Staged Improvement in Awareness of Disease for Elderly Cancer Patients in Southern China

Background: In mainland China, awareness of disease of elderly cancer patients largely relies on the patients’families. We developed a staged procedure to improve their awareness of disease. Materials and
Methods:Participants were 224 elderly cancer patients from 9 leading hospitals across Southern China. A questionnairewas given to the oncologists in charge of each patient to evaluate the interaction between family and patients,patient awareness of their disease and participation in medical decision-making. After first cycles of treatment,increased information of disease was given to patients with cooperation of the family. Then patient awarenessof their disease and participation in medical decision-making was documented.
Results: Among the 224 cancerelderly patients, 26 (11.6%) made decisions by themselves and 125 (55.8%) delegated their rights of decisionmakingto their family. Subordinate family members tended to play a passive role in decision-making significantly.Patients participating more in medical decision-making tended to know more about their disease. However, incontrast to the awareness of disease, patient awareness of violation of medical recommendations was reverselyassociated with their participation in medical decision-making. Improvement in awareness of diagnosis, stagesand prognosis was achieved in about 20% elderly cancer patients. About 5% participated more actively inmedical decision-making.
Conclusions: Chinese elderly cancer patient awareness of disease and participationin medical decision-making is limited and relies on their family status. The staged procedure we developed toimprove patient awareness of disease proved effective.