Prospective analysis of the information level of Italian cancer patients

Veronesi, A.; Busato, Claudia de Abreu; Annunziata, Maria Antonietta; Magri, M. D.; Foladore, S.; Zanon, Matheus; Tumolo, Salvatore; Monfardini, S.

doi:10.1016/0959-8049(94)00489-r

Cited by 13 publications

(10 citation statements)

References 6 publications

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“…This is in contrast with data from Italian studies showing that only 10-16% of patients who were informed of their diagnosis had learned of it from their GPs, while the majority had obtained the information from the surgeons [2,3], or, as also reported from non-Italian studies [31], by means of their own research. In fact, most physicians endorsed the view that the GP should always be involved in the diagnostic and therapeutic process, and half of the sample indicated that the GP, rather than those who made the diagnosis, should have the key role of communicating the diagnosis to his/her patient.…”

Section: Discussionmentioning

confidence: 57%

“…Regarding reported practices, 25.4% of the physicians said that they 'always disclosed the diagnosis', 52.2% said they disclosed it 'only in some cases', and 18% said they disclose the diagnosis 'only in part.' 3,d.f. 1,P~0.05).…”

Section: Disclosure Attitudes and Practicesmentioning

confidence: 99%

“…Italy, Spain and Greece) in the traditional medical practice of non-disclosure of cancer diagnosis and prognosis to the patients affected [1][2][3][4][5][6][7][8], the problem of communication in oncology is far from solved. Italy, Spain and Greece) in the traditional medical practice of non-disclosure of cancer diagnosis and prognosis to the patients affected [1][2][3][4][5][6][7][8], the problem of communication in oncology is far from solved.…”

Section: Introductionmentioning

confidence: 99%

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Physicians' attitudes to and problems with truth-telling to cancer patients

Grassi¹,

Giraldi

Messina

et al. 2000

Support Care Cancer

152

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Disclosure of a diagnosis of cancer to patients is a major problem among physicians in Italy. The aim of the study was to assess physicians' attitudes to and opinions about disclosure. A convenience sample of 675 physicians in Udine (North Italy) completed a ten-item questionnaire. About 45% indicated that, in principle, patients should always be informed of the diagnosis, but only 25% reported that they always disclosed the diagnosis in practice. Physicians with a surgical specialization employed in general hospitals endorsed disclosure of the diagnosis more frequently than GPs and older physicians. One third of the responding physicians persist in the belief that the patients never want to know the truth. Hospital doctors considered the hospital, rather than the patient's home, was the most appropriate place to inform the patients. The opposite result was found among GPs. Almost all the physicians endorsed the involve-

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Section: Discussionmentioning

confidence: 57%

Section: Disclosure Attitudes and Practicesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Physicians' attitudes to and problems with truth-telling to cancer patients

Grassi¹,

Giraldi

Messina

et al. 2000

Support Care Cancer

152

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“…We have no information about these patients' awareness of their cancer diagnosis. However, cancer in Italian culture is strongly associated with pain, suffering and death, and frequently the relatives, in agreement with physicians, keep the truth from the patient (Veronesi et al, 1995). With regard to the seriousness of the disease, during the first year after diagnosis, 10 778 out of 27 123 patients (39.7%) died, the majority of them because of a particularly aggressive cancer or of a diagnosis occurring in advanced phases.…”

Section: Discussionmentioning

confidence: 86%

High suicide mortality soon after diagnosis among cancer patients in central Italy

Crocetti¹,

Arniani²,

Acciai³

et al. 1998

Br J Cancer

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Summary A high suicide mortality risk has been documented among a population-based cohort of 27 123 cancer patients resident in central Italy where the general suicide rate is low. Forty-one suicides were observed (SMR = 2.36) which were only 0.2% of all deaths. However, the highest risk (SMR = 27.7) during the first 6 months after diagnosis, represents a greater contrast with the general population than has been observed in other studies.Keywords: suicide; mortality An increased suicide risk has been shown for cancer patients in some population-based studies (Campbell, 1966;Louhivuori and Hakama, 1979;Olafsen, 1981;Fox et al, 1982;Allebeck et al, 1989;Chatton-Reith et al, 1990;Allebeck and Bolund, 1991;Levi et al, 1991; Storm et al, 1992;Louhivuori, 1993;Tanaka et al, 1996). All these studies have been carried out in countries with suicide rates in the general population that are from two to five times greater than in Italy (La Vecchia et al, 1994).Some of these studies evidenced a high risk near the time of cancer diagnosis (Fox et al, 1982;Allebeck and Bolund, 1991;Chatton-Reith et al, 1990;Levi et al, 1991; Storm et al, 1992;Tanaka et al, 1996). During the first year after diagnosis the risk varied from two to five times the expected (Allebeck et al, 1989;Allebeck and Bolund, 1991;Levi et al, 1991; Storm et al, 1992;Tanaka et al, 1996), but among Swedish cancer patients it was considerably higher (SMR = 16.0 for men and SMR = 15.4 for women) (Allebeck et al, 1989).The purpose of the present study was to estimate the risk of suicide among cancer patients resident in a low-risk area for suicide mortality, and its relationship with time since diagnosis. MATERIALS AND METHODSIn the provinces of Florence and Prato, central Italy (about 1 200 000 inhabitants), a population-based cancer registry, the Tuscany Cancer Registry (RTT), has been active since 1984 (Buiatti et al, 1992).After the exclusion of non-melanomatous skin cancers (2361 cases, 7.6%), cancers known from the death certificate only (DCO = 1355 cases, 4.4%) or from autopsy only (69 cases, 0.2%), 27 123 incident cancer cases (14 683 men and 12 440 women) The suicide risk was significantly elevated in all age groups relative to the general population, except for persons younger than 54 years of age.According to time since cancer diagnosis, the highest risk was observed during the first 6 months (SMR = 27.7, 95% CI 13.8-49.6). This finding was confirmed in both genders (men: SMR = 22.9, 95% CI 9.9-45.2; women: SMR = 62.6, 95% CI 9.4-133.6). During the second period, the risk was still significantly increased in men (SMR = 11.36, 95% CI 3.7-26.5) but not in women (SMR = 15.23,). Overall, the SMR for the first year was 18.8 (95%

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“…In Western countries the moral issue of whether to tell the truth has shifted from disclosure of diagnosis to disclosure of prognosis 3,4 . In other countries 5 the disclosure of diagnosis still seems to be an issue for debate. Although we know that lack of information can increase uncertainty, anxiety, distress, and dissatisfaction, 6 orthodox medical education (at least in our country) does not equip doctors with the necessary communication skills or give them the opportunity to learn how to deal with their own emotional reactions when giving difficult information.…”

Section: Doctor‐patient Communication: Cancer Diagnosismentioning

confidence: 99%

To Tell or Not To Tell?

Zakotnik

1997

Annals of the New York Academy of Sciences

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Prospective analysis of the information level of Italian cancer patients

Cited by 13 publications

References 6 publications

Physicians' attitudes to and problems with truth-telling to cancer patients

Physicians' attitudes to and problems with truth-telling to cancer patients

High suicide mortality soon after diagnosis among cancer patients in central Italy

To Tell or Not To Tell?

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