Will I or my loved one die? Concordant awareness between terminal cancer patients and their caregivers is associated with lower patient anxiety and caregiver burden.

Carlo Lai, Paola Aceto, Gaia Romana Pellicano, Giulia Servidei, Aldo Gambardella, Luigi Lombardo

Objective: The aims of this study were to investigate the association between patients’ awareness of their terminal illness and the levels of anxiety and depression, whether the concordance between the patients’ and caregivers’ belief about the patient’s terminal illness was associated with patient’s anxiety and depression, and with the caregiver burden.
Method: The study recruited 31 terminally ill patients with cancer along with their caregivers from a Palliative Care Unit. All data about patients and caregivers’ awareness of the illness, patients’ depression and anxiety, and caregiver burden were collected. Results: Patients aware of their short-term prognosis of death showed lower levels of anxiety than the unaware ones, especially women. Aware patients with concordant caregivers showed lower levels of anxiety but not of depression. Caregivers concordant with the patients’ awareness presented lower levels of strain and burden. Finally, terminal patients who had an adult child caregiver were less likely to be aware of their terminal condition.
Conclusions: It appears that illness awareness and the caregiver’s concordance with the patient’s belief on the terminal condition are associated with lower anxiety, especially in women, and a reduced burden for caregivers.