Illness understanding in patients with advanced lung cancer: curse or blessing?

Janssens, Annelies; Kohl, Sisca; Michielsen, Toke; Langendonck, Shana Van; Hiddinga, Birgitta I.; Meerbeeck, Jan P. van

doi:10.21037/apm.2016.01.04

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…Patients who are able to make informed decisions about their treatment often opt for a less invasive approach with an emphasis on symptom control. 16 Moreover, diagnostic non-disclosure is rarely successful; the majority of patients eventually find out their diagnosis, often in a less supportive context. 17 The suffering created by concealing diagnoses is not limited to the patients: Beng highlights the psychological distress experienced by patients' relatives 1 and Ong et al raise the impact of moral distress and emotional exhaustion on the medical team.…”

Section: Concealing Serious Diagnosesmentioning

confidence: 99%

Breaking bad news: tackling cultural dilemmas

Holmes

Illing

2021

BMJ Support Palliat Care

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Requesting that serious diagnoses be concealed from patients, a widespread phenomenon in many cultures, presents a professional dilemma. Practical and sensitive communication strategies are needed.MethodologyIn this paper, we use analysis of the existing literature to develop a communication tool for practitioners facing requests for diagnostic non-disclosure. Our approach builds on existing strategies, in providing a mnemonic communication tool, permitting more than one outcome, and focusing on the need for mutual understanding and cooperation.ResultsExisting work on this dilemma highlights the need to appreciate the family's standpoint, affirm their benevolent intentions and correct misperceptions. To this end, we have developed a mnemonic tool, 'ARCHES', to be used in situations where the family has requested diagnostic non-disclosure. The model has six stages: acknowledge the request for non-disclosure, build the relationship, find common ground, honour the patient's preferences and outline the harm of non-disclosure, provide emotional support and devise a supportive solution.ConclusionFacing requests for diagnostic non-disclosure is a challenge of communication. The dilemma is particularly marked when practising across cultures. Our model gives a structure for building rapport with the family and realigning their misperceptions while upholding the patient's right to knowledge.

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Section: Concealing Serious Diagnosesmentioning

confidence: 99%

Breaking bad news: tackling cultural dilemmas

Holmes

Illing

2021

BMJ Support Palliat Care

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Defining “early palliative care” for adults diagnosed with a life-limiting illness: A scoping review

Kircher

Hanna

Tranmer

et al. 2023

Preprint

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Background: Palliative care is for people suffering from life-limiting illnesses that focuses on providing relief from symptoms and stress of illness. Previous studies have demonstrated that specialist palliative care consultation delivered earlier in the disease process can enhance patients’ quality of life, reduce their symptom burden, reduce use of hospital-based acute care services and extend their survival. However, various definitions exist for the term early palliative care (EPC). Objective: To investigate how EPC has been defined in the literature for adults with life- limiting illnesses. Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and the follows the Joanna Briggs Institution methodology for scoping reviews. Results: We identified 116 articles between 2008-2020 which met inclusion criteria. Five categories of operational definitions for EPC emerged: 1) time-based (time from advanced cancer diagnosis to EPC initiation); 2) prognosis-based (prognosis or the ‘surprise question’); 3) location-based (access point within the healthcare system such as outpatient setting); 4) treatment-based (physician’s judgement or prior to specific therapies); and 5) symptom-based (using symptom intensity questionnaires). Many studies included patients with cancer (n=78), with the most common definition category being time-based (n =41). Amongst studies focusing on multiple or non-cancer diagnoses (n=38), the most common definition category was symptom-based (n =13). Conclusion: Our findings provide a useful reference point for those seeking to understand the scope and breadth of existing EPC definitions in cancer and non-cancer illnesses and contemplate their application within clinical practice

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Illness understanding in patients with advanced lung cancer: curse or blessing?

Cited by 2 publications

References 19 publications

Breaking bad news: tackling cultural dilemmas

Breaking bad news: tackling cultural dilemmas

Defining “early palliative care” for adults diagnosed with a life-limiting illness: A scoping review

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