Cancer caregivers' experiences of prognosis in Australia: a qualitative interview study.
OBJECTIVES
Forecasting survival in cancer is a particularly challenging facet of oncological work and can involve complex interactions with patients and their families. While there is considerable research on patient experiences of being provided with, or becoming aware of, their prognosis, there has been much less emphasis placed on the experiences of caregivers. The aim of this paper was to examine caregivers' experiences of prognosis.


DESIGN
This study used semistructured interviews; transcripts were analysed thematically using the framework approach. These data are part of a larger research project focused on experiences of cancer survivorship.


SETTING
Recruitment was from two metropolitan hospitals in Queensland, Australia.


PARTICIPANTS
50 caregivers of patients living with cancer and receiving treatment at two metropolitan hospitals (32% male, 68% female) participated in this study.


RESULTS
Four main themes were identified: (1) caregivers' uncertainty around the meaning and implications of prognosis, (2) caregivers' sense of exclusion in prognostic conversations, (3) the practice of situating prognosis within a context of hope and (4) the precarious balance between realism, optimism and strategic 'ignorance'.


CONCLUSIONS
Caregivers are in many respects the unseen third party of prognostic communication. Developing a better understanding of caregivers' perceptions of prognosis, including how this may be challenged, accepted or otherwise, is important in engaging caregivers in the process of communicating prognostic information. Facilitating greater participation by caregivers in prognostic conversations could potentially address evident complexities and even improve the experiences of all stakeholders in cancer care settings.
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D000328:Adult D017028:Caregivers D003142:Communication D019468:Disease Management D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009369:Neoplasms D011379:Prognosis D036301:Qualitative Research D011793:Queensland D015996:Survival Rate
cancer prognosis clinical forecasting informal care qualitative research