Attitudes of Patients With Cancer Towards Truth-telling and Self-Determination in Kerman, 2016: A Cross Sectional Study

Abstract

Background: Regarding the patient autonomy principle, patients have the right to make informed decisions about their medical care. In situations like cancer diagnosis, telling the truth is still a challenge for health care providers, especially in eastern countries. Methods: The present cross sectional study was conducted from March to June 2016, in which the convenience sampling method was used. The questionnaire used to collect data consisted of 3 parts. The first part included demographic characteristics; the second part consisted of 22 items that examined the patients' attitudes towards truth-telling; third part of the questionnaire was Ende (1989) autonomy preference index (API). Results:The overall scores showed that the participants had a positive tendency to truth-telling and self-determination. The majority of participants believed that knowing the truth might make them more cooperative during treatment period, prevent unnecessary treatments, and help them deal better with their difficulties. Participants reported their preferences for decision making as low and seeking information as high. They preferred that leave decisions be made by doctors. However, they reported a positive attitude towards information seeking. Conclusions:The results of this study showed that Iranian patients with cancer had highly positive attitudes towards truth-telling and self-determination. Patients expect that their physician play the main decision maker role. Moreover, the preference for selfdecision making is high, correlated with education level.

From the challenge of assessing autonomy to the instruments used in practice: A scoping review

“…50 Eight of these studies were carried out in the United States of America (USA), 19,26,31,40,47,50–52 7 in Norway, 20,21,27,34,43,45,48 5 in Finland, 22–25,28 3 in Holland, 32,35,44 2 in England, 30,39 1 in Australia, 38 1 in Thailand, 18 1 in Denmark, 36 1 in Belgium, 37 1 in Ireland, 29,46 1 in Canada, 53 1 in France 54 and 1 in Iran. 33…”

“…In total 34 publications, it was possible to identify 7 different instruments, namely: The Health Care Climate Questionnaire (HCCQ), 18–30,35–40,43–48,50–53 Treatment Self-Regulation Scale (TRSQ), 19,22–25,27,28,34,38,40,43,45,53 Basic Needs Satisfaction in General Scale (BNSG), 31,54 Impact Participation and Autonomy (IPA), 32 Autonomy Preference Index (API) 33 and Perceived Parental Autonomy Support Scale (P-PASS). 37…”

“…59 In the current research, this index was applied by only one study. 33 The Perceived Parental Autonomy Support Scale is used to find out what the child's perception of the autonomy offered by their parents or their substitutes, evaluating how they allow them to make decisions within certain limits if they explain the reasons behind the requirements, rules and limits imposed and whether the parents are aware, accept and recognise the child's feelings. 63…”

Critical care nurses’ experiences on dishonesty: A qualitative content analysis

“…13 Some research results have shown that too much information can lead to feelings of disappointment, depression, and isolation for the patient, so nurses should not tell the truth. 6,11,14…”

“…13 Some research results have shown that too much information can lead to feelings of disappointment, depression, and isolation for the patient, so nurses should not tell the truth. 6,11,14 Given the existing ethical challenges of providing patients with information (such as being forced to tell part of the truth, or hiding important information, or lying), especially in ICU and CCU, further investigation in the field of how to give information and truth-telling boundaries is required.…”