Background Assessment of prognostic awareness (PA) in patients with advanced cancer is challenging because patient responses often indicate their hopes. The objectives of this scoping review were to summarize studies that measured PA in patients with advanced cancer and to synthesize data about how PA was measured and whether hope was incorporated into the measurement. Methods MEDLINE and Embase databases were searched from inception to December 14, 2021. Data regarding the impact of hope on assessment of PA was extracted when studies reported on patients’ beliefs about prognosis and patients’ beliefs about their doctor’s opinion about prognosis. An interpretive synthesis approach was used to analyze the data and generate theory regarding the incorporation of hope into the assessment of PA. Results In total, 52 studies representing 23,766 patients were included. Most were conducted in high-income countries and measured PA based on goal of treatment (curable vs incurable). Five studies incorporated hope into the assessment of PA and reported that among patients who responded that their treatment goal was cure, an average of 30% also acknowledged that their doctors were treating them with palliative intent. Interpretive synthesis of the evidence generated a trinary conceptualization of PA- patients who are aware and accepting of their prognosis; aware and not accepting; and truly unaware. Each of these groups will benefit from different types of interventions to support their evolving PA. Conclusion The trinary conceptualization of PA may promote understanding of the impact of hope in the assessment of PA and guide future research.

中文翻译：

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衡量晚期癌症患者的预后意识：对希望影响的范围界定审查和解释性综合

背景 对晚期癌症患者的预后意识（PA）进行评估具有挑战性，因为患者的反应通常表明他们的希望。本次范围审查的目的是总结测量晚期癌症患者 PA 的研究，并综合有关如何测量 PA 以及是否将希望纳入测量中的数据。方法 检索 MEDLINE 和 Embase 数据库，时间范围从建库到 2021 年 12 月 14 日。当研究报告患者对预后的信念以及患者对医生对预后的看法的信念时，提取了有关希望对 PA 评估的影响的数据。使用解释性综合方法来分析数据并生成有关将希望纳入 PA 评估的理论。结果 总共纳入了代表 23,766 名患者的 52 项研究。大多数是在高收入国家进行的，并根据治疗目标（可治愈与不可治愈）测量 PA。五项研究将希望纳入 PA 评估中，并报告称，在回答其治疗目标是治愈的患者中，平均 30% 的人也承认他们的医生正在以姑息治疗的意图治疗他们。对证据的解释性综合产生了 PA- 患者的三元概念，这些患者了解并接受其预后；知道但不接受；并且确实不知道。每个群体都将受益于不同类型的干预措施，以支持其不断发展的 PA。结论 PA 的三元概念化可能有助于理解希望在 PA 评估中的影响并指导未来的研究。