Patients’ Preference to Hear Cancer Diagnosis
Abstract
Objective: Bad news disclosure is one of the complex communication tasks of the physicians. Bad news is defined as:" any news that adversely and seriously affects an individual's view of his or her future". Recent studies indicate that the patients’ and physicians’ attitudes toward disclosure of bad news have been changed since few years ago. The evidence of breaking bad news is also different across different cultures . In the present study, we aimed to evaluate the patients' prospect about breaking bad news and to provide a clinical guidance for Iranian patients and those patients in countries with a similar cultural background.
Methods: A cross sectional descriptive study was conducted on a sample of 200 cancer patients at a cancer institute in Tehran. The patients' demographic characteristics and their attitudes toward the manner of disclosing the diagnosis were registered in a research based questionnaire.
Results: In this study, 165 patients (82.5%) claimed to be aware of the diagnosis; however, only 12 patients (73%) were aware of the actual diagnosis of their disease. Most patients tended to know the diagnosis (n = 186, 93%) and accepted patient as the first person to be informed (n = 151, 75.5%) by their physician (n = 174, 87%). The preference of being alone or with a family member when exposed to bad news was almost the same . Most patients (n = 169, 84.5%) believed that physicians should consult the patients to make treatment decisions. Treatment options (n = 140, 70%) and life expectancy (n = 121, 60.5%) were the most desirable topics to be discussed. Most patients (n = 144, 72%) agreed upon allowing them to express their emotional feelings.
Conclusion: According to the patients' preferences about being fully informed about the diagnosis, it is suggested that the disclosure of cancer diagnosis be done by a physician and in the presence of a family member. It is also recommended that physicians consult the patients about treatment options.
VandeKieft GK. Breaking bad news. Am Fam Physician 2001; 64: 1975-1978.
Dias L, Chabner BA, Lynch TJ, Jr. , Penson RT. Breaking bad news: a patient's perspective. Oncologist 2003; 8: 587-596.
Farrell M. The challenge of breaking bad news. Intensive Crit Care Nurs 1999; 15: 101-110.
Fujimori M, Akechi T, Morita T, Inagaki M, Akizuki N, Sakano Y, et al. Preferences of cancer patients regarding the disclosure of bad news. Psychooncology 2007; 16: 573-581.
Meredith C, Symonds P, Webster L, Lamont D, Pyper E, Gillis CR, et al. Information needs of cancer patients in west Scotland: cross sectional survey of patients' views. BMJ 1996; 313: 724-726.
Valizadeh L,Zamanzadeh V,Rahmani A,Howard F,Nikanfar AR,and Ferguson C, Cancer disclosure: Experiences of Iranian cancer patients, Nursing and Health Sciences,2012,14,250-256
Yun YH, Lee CG, Kim SY, Lee SW, Heo DS, Kim JS, et al. The attitudes of cancer patients and their families toward the disclosure of terminal illness. J Clin Oncol 2004; 22: 307-314.
Parker PA, Baile WF, de Moor C, Lenzi R, Kudelka AP , Cohen L. Breaking bad news about cancer: patients' preferences for communication. J Clin Oncol 2001; 19: 2049-2056.
Butow PN, Dunn SM , Tattersall MH. Communication with cancer patients: does it matter? J Palliat Care 1995; 11: 34-38.
Rassin M, Levy O, Schwartz T , Silner D. Caregivers' role in breaking bad news: patients, doctors, and nurses' points of view. Cancer Nurs 2006; 29: 302-308.
Marwit SJ , Datson SL. Disclosure preferences about terminal illness: an examination of decision-related factors. Death Stud 2002; 26: 1-20.
Ptacek JT , Eberhardt TL. Breaking bad news. A review of the literature. JAMA 1996; 276: 496-502.
Lind SE, DelVecchio Good MJ, Seidel S, Csordas T , Good BJ. Telling the diagnosis of cancer. J Clin Oncol 1989; 7: 583-589.
Taylor KM. "Telling bad news": physicians and the disclosure of undesirable information. Sociol Health Illn 1988; 10: 109-132.
Miyaji NT. The power of compassion: truth-telling among American doctors in the care of dying patients. Soc Sci Med 1993; 36: 249-264.
Schofield PE, Butow PN, Thompson JF, Tattersall MH, Beeney LJ , Dunn SM. Psychological responses of patients receiving a diagnosis of cancer. Ann Oncol 2003; 14: 48-56.
Buckman RA. Breaking bad news: the S-P-I-K-E-S strategy. Commun Oncology 2005; 2: 138-142.
Sapir R, Catane R, Kaufman B, Isacson R, Segal A, Wein S, et al. Cancer patient expectations of and communication with oncologists and oncology nurses: the experience of an integrated oncology and palliative care service. Support Care Cancer 2000; 8: 458-463.
Fried TR, Bradley EH, O'Leary J. Prognosis communication in serious illness: perceptions of older patients, caregivers, and clinicians. J Am Geriatr Soc 2003; 51: 1398-1403.
Kaplowitz SA, Osuch JR, Safran DSC. Physician communication with seriously ill cancer patients: Result of a survey of physicians. End of Life Issues: Interdisciplinary and Multi-dimensional Perspectives. New York : Springer Publishing Company; 1999.
Mueller PS. Breaking bad news to patients. The SPIKES approach can make this difficult task easier. Postgrad Med 2002; 112: 15-16, 18.
Goncalves F, Marques A, Rocha S, Leitao P, Mesquita T , Moutinho S. Breaking bad news: experiences and preferences of advanced cancer patients at a Portuguese oncology centre. Palliat Med 2005; 19: 526-531.
Tse CY, Chong A, Fok SY. Breaking bad news: a Chinese perspective. Palliat Med 2003; 17: 339-343.
Schofield PE, Beeney LJ, Thompson JF, Butow PN, Tattersall MH , Dunn SM. Hearing the bad news of a cancer diagnosis: the Australian melanoma patient's perspective. Ann Oncol 2001; 12: 365-371.
Files | ||
Issue | Vol 9 No 1 (2014) | |
Section | Articles | |
Keywords | ||
Bad news being aware of diagnosis life expectancy patients’ request treatment options |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |