Attitudes of cancer patients and their families toward disclosure of cancer diagnosis in Saudi Arabia: a Middle Eastern population example

Abstract

ObjectivesParticularly in the Middle East, few studies have explored the attitude of cancer patients and their families toward cancer diagnosis disclosure (CDD). This study was conducted to investigate the preference and attitude of a sample of cancer patients and their families in Saudi Arabia toward CDD.MethodsWe constructed a questionnaire based on previous studies. The questionnaire assessed preference and attitude toward CDD. Participants were recruited from the King Abdullah Medical City, which has one of the largest cancer centers in Saudi Arabia.ResultsThree hundred and four cancer patients and 277 of their family members participated in the study. The patient group preferred CDD more than the family group (82.6% vs 75.3%, P<0.05). This preference is especially more evident toward disclosure of detailed cancer information (status, prognosis, and treatment) (83.6% vs 59.9%, P<0.001). In a binary logistic regression, factors associated with preference toward CDD included having information about cancer (odds ratio [OR] 1.8; 95% confidence interval [CI], 1.15–2.84) and being employed (OR, 1.77; 95% CI, 1–2.82) while being from the patient group was the only factor associated with preference toward detailed cancer information (OR, 3.25; 95% CI, 2.11–5.05). In terms of patient reaction after CDD, “fear” was the attitude expected by the family group more than the patient group (56.3% vs 70.4%, P<0.001) while “acceptance” was the attitude anticipated by the patient group more than the family group (38% vs 15.2%, P<0.001).ConclusionPatients preferred CDD and disclosure of related information, while their families were more inclined toward scarce disclosure. Family members seem to experience negative attitudes more than the patients themselves.

Nurses' experiences and attitudes toward diagnosis disclosure for cancer patients in China: A qualitative study

“…Physicians in China should realize the different attitudes toward CDD between patients and family members . Similar results have been presented in other studies . Moreover, Gan's quantitative study found that physicians were less positive toward cancer diagnosis disclosure (CDD) than patients and family members, consistent with Tang's study results …”

“…Previous studies have demonstrated that there are many benefits of diagnosis disclosure for cancer patients . Despite the low diagnosis disclosure rate in Asian countries, many studies have found that a majority of patients with a terminal illness want to know the truth . Our former study also found that cancer patients' views of diagnosis disclosure were different from those of their family members.…”

“…[11][12][13] Despite the low diagnosis disclosure rate in Asian countries, many studies have found that a majority of patients with a terminal illness want to know the truth. [14][15][16] Our former study also found that cancer patients' views of diagnosis disclosure were different from those of their family members. Physicians in China should realize the different attitudes toward CDD between patients and family members.…”

Diagnosis disclosure in patients with serious diseases

“…Despite the wishes of the patients to the truth, clinicians still are reluctant to disclose their disease diagnosis in numerous countries. [8][9][10] Prager [11] reported a case in the U.S.A that a 70-year-old Egyptian man who speaks Arabic only presented with bone cancer evidence. When Dr. Prager called to be conducted a biopsy to approve the cancer diagnosis, the family refused to be disclosed any information to the patient.…”

“…Still, most of them are reluctant to disclose any information to patients, particularly to patients with malignancy such as breast cancer, prostate cancer, terminally ill patients, and end-stage renal disease. [10,12] Concerning the scarcity in the literature in this region, it would be invaluable to examine the clinicians' attitudes toward truth-telling and related factors. The recent literature reports that clinicians still struggle to find the best way to disclose difficult information without applying harm to patients.…”