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.

Keywords

communication neoplasms physician-patient relations truth disclosure

Get full access to this article

View all access options for this article.

References

Premi JN Communicating bad news to patients. Can Fam Physician 1981; 27: 837-41.

Holland JC Now we tell - but how well? [editorial]. J Clin Oncol 1989; 7: 557-59.

McNeil C. Culture: the impact on health care. J Cancer Educ 1990; 5: 13-16.

Garro LC Culture, pain and cancer. J Palliat Care 1990 ; 6: 34-44.

Chan A. , Woodruff R. Palliative care in a multicultural society: a comparison of the palliative care needs of English-speaking and non-English-speaking patients [abstract] . 9th International Congress on Care of the Terminally Ill. J Palliat Care 1992; 8: 69.

Ryan M. Ethics and the patient with cancer. Br Med J 1979; 2: 480-81.

Ventafridda V. , De Conno F. , Vigano A. , Ripamonti C. , Galluci M. , Gamba A.

Comparison of home and hospital care of advanced cancer patients

Tumori 1989; 75:619-25.

Vega J. , Martinez P. Enfermo terminal y eutanasia desde el punto de vista del personal sanitario . Valladolid: Publicaciones Universidad , 1991.

Rihuete MI , Varela G. , Carrasco I. Actitudes ante la información del diagnóstico de cáncer. Oncologia 1993; 16: 17-25.

10.

Estape J. , Palombo H. , Hernandez E. et al. Cancer diagnosis disclosure in a Spanish hospital. Ann Oncol 1992; 3: 451-54.

11.

Stiefel F. , Senn H-J. Cancer diagnostic disclosure in a Spanish hospital: how do they discuss treatment options? [editorial]. Ann Oncol 1992; 3: 422.

12.

Centeno-Cortés C. Medicina paliativa: necesidades psycosociales del enfermo oncológico en situación terminal [thesis]. Valladolid: Universidad de Valladolid, 1993.

13.

Perez Manga G. Importance de plusieurs facteurs dan's l'attitude psychique du malada oncologique. IIIèmes journées medicales sur problemes psychologiques en rapport avec le cancer; 10-11 Dec 1980, Institut J Paoli Calmettes, Marseille: 83.

14.

Poveda J. Valor terapéutico de la información al paciente oncológico terminal como terapia de apoyo y su cuantificación [thesis]. Madrid: Universidad Autónoma, 1990.

15.

Buckman R. Communication in palliative care: a practical guide. In: Doyle D , Hanks G , MacDonald N eds. Oxford textbook of palliative medicine. Oxford; Oxford University Press, 1993: 47-61.

16.

Venegas A de. Agonía del tránsito de la muerte. Toledo 1537, 11v.

17.

Vachon M. Emotional problems in palliative medicine: patient, family and professional . In: Doyle D , Hanks G , MacDonald N eds. Oxford textbook of palliative medicine. Oxford: Oxford University Press, 1993:575-605.