Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices

Tang, Woung-Ru; Hong, Ji-Hong; Rau, Kun‐Ming; Wang, Cheng‐Hsu; Juang, Yeong‐Yuh; Lai, Cheng‐Hung; Fujimori, Maiko; Fang, Chun-Kai

doi:10.1002/pon.4257

Cited by 15 publications

(16 citation statements)

References 37 publications

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“…Similar results have been presented in other studies . Moreover, Gan's quantitative study found that physicians were less positive toward cancer diagnosis disclosure (CDD) than patients and family members, consistent with Tang's study results …”

Section: Introductionsupporting

confidence: 89%

“…Nurses should actively participate in cancer diagnosis delivery, and more collaboration between nurses and physicians must occur.found that physicians were less positive toward cancer diagnosis disclosure (CDD) than patients and family members, consistent with Tang's study results. 17,18 Although physicians hold the responsibility and authority for CDD, nurses are active participants in the diagnosis process and prognosisrelated communication. 19 The exact roles and responsibilities of nurses during CDD are not well delineated.…”

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confidence: 99%

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Nurses' experiences and attitudes toward diagnosis disclosure for cancer patients in China: A qualitative study

et al. 2019

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Objective To qualitatively investigate and explore oncology nurses' perceptions of cancer diagnosis disclosure (CDD) for cancer patients. Methods Purposive sampling led to the inclusion of 25 nurses with diverse characteristics from four inpatient oncology nursing wards in two tertiary hospitals. Semistructured, one‐on‐one, in‐depth interviews were conducted. Colaizzi's analysis method was performed with NVivo software to develop categories and themes. Results Four themes were identified: (a) impact of CDD, including advantages and disadvantages for patients and nurse distress; (b) barriers to CDD, including requests from family members, patients themselves, and communication skills; (c) strategies for CDD, including communication with family members, physician‐nurse collaboration, and patient education; and (d) nurses' roles in CDD, including active participants and promoters and advocates. Conclusions More channels of information and education on cancer, cancer diagnosis, life, and death will be needed in the future. Nurses should actively participate in cancer diagnosis delivery, and more collaboration between nurses and physicians must occur.

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Section: Introductionsupporting

confidence: 89%

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confidence: 99%

Nurses' experiences and attitudes toward diagnosis disclosure for cancer patients in China: A qualitative study

et al. 2019

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“…An early survey of international oncologists indicated a clear trend toward more open cancer disclosure in all cultures; however, the percentage of patients who are informed about their illness and participate in decision-making is highest in Western countries, and Asian cultures continue to lag behind in this trend. 13 For example, Jenkins et al 14 documented that almost all patients in the United Kingdom wanted to know whether their illness was cancer and if it was terminal; however, the surveys of other cultural groups indicate that the disclosure of cancer and prognostic information is undesirable. Compared with Western family caregivers, the caregivers in Asian countries are more likely to withhold unfavorable information from patients at the patients’ request and to give treatments with unproven effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Death attitudes and truth disclosure: A survey of family caregivers of elders with terminal cancer in China

Tang

2018

Nurs Ethics

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Background: Although family caregivers play an important role in end-of-life care decisions, few studies have examined the communication between family caregivers and patients at the end of life. Objective: The objective was to describe family caregivers’ attitudes toward death, hospice, and truth disclosure. Research design: A quantitative method was used, and a closed-ended survey of 140 family caregivers was conducted in China. The subjects included 140 primary family caregivers of elders with terminal cancer enrolled at a hospice center from April to August 2017. Participants: 140 primary family caregivers of elders with terminal cancer participated the study. Research Context: A high proportion of cancer patients continue to receive inadequate information about their illness. Family caregivers’ inhibitions about disclosing information to cancer patients have not yet been the objects of research in China. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Shenzhen, China. Findings: A questionnaire survey collected information on family caregivers’ background information, emotional state, personal needs, death attitudes, and truth-disclosure opinions. The results revealed that family caregivers’ death attitudes and truth-disclosure opinions played an important role in the process of caring for elders with terminal cancer. Discussion: By adopting a quantitative method, the author revealed not only the general patterns of family caregivers’ attitudes toward cancer diagnosis disclosure but also the reasons for their actions and the practices of family disclosure. Conclusion: The findings suggested that ineffective communication concerning end-of-life issues resulted from family caregivers’ lack of discussion and difficulty in hearing the news. Future studies should examine strategies for optimal communication between family caregivers and patients, especially with regard to breaking the bad news. Professional training in breaking bad news is important and is associated with self-reported truth-disclosure practices among family caregivers.

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“…Item responses are rated on a 5‐point scale from 1 (extremely unimportant) to 5 (extremely important) 9 25 Higher score indicates that the healthcare providers' truth‐telling perception better met the truth‐telling preferences of patients and their caregivers 5 26 We used the TTQ to measure APNs' perception of cancer truth‐telling; the Cronbach's α of the overall scale measured at different time points was 0.93–0.94, and the four subscales was 0.62–0.93.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of communication skill training on cancer truth‐telling for advanced practice nurses in Taiwan: A pilot study

Chen

Yang

et al. 2021

Psycho-Oncology

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Objective Advanced practice nurses (APNs) can best support physicians in improving the quality of truth‐telling. However, the effectiveness of communication skill training (CST), based on the Japanese SHARE model exclusive to APNs, has not been tested from APNs' and recipients' viewpoints, motivating the author to conduct the present study. Methods A two‐group before–after model design was adopted, and 61 APNs from two hospitals were randomly assigned to either an experimental group (EG; N = 28) or an control group (CG; N = 33). APNs in the EG received 6 h of CST under the guidance of qualified facilitators and simulated patients. This study used APNs' subjective assessment (N = 61) (self‐confidence and perceptions on truth‐telling) and recipients' opinions (N = 480) (cancer patients' and their caregivers' satisfaction with truth‐telling and emotional status) to assess the effectiveness of the SHARE CST. Data were collected before CST (baseline, T0), immediately after (T1), and 2 weeks after (T2). Results APNs in the EG had more confidence (p < 0.05) and better perceptions of cancer truth‐telling (p < 0.01) than APNs in the CG at both T1 and T2. No group differences were found in patients' or their caregivers' satisfaction with truth‐telling, emotional distress, and anxiety (p > 0.05). In addition, patients in the EG had higher depression than patients in the CG (β = 1.65, p = 0.01). Conclusions SHARE CST can improve APNs' confidence and perceptions of cancer truth‐telling. However, more rigorous studies are required to test the effectiveness of CST from recipients' viewpoint.

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Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices

Abstract: Taiwanese medical educational policies need to be revised to better equip doctors to practice truth telling in accordance with the preferences of cancer patients and families. Communication skills training should be prioritized for doctors who refrain from truth telling in actual practice.

Cited by 15 publications

References 37 publications

Nurses' experiences and attitudes toward diagnosis disclosure for cancer patients in China: A qualitative study

Nurses' experiences and attitudes toward diagnosis disclosure for cancer patients in China: A qualitative study

Death attitudes and truth disclosure: A survey of family caregivers of elders with terminal cancer in China

Effectiveness of communication skill training on cancer truth‐telling for advanced practice nurses in Taiwan: A pilot study

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