Questioning diagnosis disclosure in terminal cancer patients: a prospective study evaluating patients' responses

Abstract

This study attempted to assess the degree of knowledge of the diagnosis, and the attitude towards that information, in a group of terminally ill cancer patients. We also tried to determine the influence of the knowledge of the diagnosis on other patient psychosocial needs. We assessed 97 patients (64 in an oncology service, 33 in a palliative care unit) by means of a semistructured personal interview, and a psychosocial needs questionnaire. Data collected showed that 68% of patients had not been informed of their diagnosis; 60% of this group had a high degree of suspicion of their diagnosis, but 42% of noninformed patients did not want to receive more information. Information on diagnosis appears to be beneficial in establishing satisfactory relationships and communication between patients and relatives and staff. We have tried to answer the most relevant issues related to diagnosis disclosure in our clinical setting, questioning the feasibility of truth telling within our cultural boundaries.

Deciding what information is necessary: do patients with advanced cancer want to know all the details?

“…47 A desire for information may not be true for all patients or all cultural groups however. 4,47 Equally, a patient's desire for information is not always accompanied by a desire to be involved in clinical decision making, as some find this burdensome. 32,66 Oncology patients want physicians to communicate honestly with them about the severity of their disease 40,46,67 but to also be optimistic.…”

Awareness of diagnosis, and information-seeking behavior of hospitalized cancer patients in Greece

“…Despite increasing concerns about information disclosure in health care settings during the last decades, many cancer patients worldwide are still unaware of their true diagnosis [4,7,12,16,20,22,25]. Although such an attitude is considered acceptable in some societies, multiple studies from different countries support the fact that the vast majority of cancer patients seeks detailed information and wish to play a more decisive role in the management of their disease [6,11,13,16,19,20,22].…”

Disclosure preferences regarding cancer diagnosis and prognosis: to tell or not to tell?

“…[22][23][24] Most researchers have considered patients' characteristics only in order to predict their preferences, although many doctors believe that these preferences are influenced by the seriousness of the cancer and patients' attitudes toward medical care. 13 19 The first purpose of the present study was to examine patients' preferences regarding the disclosure of a cancer diagnosis and its prognosis separately.…”