The Evaluation of the Relationship Between the Level of Disclosure of Cancer in Terminally Ill Patients With Cancer and the Quality of Terminal Care in These Patients and Their Families Using the Support Team Assessment Schedule
Restricted accessResearch articleFirst published online June, 2013
The Evaluation of the Relationship Between the Level of Disclosure of Cancer in Terminally Ill Patients With Cancer and the Quality of Terminal Care in These Patients and Their Families Using the Support Team Assessment Schedule
To examine the relationship between informing patients of cancer and the quality of terminal care.
Methods:
This was a study of 87 consecutive terminally ill cancer patients who died during the last 27-month period. Notification of cancer was classified into 4 groups (A, B, C, and D, respectively): “nondisclosure,” “disclosure of cancer diagnosis,” “disclosure of life threatening,” and “disclosure of poor prognosis.” We evaluated the quality of palliative care using Support Team Assessment Schedule–Japanese (STAS-J).
Results:
A, B, C, and D groups included 8, 22, 37, and20 cases, respectively. Regarding physical symptoms, no marked difference was noted. Anxiety was significantly reduced, and the recognition of disease conditions and the level of communication were significantly higher in the groups that received specific information (P < .001).
Conclusions:
Informing patients of more specific information will increase the quality of terminal care.
BaileWFBuckmanRLenziRGloberGBealeEAKudelkaAP. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302–311.
2.
LeeRGGarvinT. Moving from information transfer to information exchange in health and health care. Soc Sci Med. 2003;56(3):449–464.
3.
TakayamaTYamazakiKatsumata N.Relationship between outpatients’ perceptions of physicians’ communication styles and patients’ anxiety levels in a Japanese oncology setting. Soc Sci Med. 2001;53(10):1335–1350.
4.
ThomsenOOWulffHRMartinASingerPA. What do gastroenterologists in Europe tell cancer patients?Lancet. 1993;341(8843):473–476.
5.
LogeJHKaasaSEkebergOFalkumEHyttenK. Attitudes toward informing the cancer patient--a survey of Norwegian physicians. Eur J Cancer. 1996;32A(8):1344–1348.
6.
WangSYChenCHChenYSHuangHL. The attitude toward truth telling of cancer in Taiwan. J Psychosom Res. 2004;57(1):53–58.
7.
LiJYZouLQHuangMJ. To tell or not to tell: attitudes of Chinese oncology nurses towards truth telling of cancer diagnosis. J Clin Nurs. 2008;17(18):2463–2470.
8.
GhavamzadehABaharB. Communication with the cancer patient in Iran. Ann N Y Acad Sci. 1997;809:261–265.
9.
OzdoganMSamurMArtecMYildizMSavasBBozcukHS. Factors related to truth-telling practice of physicians treating patients with cancer in Turkey. J Palliat Med. 2006;9(5):1114–1119.
10.
UchitomiY. Psycho-oncology in Japan: history, current problems and future aspect. Jpn J Clin Oncol. 1999;29(9):411–412.
11.
FallowfieldLLipkinMHallA. Teaching senior oncologists communication skills: results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol. 1998;16(5):1961–1968.
12.
BaileWFLenziRKudelkaAP. Improving physician-patient communication in cancer care: outcome of a workshop for oncologists. J Cancer Educ. 1997;12(3):166–173.
13.
RamirezAJGrahamJRichardsMACullAGregoryWM. Mental health of hospital consultants: the effects of stress and satisfaction at work. Lancet. 1996;347(9003):724–728.
14.
OkamuraHUchitomiYSasakoMEguchiKKakizoeT. Guidelines for telling the truth to cancer patients. Jpn J Clin Oncol. 1998;28(1):1–4.
15.
HancockKClaytonJMParkerSM. Truth-telling in discussing prognosis in advanced life-limiting illnesses: a systematic review. Palliat Med. 2007;21(6):507–517.
16.
InnesSPayneS.Advanced cancer patients’ prognostic information preference: a review. Palliat Med. 2009;23(1):29–39.
17.
AkabayashiAFettersMDElwynTS. Family consent, communication, and advance directives for cancer disclosure: a Japanese case and discussion. J Med Ethics. 1999;25(4):296–301.
18.
PorterLSKeefeFJHurwitzHFaberM. Disclosure between patients with gastrointestinal cancer and their spouses. Psychooncology. 2005;14(12):1030–1042.
19.
AabomBKragstrupJVondelingHBakketeigLSStovringH. Defining cancer patients as being in the terminal phase: who receives a formal diagnosis, and what are the effects. J Clin Oncol. 2005;23(30):7411–7416.
20.
OzdoganMSamurM, Bozcuk HS, et.al. “Do not tell”: what factors affect relatives' attitudes to honest disclosure of diagnosis to cancer patients?Support Care Cancer. 2004;12(7):497–502.
21.
MiyashitaMMatobaKSasaharaT. Reliability and validity of Japanese version STAS (STAS-J). Palliat Support Care. 2004;2(4):379–385.
22.
HigginsonIJ.Clinical Audit in Palliative Care. Oxford, UK: Radcliffe Medical Press; 1993:8–15.
23.
HigginsonIJ. Clinical audit and organizational audit in palliative care. Cancer Surv. 1994;21:233–245.
24.
EdmonndsPMStuttafordJMPennyJLynchAMChamberlainJ. Do hospital palliative care teams improve symptom control? Use of a modified STAS as an evaluation tool. Palliat Med. 1998;12(5):345–351.
25.
LoRSDingAChungTWooJ. Prospective study of symptom control in 133 cases of palliative care. Palliat Med. 1999;13(4):335–340.
26.
HigginsonIJ.Clinical audit and organizational audit in palliative care. In: FieldDClarkDCornerJ, eds. Researching Palliative Care. Buckingham, UK: Open University Press; 2001:170–183.
27.
UchitomiYYamawakiS. Truth-telling practice in cancer care in Japan. In: SurboneAZwitterM, eds. Communication With the Cancer Patient. Information & Truth. New York, NY: The New York Academy of Sciences: 1997:290–299.
28.
MoritaTFujimotoKTeiY. Palliative care team: the first year audit in Japan. J Pain Symptom Manage. 2005;29(5):458–465.
29.
WilkinsonSFellowsDLeliopoulouC. Does truth telling influence patient’s psychological distress. Eur J Palliat Care. 2005;12:124–126.
30.
MoritaTAkechiTIkenagaM. Communication about the ending of anticancer treatment and transition to palliative care. Ann Oncol. 2004;15(10):1551–1557.
31.
LederbergMS. The family of the cancer patient. In: HollandJC, ed. Psycho-oncology. New York, NY: Oxford University Press; 1998:1981–1993.
32.
HollandJC. Anxiety and cancer: the patient and the family. J Clin Psychiatry. 1989;50(suppl):20–25.
33.
MiyashitaMYasudaMBabaR. Inter-rater reliability of proxy simple symptom assessment scale between physician and nurse: a hospital-based palliative care team setting. Eur J Cancer Care (Engl). 2010;19(1):124–130.
34.
LawlorPGFainsingerRLBrueraED. Delirium at the end of life: critical issues in clinical practice and research. JAMA. 2000;284(19):2427–2429.
35.
WadaTWadaMWadaMOnishiH. Characteristics, interventions, and outcomes of misdiagnosed delirium in cancer patients. Palliat Support Care. 2010;8(2):125–131.
