure on QoL of palliative care patients.

Methods A systematic review was conducted across seven databases (AMED, CINAHL plus, Cochrane Library, Medline (via the PubMed interface), Embase, Scopus and Web of Science). All primary studies, of any design, that explored the effects of prognostic disclosure on QoL of adult palliative care patients were eligible.

Results A total of 1926 records were screened for eligibility. Twenty-five articles were included (11 cross-sectional, 10 cohort, 3 mixed methods and 1 qualitative study). Studies were conducted in 11 countries. Five studies reported the sources of prognostic disclosure, while 20 studies did not. Emotional QoL was the most reported domain among the studies. The effects of prognostic disclosure on emotional aspects, overall QoL and other domains, including symptoms, physical functions, role functions, social functions and cognitive functions, were inconsistent.

Conclusions The effects of prognostic disclosure on QoL across cultures and countries are inconsistent. Cultural differences are not sufficient to explain the effects. Future research is needed to explore the association between prognostic disclosure and QoL, and develop tools to support clinicians to share prognostic information in the most sensitive and supportive way.

  • communication
  • end of life care
  • quality of life
  • prognosis

https://doi.org/10.1136/bmjspcare-2020-002460

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    Footnotes

    • Contributors SW and KH were responsible for concept or design of the work. All authors were responsible for the acquisition, analysis and interpretation of the data. SW wrote the first draft of the manuscript. KH and RW revised the draft. All authors approved the final version of the 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.

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