Information disclosure to cancer patients in Mainland China: A meta‐analysis

Abstract

Objective This study aims to systematically examine Chinese cancer patients' and families' preferences for information disclosure to the patient, patient awareness, and predictors of patient awareness. Methods The Preferred Reporting Items for Systematic reviews and Meta‐Analyses guidelines were followed. Web of Science, Scopus, Proquest, Taylor & Francis Online, and China National Knowledge Infrastructure were searched in April 2022 and Chinese Biomedical Literature Database in July 2022 for quantitative studies. The Mixed Methods Appraisal Tool was used for quality assessment. Results A total of 22 studies were included, and the average quality score was 0.65/1. Meta‐analyses showed that 89.6% and 81.8% of cancer patients wanted to know their diagnosis and prognosis, respectively. Meanwhile, 50.0% and 32.4% of families prefer diagnosis disclosure and prognosis disclosure to the patient, respectively. Significantly more patients than families favored disclosure to the patient. In reality, only 59.3% of cancer patients know their diagnosis, and 19.9% know their prognosis. For predictors, while patients' gender, cancer type (breast cancer or not), treatment method (operation or other), or complications (yes or no) do not influence diagnosis awareness, being younger, being married, having higher educational attainment, having early‐stage rather than late‐stage cancer, and being in a higher‐grade hospital all predict better chances of knowing a diagnosis. No study explored predictors of patients' prognosis awareness. The findings did not vary according to publication time or sample size. Conclusions Chinese cancer patients are eager to know their diagnosis and prognosis, but families are hesitant about disclosure to the patient, and patients' awareness is low. While cultural, legal, and medical backgrounds lay the foundation for information disclosure in Mainland China, case‐by‐case practical factors also make a difference.

Prognosis-Related Communication: Ethical Dilemmas Among the Oncology Nurses in China (Preprint)

“…In this study, about 89% of the participants reported either fully or partially engaging in prognosis communication with patients or their families, which is higher than a previous study in Taiwan where about 71% of nurses reported doing so [25] but it is lower than another study in China that 97.2% of oncology nurses engaged in truth telling [26]. However, consistent with a previous study [15], our study revealed that full disclosure of prognosis was more frequently given to families (43.7%) rather than to patients (20.1%).…”

“…Withholding end-of -life (EOL) communication from patients and relying solely on family members for EOL decision-making raises concerns, as families may not fully understand the patient's prognosis or their EOL wishes [13,14]. Recent studies indicate that the majority of cancer patients in China want to be informed of their prognosis [15][16][17]. For example, a metaanalysis of studies in China revealed that 81.8% of cancer patients, compared to 32.4% of the family, prefer prognosis disclosure, but only 19.9% of patients are actually informed [15].…”

“…Recent studies indicate that the majority of cancer patients in China want to be informed of their prognosis [15][16][17]. For example, a metaanalysis of studies in China revealed that 81.8% of cancer patients, compared to 32.4% of the family, prefer prognosis disclosure, but only 19.9% of patients are actually informed [15]. Although clinciains aim to maintain hope through nondisclosure, they experience conflicts in balancing hope preservation with truth-telling [12].…”

Exploring the experience of meaning-centered group psychotherapy among Chinese cancer patients during active treatment: a descriptive qualitative study

“…When confronted with a cancer diagnosis, individuals often grapple with questions about the purpose and meaning of their existence ( 7 , 28 ). Cultural influences contribute to the tendency for Chinese cancer patients to refrain from openly discussing matters pertaining to their condition with both family members and healthcare professionals ( 29 , 30 ). The MCGP offers a supportive space wherein patients can openly explore their life experiences, emotions, relationships, and the profound impact the disease has had on them.…”

Informed consent in cancer clinical care: Perspectives of healthcare professionals on information disclosure at a tertiary institution in Uganda

“…This circumstance significantly impacts their support needs and personal relationships, psychological wellbeing, and presents challenges for patients and families during the consenting process. In some cultures, unpleasant facts about the prognosis of disease conditions are unwelcome and are better withheld [6][7][8]. Some patients may feel discomfort talking about death and dying, may have strong emotional responses, and others may be in denial of the diagnosis and prognosis [9].…”