The influence of personal expectations on cancer patients' reports of health-related quality of life.

The role of personal expectations on reports of health-related quality of life (HRQL) in the context of a set of other variables commonly thought to affect patient report of HRQL was examined. The complete set of predictor variables included: (1) patient factors including age, gender, race, education, income, insurance type, living arrangement and expectations; and (2) clinical factors namely performance status rating (PSR), diagnosis and disease stage. The outcome measures included five dimensions of HRQL (relationship with physician, physical, social, emotional and functional well being) and an overall measure of HRQL. Five variables (PSR, expectation rating, age, living arrangement and managed care enrollment) exerted significant effects on the summated rating of HRQL. Older cancer patients, those living with others, those enrolled in managed care organizations and those who report better-than-expected experience are more likely to have a higher overall HRQL. In addition to treating the disease itself, quality of life can possibly be enhanced by narrowing the disparities between individuals' expectations and what actually occurs. Patients would likely therefore benefit from being encouraged to set and maintain realistic goals concerning their cancer prognosis and treatment process.