Differences in the disclosure of a cancer diagnosis by healthcare professionals and the repercussions on patients’ emotions and health

Abstract

Purpose: This study serves a dual purpose. Our initial aim is to study how a cancer diagnosis is disclosed to patients by different physicians (oncologists, consultants, and general practitioners). Secondly, we set out to study how the way in which oncologists normally communicate with their patients is related to variables such as anxiety, depression, coping mechanisms, and the perception of both their health and their quality of life. Methods: A cohort of 177 patients from three cancer associations answered a battery of questionnaires on sociodemographic data, aspects of the disease, monitoring of the SPIKES protocol by the physician delivering the diagnosis, and their satisfaction with their communication with the oncologist (EORTC QLQ-COMU26). The patients also completed the ADAF screening questionnaire for detecting the presence of anxiety, depression, and dysfunctional coping strategies. Results: The analyses recorded medium-low scores for some of the steps in the SPIKES protocol when delivering the diagnosis, and significant differences in some of them among the different physicians. It seems that oncologists perform this task better than consultants. In turn, satisfaction with the communication with oncologists is related to the levels of anxiety, depression, vulnerability, and the perception of health and quality of life among cancer patients. Conclusions: Better communication strategies are called for among all healthcare professionals to enable them to deal with the task of breaking bad news to their patients. This will have a positive impact on patients’ emotional and health issues, while reducing stress and burnout among the physicians themselves.