Prognostic Understanding, Anxiety, and Prognostic Acceptance in Patients with Advanced Cancer: A Mediation Analysis

Laura Christine Polacek, Fordham University


Prognostic understanding in patients with advanced cancer is integral to end-of-life decision-making and care, and research has sought to understand its relationship with psychological outcomes, which have also been identified as important at end of life. This study investigated the relationship between prognostic understanding, anxiety, and prognostic acceptance in a sample of 64 patients with advanced cancer at an inpatient palliative care hospital. Regression analyses were used to explore the relationship between these variables as well as the individual characteristics of intolerance of uncertainty and need for control. Results revealed no significant relationship between prognostic understanding and other study variables. Anxiety was associated with difficulty accepting one’s prognosis. Perceptions that having cancer is unfair and negatively impacts daily life (i.e., struggle with illness) was associated with intolerance of uncertainty. This study provides preliminary data on the use of the Prognostic Understanding Perceptions Scale and Peace, Equanimity, Acceptance in Cancer scales in inpatient palliative care samples, addressing measurement challenges identified in past literature. Additional, longitudinal, research is needed to better understand the relationship between different aspects of prognostic understanding and anxiety following diagnosis of advanced cancer. Given the association between anxiety and difficulty accepting one’s prognosis, research is also needed to examine the feasibility and efficacy of various mental health treatments (e.g., CBT, MCP) in inpatient palliative care.

Subject Area

Clinical psychology|Psychology|Oncology|Management

Recommended Citation

Polacek, Laura Christine, "Prognostic Understanding, Anxiety, and Prognostic Acceptance in Patients with Advanced Cancer: A Mediation Analysis" (2023). ETD Collection for Fordham University. AAI30489613.