Diagnosis disclosure in a Portuguese oncological centre

Abstract

The disclosure of a diagnosis of cancer to patients is a controversial matter. There have been major differences in practice concerning this issue through time and between cultures. A questionnaire was sent to the doctors of the Oporto Centre of the Portuguese Institute of Oncology in order to assess their attitudes. We received 45 responses (40%) from the 113 questionnaires sent. Of these, 32 (71%) said that they disclose the diagnosis as a general policy or at the patients' request, and 13 (29%) disclose it rarely or not at all. The most frequent reason indicated by these 13 physicians was that the disclosure might damage the patients psychologically. Forty-four (98%) doctors inform the family of the diagnosis. Thirty-nine (87%) think that patients are satisfied with the information provided. This study was carried out in one oncological centre only, so it is inappropriate to conclude that this is what happens throughout Portugal. As far as we know, this is the first study in Portugal addressing this area of practice. This subject is a very important topic of research both in Portugal and in other countries, as many published recommendations are not research based.

Keywords

breaking bad news communication diagnosis disclosure physician–patient relation

Get full access to this article

View all access options for this article.

References

Reiser SJ . Words as scalpels: transmitting evidence in the clinical dialogue. Ann Intern Med 1980; 92: 837–842.

Novack DH , Plumer R , Smith RL , Ochitill H , Morrow GR , Bennett JM . Changes in physicians' attitudes toward telling the cancer patient. J Am Med Assoc 1979; 241: 897–900.

Loge JH , Kaasa S , Ekeberg Ø , Falkum E , Hytten K . Attitudes toward informing the cancer patient–a survey of Norwegian physicians. Eur J Cancer 1996; 32A: 1344–1348.

Thomsen OØ , Wulff HR , Martin A , Singer PA . What do gastroenterologists in Europe tell cancer patients? Lancet 1993; 341: 473–476.

Mystakidou K , Liossi C , Viachos L , Papadimitrou J . Disclosure of diagnostic information to cancer patients in Greece. Palliat Med 1996; 10: 195–200.

Cortés CC , Olarte JMN . Questioning diagnosis disclosure in terminal cancer patients: a prospective study evaluating patients' responses. Palliat Med 1994; 8: 39–44.

Estapé J , Palombo H , Hernández E et al. Cancer diagnosis disclosure in a Spanish hospital. Ann Oncol 1992; 3: 451–454.

Surbone A . Truth telling to the patient. J Am Med Assoc 1992; 268: 1661–1662.

Buckman R . Communication in palliative care: a practical guide. In: Doyle D , Hanks GWC , MacDonald N eds. Oxford textbook of palliative medicine, 2nd edn. Oxford: Oxford University Press, 1998: 47–61.

10.

Ptacek JT , Eberhardt RL . Breaking bad news. J Am Med Assoc 1996; 276: 496–502.