Abstract 470P
Background
Studies report that almost 50% cancer patients are uninformed of their diagnosis or prognosis, and these rates are significantly higher in palliative care settings. We aimed to examine the presence of collusion and associated coping strategies and concerns of advanced cancer patients and their caregivers (CGs), in an outpatient specialist palliative care clinic (SPC).
Methods
We retrospectively analysed the assessment records of adult advanced cancer patients, newly referred to our SPC clinic from Jan to March 2024. We noted the demographic, clinical, diagnosis and prognosis awareness, coping and concerns reported by patients and CGs. Incomplete records were excluded. Descriptive and association measures were used for the analysis.
Results
Medical records of 100 patients were included in the study. Of these, 53 were male and 50 were on disease directed treatment. CGs were mainly male (57) and children of the patients (49). Collusion regarding diagnosis was present in 35 and regarding prognosis in 65 of patient-caregiver dyads. Place of residence significantly affected collusion; with patients whose domicile was out of state having collusion 80%. Seeking support and problem solving were the main coping strategies used by both patients and their CGs. More caregivers than patients had concerns about treatment (26 vs 13), symptoms (15 vs 13) and finances (20 vs 9). We noted a difference in themes reported by patients (uncertainty and dependency) and CGs (healthcare access, decision-making and financial burden).
Conclusions
Our study revealed a high prevalence of collusion in disclosing prognosis in caregiver-patient dyads, which was associated with place of residence. Although concerns differed, both patients and caregivers sought practical coping strategies. Future research needs to be undertaken about specific sociocultural, spiritual religious factors influencing collusion in in a multicultural, multifaith country like India.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.